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Hip replacement

The Prosthesis

A Stanmore hip with a plastic cup, metal ball and smooth cemented stem

In a hip replacement the ball of the normal joint is replaced by a metal or ceramic ball. This is fixed by means of a stem that is inserted into the thigh bone. There are 2 common types of stem; one is smooth and is cemented into place whilst the other has a roughened surface that allows bone to grow into it. The decision as to which type is used is made on the quality of the bone; in thin bones a cemented stem will be favoured.

A new lining is also inserted into the hip socket. There are a number of different designs:

• The lining may be made of plastic (high density polyethylene), ceramic or metal

• Like the stem the lining may either be cemented or rely on bony ingrowth for its fixation

The Surgery

Hip replacement is done under either a general or regional anaesthetic. An incision about 10 to 15 cm long is made over the side of your hip. The operation typically takes about 1 hour.

When you return to the ward you will have a 'drip' in your arm and may also have a drain coming out of your wound. Blood transfusion is required in only about 10% cases. You will be given painkillers to relieve any discomfort.

You will start walking within 12 to 24 hours of surgery. Initially you will require a frame but within a day or so you will be using crutches or sticks. You will be taught to climb stairs after 2 to 3 days. You will then be fit for discharge which usually occurs on the third or fourth postoperative day.

If necessary outpatient physiotherapy will be arranged. You will be seen in clinic 6 weeks following surgery but should contact the hospital if you have any concerns before then.