Total hip replacement surgery (THR) is one of the most successful operations carried out today. Despite the overall success of the surgery, there are many things you should know about THR surgery. Here are some commonly asked questions that may help you learn more about the procedure and its risks and benefits:

Who should have THR?
The most common reason for hip replacement is osteoarthritis, but many patients have hip replacements for other types of arthritis such as rheumatoid arthritis, post-traumatic arthritis or other reasons such as avascular necrosis. The overwhelming indication for joint replacment surgery is pain. Most pain in the hip is felt in the groin or the buttock and can sometimes be felt down the leg. A simple x-ray can help tell if you have arthritis of the hip.
If the pain in your hip is limiting your daily activities and impacting your quality of life, you may be a good candidate for a total hip replacment.

What are my chances of having a good outcome from THR?
Approximately 90% of people who undergo THR report good or excellent results from their surgery.

What are the risks of surgery?
All surgery has risks involved, including THR. The following is a list of the most common risks:

Risk of Anesthesia: undergoing anesthesia is much less risky than it used to be. Now days most of the risk depends on your overall health. Patients with heart or lung disease for example may have a slightly higher risk of adverse events during surgery than other people. To minimize the risk we ask you to undergo preadmission testing so that we can be aware of any potential issues and address them ahead of time. We may also ask for pre-operative medical clearance from your primary care physician, or possibly from your cardiologist. Regional anesthetic also lowers your risk.

Infection: developing an infection in your new total joint is a potentially devastating problem. The rate of infection is currently less than 1%. We do everything we can to keep that risk even lower, including giving you antibiotics before and after the procedure and wearing special hoods to minimize the amount of bacteria in the room. If you have an infection prior to the surgery such as a tooth abcess or urinary tract infection, it may be prudent to delay the surgery until the infection has been adequately treated.
Once you have a had a hip or knee replacement, you will need to take antibiotics whenever you have a dental procedure (even a cleaning) or other invasive procedures such as a colonoscopy.

Blood Clots: Developing a blood clot in the leg can occur after any orthopaedic procedure. Patients are placed on a blood thinner after surgery to decrease that risk.

Dislocation: While hip replacements are improving, they can dislocate in certain situations if precautions are not followed. Fortunately, dislocation is rare as long as hip precautions are maintained for the first 3 to 6 months after surgery. You will be taught hip precautions during your hospital stay. New technology is lowering the dislocation risk.

How long will my hip replacement last?
A hip replacement can be expected to last 10-20 years. There are some that have lasted much longer than that. Hips wear out for many reasons including patient activity level, patient size, and the quality of the materials used in the implant.

What is the recovery time for THR?
Recovery is approximately six to twelve weeks. Every patient is different and recovers at their own pace. Most are back to daily activities in less than six weeks, but demanding activities will require a little longer rehabilitation. You will work with a physical therapist to get your strength and mobility back. Don't worry about comparing yourself to other replacement patients. You will recover in your own time.

When can I drive?
If you had your right hip replaced, you may drive at 6 weeks after surgery. If you had your left hip replaced, you may drive as soon as your are no longer taking narcotic pain medications.

What are my limitations after THR?
Once you have fully recovered you may do almost any activity except running or jogging. You must maintain hip precautions after THR for 3 to 6 months. If there are specific activities you do, ask Dr. Williams about them.

Does Dr. Williams perform Minimally Invasive Surgery?
Yes. Minimally invasive surgery (MIS) involves smaller incisions and less damage to the soft tissues. There is a lot of debate in the orthopaedic community about whether MIS lives up to its hype, but most patients do seem to recover a little faster. MIS in combination with advanced anaesthesia techniques does seem to make the experience more pleasant for most patients.

What about "alternative bearings"?
Metal-on-metal bearings or ceramic-on-ceramic bearings are available in addition to the traditional metal-on-polyethylene bearings. Each has their benefits. Talk to Dr. Williams about the right choice for you.

What about hip resurfacing?
Hip resurfacing is a new procedure that removes less of the bone than standard hip replacement. It may be a good option in some patients, but at this time is unproven and does have some risks associated with it. Dr. Williams will be happy to talk to you about this procedure.


For more information on THR, contact Dr. Williams for an appointment.

To see an excellent interactive demonstration on how a hip replacement is performed, click here.