Painful and swollen hip joints are common in adults and may compromise mobility. Hip replacement is often the solution, and knowing what to expect is helpful. Although your doctor may have referred you to an orthopaedic specialist who recommended arthroplasty to relieve your hip pain, this does not necessarily mean you will be a suitable candidate for this procedure.
To be considered for the surgery, you must undergo a thorough pre-operative evaluation to assess your general health. The investigation might include blood tests, medical imaging studies like X-rays and MRI scans, and a cardiac assessment to confirm you can tolerate the anaesthesia. Following a successful evaluation, you may receive some pre-operative counselling to prepare you for the upcoming procedure.
If you are overweight, preparation might include modifying your diet, while smokers will be advised to quit, at least before the surgery and during the recovery period. All candidates should also ensure their homes are adapted to accommodate their diminished mobility during recovery and arrange help if living alone.
About Hip Replacement Procedures
The procedure may be conducted arthroscopically or with open surgery in which the joint is fully exposed. The former is generally considered more suitable for younger, active patients or those with limited joint deterioration.
Minimally invasive hip replacement: This procedure can be conducted under general or local anaesthesia, and patients can frequently be discharged on the same day. This approach to hip arthroplasty offers the following benefits:
- Reduced risk of complications: These include blood loss, infection and scarring.
- Shorter recovery time: This approach enables shorter hospital stays and faster recovery times than open surgery.
- Less soft tissue disruption: Arthroscopy avoids the extensive tissue dissection associated with open surgery, thus reducing postoperative pain levels.
- Open hip surgery: Despite the desirable potential benefits of the minimally invasive approach, performing open surgery on the hip joint is sometimes the more viable option. The following are the most common reasons for an orthopaedic surgeon to favour this lengthier and more radical approach to hip arthroplasty:
- Severe deformities: Patients with bone anomalies like acetabular dysplasia or protrusion, or congenital hip dislocation may require open surgery to restore joint alignment and ensure the prosthesis will remain stable.
- Fracture management: Patients with a femoral neck or acetabular fracture may require internal fixation to stabilise it. Under these circumstances, the hip replacement is best performed using the open approach.
- Revision surgery: Despite the consistently high success rate, hip implants sometimes fail, often due to inappropriate activities by the patient during the recovery stage. In such cases, open surgery is the best option to remove and replace failed implants, repair bone damage and achieve a more durable outcome.
- Medical complications: Obese patients and those with conditions like pulmonary dysfunction or cardiovascular disease are better suited to open as the increased exposure and access enable better control of intraoperative variables. This approach reduces the risk of secondary complications arising from these common comorbidities.
Your surgeon will advise you regarding the best hip replacement option based on your medical history and pre-operative assessment. Naturally, you want reassurance that you are in good hands. That’s precisely why so many local and overseas patients choose to contact the orthopaedic unit of the Wilgers Life Hospital in Pretoria.
