In this article, the next in a series discussing hip osteoarthritis and treatment options, Mr Simon Newman explains the process you will go through when you have a hip replacement.
In the build up
At your appointment with one of the Grosvenor Orthopaedic Partners Hip Specialist Consultants, the options of non-operative options for managing your pain will be discussed before you consider a hip replacement. This is important as we would always recommend that you have considered all effective non-operative options before opting for surgery. Your Consultant will talk to you about the pros and cons of hip replacement surgery so that you can make an informed choice about whether to proceed with surgery.
Once you have decided to proceed with surgery, the Grosvenor Orthopaedic Partners team will arrange for you to undergo a pre-assessment session in the hospital where your operation will be performed. The purpose of this appointment is to ensure you are as fit as you can be before you have your surgery, it is essentially a health MOT. If any issues are picked up then occasionally you may need to be referred on to see other specialists before having your hip replacement. The pre-assessment team will provide you with all the information you need to prepare for the operation including what medication to take, explain the protocol for eating and drinking before surgery, and provide you with special antiseptic wash.
On the day of surgery
You will be shown to your room and seen by a nurse and the anaesthetist. Your surgeon will see you and complete the final parts of the consent process as well as make a pen mark on the hip to be operated on. The nurses will provide you with a gown to change into.
The Anaesthetic room
Your nurse will accompany you to the theatre complex where you will go into the anaesthetic room. Most hip replacements are performed under a spinal anaesthetic. This numbs your body form the waist down so that you feel no pain. This may be combined with some sedation which causes you to fall asleep, or some patients prefer to stay awake and listen to music via earphones. Alternatively, a general anaesthetic is performed where you fall asleep and a tube is passed through your mouth to help with breathing. The anaesthetist will discuss the pros and cons of these options with you.
In the Operating Theatre
In theatre you are positioned for the operation using supports and your skin is carefully prepared with antiseptic and sterile drapes are placed. An incision is made to access the hip joint and the worn out femoral head is removed. A hip replacement comprises a cup that sits in the pelvis and a metal implant that sits in the centre of the thigh bone.
Special instruments are used to craft a space in the pelvis for the cup of the hip replacement to sit. The cup is then either impacted into place or held with bone cement. The space in the femur is produced with rasps and the metal implant is again either impacted into place or held with bone cement. Your surgeon will test the stability of the hip before repairing the tissues and skin with sutures.
Immediately after surgery
After the operation you will go to the recovery area to be monitored for a short while and get something to eat and drink. You will be given painkillers to ease any discomfort as the anaesthetic wears off.
When you are comfortable, you will return to you room and the physiotherapy and ward team will help you to get walking again with your new hip. You will stay in hospital as long as is necessary for you to be comfortable and able to manage in your home. Our experienced physiotherapists and occupational therapists will work with you to
If you are interested in finding out more about hip replacement, please arrange an appointment to meet one of our specialist hip surgeons.