FAQs with Hip Replacements

Frequently Asked Questions After Hip Joint Surgery:

This is an artificial joint and patients will immediately feel the difference of having NO More Arthritis pain once the operation is done and being able to walk almost immediately 3-4 hours after surgery with all the weight through the new hip.

Hip replacements are very successful procedures this day and age with very good outcomes and longevity.

Pain, Swelling and Bruising?:

The pain usually decreases rapidly during the first few weeks, but pain usually continues to improve for 12 months or even longer.

It has to be understood with any Joint Replacement it takes atleast 12 months to realize its benefits.

Walking helps. Exercise, stockings and elevation also help.

Swelling from the thigh down into the foot is common after surgery. The swelling gradually decreases with time, and can take a few weeks to months to disappear.

Muscle movement such as in walking and exercise will help to reduce the swelling.

Bruising: in some patients extensive bruising can be found. This can extend from your thigh down into your foot. It will gradually get better and usually does not impair healing.

Exercising:

Mild to moderate exercise is helpful, over-exercise is certainly painful and can even be harmful.

Driving?

Some people regain their co-ordination and confidence quicker than others. Following hip surgery, avoid driving for 2 weeks and longer if still taking pain medications especially opiates (morphine based)

Stair Climbing?

The Physiotherapists usually show you how to do stairs the day of the surgery or the day after.

Shoes?:

Avoid High Heels for 3-4 months.

Wear comfortable shoes

Medications after surgery?

Blood thinning medications (Aspirin) should be taken for 6 weeks. All pain medications may be taken as directed for pain.

If you have any questions about your medications, please ask us.

Sleeping Problems?

Sleeping trouble is the most common question.

Surgical heeling takes approximately 6-12 weeks. Therefore you may be slightly uncomfortable for this time. Taking prescribed medication and ice can help.

Getting out of bed and moving around also helps.

If there is a risk, a potential complication, or a concern to you, which is not mentioned here, please do not hesitate to ask.

With any surgery, there are risks and potential complications associated.

Dr. Nizam will discuss this before surgery is to take place so that you understand them.

Bleeding from the wound site is common (can vary from 1-5%) and usually stops within hours or days after surgery. On very rare occasions patients may have to be taken back to theatre to control uncontrollable bleeding in vessel damage.

Infection

Infection is < 2% of cases.

We take every precaution to minimize the risk .

We give intravenous antibiotics at the time of your joint surgery and after surgery.

If in the unlikely event of a deep infection, if this is within 4 weeks of surgery, we can washout the joint, change the bearing and give antibiotics, but if the infection is many months after surgery, the implant may be removed to treat the infection before reimplanting a new joint at a later date ( 2 stage revision). There is also possibility of doing a 1-stage revision for infection where we put antibiotic impregnated calcium sulphate in the joint too.

In rare cases when the infection cannot be treated successfully, a patient may need to have the artificial joint removed permanently.

Please call the office, or contact your family doctor if infection is suspected in any area.

If dental surgery, bladder surgery, bowel surgery or rectal surgery is planned, the physician or dentist should be informed that you have had a joint replacement.

Blood Clots (deep vein thrombosis, pulmonary embolism)

Another risk is blood clots after a joint replacement.

Since our patients are mobilized very soon after surgery, this risk is small.

Calf compressors during and after surgery also help.

After surgery “TED stockings” and low doses of aspirin or other anticoagulation (blood thinner) medications are prescribed depending on the patient’s medical history.

In patients without any history of thromboembolic (blood clot) problems, we advise taking aspirin, 300 mg per day, for a period of six weeks. This is normal aspirin, and if you take low dose aspirin, such as Cartia, which is 100 mg per tablet, three of these need to be taken per day.

These measures are in place to reduce the risk of forming a clot.

In the event the patient is diagnosed with a blood clot, intravenous or subcutaneous anticoagulation therapy may be required.

There is no perfect treatment, and while trying to decrease the significant risk of deep vein thrombosis and the possibility of more serious complications, such as pulmonary embolism (blood clots breaking off and traveling to the lungs), other potential side effects (such as bleeding) can occur with the drugs used to decrease this complication. These medications require extreme care in their use.

Leg Length Differences:

A hip joint that is arthritic enough to require replacement is stiff and may also be a little short, because of deformity, wear or destruction of the joint surfaces. After surgery, the operated side almost always feels longer.

This is because We Restore the Anatomical Length (What it should be if you never had arthritis). This feeling gradually diminishes with increasing use & strengthening, over a period of 12 to 24 months.

We usually measure the leg lengths Before, During and After the operation and lot of Planning goes to ensure we restore your original Length.

Sometimes It may be Longer only because Your Hip Determines the TENSION of the surrounding Tissues to make it STABLE and Not Dislocate. It has to be understood it is NOT due to an incorrect sizing.

Although we take measures to try and ensure limb length remains unchanged, or on some occasions, is modified to try and achieve limb length equality, generally, we can get only to within a centimetre or so of limb equality.

Some people in the community have a length difference of 7-9mm (under a cm) and not even notice it.

Generally, this is not enough to cause a limp. On occasions, however, a small shoe raise adjustment may be required.

Failure/Loosening

• This could occur in the cup or stem.
• Running and jumping should be avoided in the early postoperative period
• The risk is approximately <1% per year.
• This can also happen if the joint is infected.
• It can be corrected by another surgical procedure, replacing the worn or loose component.

Dislocation

Dislocation of components is a potential risk of any joint replacement. This is usually less than 1%
This complication is less common with anterior hip surgery.

A requires manipulation of the joint under sedation, If unsuccessful a second open surgical procedure may be necessary to correct the situation.

Nerve Damage

The nerves can be stretched during surgery and occasionally due to swelling after surgery.

We take every precaution to protect the nerves via superior surgical techniques, but the risk, exists for these potential complications to occur.

A small skin nerve on the front of the thigh may commonly be stretched during the operation, as it is done from the front. A patch of numbness over the front of the thigh may result. These symptoms, generally settle over the first six months or so. In a small proportion it may persist. It does not affect the function in the hip joint itself.

Other Complications

Other complications that can occur include, instrument failure and breakage, muscle wasting, artery or vein trauma, drug reactions, implant breakage and loss of income, through prolonged hospitalization, and a longer than anticipated recovery. These complications are not common. It is important to be aware of potential complications when considering joint surgery.

Medical Complications

(Heart attack), respiratory, gastrointestinal, neurological (stroke) and genitourinary systems in the body.

The general health of a patient undertaking surgery is an important factor.

Many patients who need hip replacement surgery are elderly, with multiple other problems. These problems may add to the risks in undertaking surgery of this type.

Death

The risk is present in any major surgical procedure requiring anaesthetic and blood transfusion.

This risk differs depending on the age, medical illnesses and the complexity of the surgery.

The risk factor is small, approximately 1 in 70 000- 100000 cases