Hip Replacement

Hip Replacement:

Surgery that is carried out to replace the worn arthritic joint with an artificial one. Surgery involves two components, a shell or a socket that is placed on the pelvic bone and a femoral prosthesis or a pin in the thigh bone. Implants are either fixed to the bone using cement (Cemented) or a close tight fit (Un-cemented), where the bone eventually grow on to the surface of the implant, known as 'Biological Integration'.

Whether your surgeon prefers an Un-cemented implant or Cemented implant is largely influenced by their training and experience. For example in America, surgeons rarely use cemented hip implants, in Europe the split is perhaps 50:50.

Cemented sockets are generally made of high density polyethylene, often referred to as a ‘poly’, in un-cemented hip the socket has a metal shell in which the polyethylene bearing sits inside. Femoral prosthesis is made of metal irrespective of cemented or uncemented.

The articulating ball on the femoral prosthesis and the lining of the socket are referred to as 'bearing surfaces'. The bearing surfaces these can be a polished metal on polyethylene, ceramic on polyethylene or ceramic on ceramic.

The gold standard being metal on polyethylene, other bearings being used in younger patients to improve wear and longevity, where information is still being collected.

Is the surgery when non-operative management (activity modification, pain killers and anti-inflammatories) have failed and quality of life is severely affected.

Hip replacement is a major surgery but can be a life changing under the right circumstances.

Almost all of the surgeons use some form of Enhanced or Accelerated recovery. This is to get you recover quickly from the surgery and feel well from surgery. This however should not be confused with healing process that carries on for many months.

Various approaches to the hip Joint have been tried by the surgeons over the years, this is somewhat influenced by the training and to a quest to help recover quickly from surgery. They all have their benefits and risks, your surgeon should be able to explain why they use a specific approach.

National Joint Registry website provides information on your surgeons/hospital practice, volume of surgery and some outcome information. The web site also has useful information leaflets on joint replacement.