THR - Total Hip Replacement

 

What is Total Hip Replacement

 

 

Total hip replacement (THR) is the replacement of the hip joint with artificial joint components. Medically it is referred to as total hip arthroplasty.

 

Since the 1960s, Total hip replacement has revolutionized the treatment of hip problems. A number of surgical methods of accessing the hip joint exist, each with advantages and disadvantages. The most commonly used approaches are the anterior (frontal), lateral (side) and posterior (rear) approaches. The operation can give considerable improvement in pain and disability levels for patients, and is widely viewed as one of the most successful medical procedures.

 

The main parts of the hip joint are:-

Femur - Main leg bone

Femoral head - the 'ball' at the top of the femur that sits in the pelvis.

Femoral neck - the bone between the femoral head and the main part of the femur.

Acetabulum - The 'cup' that the femoral head sits in.

 

It is also possible to resurface just the femoral head (resurfacing hemiarthroplasty), or to replace just certain parts of the hip joint. The replacement of the femoral head and neck is known as unipolar hemiarthroplasty. The replacement of the femoral head and neck and the addition of an acetabular cup that is not attached to the pelvis is known as bipolar hemiarthroplasty.

 

 

The surgeon will take away the whole of the rounded femur head, replacing it with a new hip stem. He will then remould the hip socket and into put a cup in (acetabulum), with without cement.

A new insert will be put into the acetabular cup, and a new head fitted to the hip stem.

 

In cases where both hips have to be replaced, it is usually preferable to do both at the same time; this is because the total recovery time is about one day more in hospital than for a single hip.

 

Following a Total Hip Replacement it is impossible to reach your feet because you cannot bend more than 90 degrees in order to reduce the risk of dislocation. You will not be allowed to drive until your consultant gives you the all-clear.

 

You will probably have to take anti blood clotting precautions (pills, injections or TED socks) for about five weeks following surgery. This is to prevent dangerous blood clots from forming. A side effect is that you may bruise more easily, and any cut may bleed more than normal.

 

A second hip replacement is known as Revision. Revision surgery is nearly always more difficult than the first or primary hip surgery. When the first prosthesis is removed, some bone is removed because the bone cells are attached to the glue or have grown into the metal. Therefore the bone becomes thinner with each revision, which adds to the risk of bone failure and also takes longer to heal. Sometimes a metal band or wire is placed around the top of the femur to reinforce it.

 

Any muscular aches and pains and swelling for quite a time is all completely natural, normal and to be expected. It is not comfortable or pleasant but will improve as time passes. It is no fun dealing with the swelling, but application of ice, some gentle massaging and elevation when resting will help.

 

You will experience a physical and emotional roller coaster journey.

 

Recovery Time

The time taken to recover varies enormously, depending on many factors such as your condition before the operation - see the chapters 'To delay or not to delay' and 'When can I do that'. Most people will recover to a reasonable level in about twelve weeks, but patients report that full recovery can take over twelve months.

 

Information differences

Everyone on the Patient.Info web forum is constantly confused and bewildered at the difference between the information that we are given by all our medical carers. [Kate53CornUK]

Please remember that information given to someone else may differ from that given to you for perfectly good medical reasons.

 

 

If you are contemplating Total Hip Replacement surgery or revision, remember that there is a good life after surgery, and that it is usually less painful than the pains you had before.

 

 

 

For further reading, I suggest the following guide from the UK National Health Service   https://www.nhs.uk/conditions/hip-replacement/

 

 

 

 

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Page last updated: 10 August 2018 - 15:20