Total Hip replacements are one of the most common and most successful operations that we do as orthopaedic surgeons.
Your hip can wear out either just with normal ‘wear and tear’, following an injury, or with underlying medical conditions such as rheumatoid arthritis.
Total Hip Replacements are one of the most successful orthopaedic surgical operations.
There are over 40 hip replacement combinations being used in Australia. We use one of the most tried and tested implants available for hip replacements, and of many different joint replacements available, the implant we use is one of only 2 companies recommended by the Australian Orthopaedic Association as having the best 15 year results with the lowest revision rate ie the lowest rate of the hip replacement needing to be redone. This is certainly reassuring data for the hips we implant.
As to the approach, this has been the subject of much debate over the last few years, with people discussing posterior, lateral, and direct anterior. The consensus is that there are pros and cons to each approach, but a hip replacement done well is the most likely thing to give the best result, and the approach has little influence on the outcome. We use a Direct Superior Approach, which is a muscle sparing less invasive incision, with the aims of a smaller scar and less pain.
Positioning of the implants is crucial to make sure the hip is stable and doesn’t dislocate out of the socket, and to ensure the final leg lengths are equal. To ensure this we use robotic technology with the Mako, which is arguably the best multiplatform orthopaedic robot in the world with the most robotically implanted joints. Prior to surgery we get a CT scan to ensure we know everything about the hip joint position, then we plan positioning of the implants looking at how flexible your spine is and seeing how the pelvis tilts and the implants move in virtual positioning software. During surgery we make sure that only the essential bone is removed and the implants are positioned perfectly with robotic guidance to give you the best outcome. There is good evidence to support a lower dislocation rate, equal leg lengths, less pain and earlier rehabilitation.
After surgery we would expect you to be in hospital 2-3 days, walking with crutches until weeks 2-3, a single stick for support until week 6, then walking without aids. Most of the discomfort and swelling will have resolved by week 4, but wont completely settle until 3-4 months.