When a patient has severe arthritis and painkillers no longer effectively control the symptoms, hip joint replacement is advised. This has the benefit of relieving the pain and allowing the patient to return to a near normal level of activity.
In simple terms, the ball of the hip is removed and the thigh bone is prepared before the metal stem is inserted. The pelvic cup is then prepared and the artificial cup is inserted and held using either bone cement or an artificial coating that bonds directly to the surrounding bone surface (figures 3,4 and 5).
There are different forms of hip replacement and each one has a role to play depending on the patients age and activity level. Younger (<70) and more active patients, will have implants where the cup liner and the ball of the hip will be made of ceramic, which is very smooth, hard wearing and produces less wear debris then traditional implants. Older patients are better suited with cemented cups made of newer forms of plastic which are also wear resistant. The risks and benefits of each type will be discussed at the time of your consultation.
In general, a hip replacement is a safe and reliable operation. The vast majority of patients are either pain free following the surgery or have a significant improvement in their symptoms, returning to a level of activity that has not been possible for some time.
Corail hip replacement with ceramic bearings and various cups
Approximately, 5% of patients will develop a post-operative complication. The most important of these are deep infection, hip dislocation, leg lengthening, nerve and blood vessel injury and blood clots. In patients with a ceramic implant, there is a small risk of Squeak and ceramic fracture. Great care is taken to minimize these risks including the use of antibiotics and blood thinning drugs around the time of the operation.
Patients tend to remain in hospital for between 3 and 5 days. During this time they undergo intensive physiotherapy, which continues after their discharge home. Patients are reviewed by Professor Fehily in out-patients six later and at this point, they can fully return to their normal activities.