Arthritis occurs when the smooth articular cartilage that lines the joint surfaces becomes damaged and starts wearing out. As the damage accumulates the cartilage roughens and thins, which eventually leads to pain and stiffness.
If your symptoms are affecting your daily activities and sleep, despite adequate non-surgical treatment, it may be time to consider a hip replacement.
A hip resurfacing is a very effective treatment for advanced osteoarthritis of the hip. It helps relieve pain and restore motion. The advantages of hip resurfacing is the preservation of bone as the ball is the femur is not removed, but just recapped, this also may make a revision (redo) surgery simpler as the ball can be removed a traditional hip stem implanted. Additionally, due to large head size the hip is less likely to dislocate (come out of joint) than a traditional total hip replacement.
The surgery itself involves a 10-15cm incision over the outside of your hip. The hip joint is then exposed and the head is shaped to accept a metal cap, the cup is relined with a metal socket. The joint is then put back into the place and the wounds closed and dressed.
After surgery, you will need to recover from the anaesthetic, but as soon as you feel comfortable the physiotherapists will come and assist you with first sitting up and then progress to sitting out of bed to taking your first steps. Usually you will be in hospital for four to five days as your mobility improves to a level that you will be safe at home. You may need to think about whether you will need some help at home for the first week or so.
A follow-up appointment with Mr Lee will be made, to review the wound and remove stitches.
Your mobility will improve over the course of the next few weeks and most patients will need crutches or a stick for the first six weeks. A lot of patients are able to drive at around six weeks, you have to be able to confidently perform an emergency stop to consider driving. Getting back to work may take up to 12 weeks depending on what activities your job entails, this is something you can discuss with Mr Lee. Your hip will continue to improve over the next few months.
There have been problems with metal-on-metal hip resurfacings reported in the press. These have been related to metal ion release into the tissues and the bloodstream. This can lead to an adverse reaction in certain patients, leading to pain and swelling around the hip joint and local tissue damage.
Whilst, these reactions happen in a very small proportion of patients with hip resurfacing, if it happens then redo (revision) surgery is often required.
Unfortunately, it is not possible to predict whom these adverse reactions may happen in. But, we do know that certain patients aren’t suitable for this type of replacement; those who have kidney problems, known allergy to metals, women of childbearing age.
If you are a suitable candidate for hip resurfacing, Mr Lee will discuss the risks and benefits with you, so that you can make an informed decision about surgery.