Hip arthritis
What is it: hip arthritis is most commonly the result of osteoarthritis (wear, tear and inflammation of the joint). It can result from inflammatory arthritis (rheumatoid, gout); joint damage after an injury/fracture (post traumatic arthritis); problems with blood supply to the hip (avascular necrosis); childhood hip problems (developmental hip dysplasia, Perthes disease, slipped upper femoral epiphysis)
Patient problems: pain in the groin, outer hip, buttock. Stiffness e.g. difficulty cutting toenails, donning/doffing socks and shoes.
Non-surgical treatment: analgesia, weight loss (if appropriate). Injections may be suitable in some cases.
Total Hip Replacement
total hip replacement
What to expect:
Before surgery: Blood tests for anaemia, check the result with your GP. Some patients need iron tablets/infusion before surgery.
MRSA – MSSA swabs: roughly 3 weeks before surgery. If swabs are positive you will get ‘decolonisation therapy’ (mouthwash, body wash, nasal ointment) for 5 days immediately before surgery. This is to help minimize the risk of infection.
Visit the dentist if you have any dental problems.
Dr McGonagle will plan your hip replacement using dedicated computer software. Dr McGonagle uses implants with a proven track record on the Australian National Joint Replacement Registry and other international joint replacement registries. Implants can be cemented (with polymethylmethacrylate) or uncemented (bone grows onto the roughened surface of the implant). Implants are made from metal (stainless steel, cobalt chrome, or titanium) and plastic (ultra-high molecular weight polyethylene).
Risks: pain, swelling, bleeding, infection, nerve injury, fracture, blood clots, dislocation, loosening, leg length unequal, reoperation.
Anesthesia: spinal / general anesthesia
During Surgery
During surgery – a urinary catheter will be inserted into the bladder, to avoid it overstretching whilst the spinal anaesthetic is working.
Dr McGonagle will make an incision on the side of your hip, remove the damaged joint surfaces and insert the total hip replacement.
Implants can be:
- Bone cement (polymethylmethacrylate) acts as agrout between implant and bone
- Uncemented – implants have a roughened surface that allows the patients bone to grow onto and into the implant’s roughened surface
After Surgery – Day 1
Urinary catheter will be removed.
Bloods and x-ray.
Mobilise with physiotherapist using a frame or crutches.
Duration in hospital: 2-3 days
Medication to prevent blood clots for 4 weeks after surgery.
Rehabilitation after surgery: Gentle walking as comfort allows is usually sufficient.
Practice nurse wound check at 2 weeks
Review in Dr McGonagle’s clinic with x-ray at 6 weeks.