Hips
Hip Arthritis
What is hip arthritis?
Hip arthritis is a condition that commonly affects the hip joint cartilage. In a healthy hip, a firm, rubbery material, known as articular cartilage, covers the bones and allows them to smoothly glide over each other.
When a hip is affected by arthritis, this layer of cartilage breaks down and causes pain, swelling and a reduction of motion.
What causes hip arthritis?
Hip arthritis is a form of osteoarthritis. The exact causes of osteoarthritis in the hip are not known, however the following factors are known to contribute to the condition:
- Having a joint injury
- Undertaking activities which place extra stress on the hip
- Being overweight
- Getting older
Osteoarthritis usually occurs as a result of inflammation or injury, and it is more likely to develop as people get older. Hip arthritis typically develops slowly over many years, although there are some exceptions.
Occasionally, hip arthritis may also be the result of a joint that has not formed properly, or a genetic (inherited) condition that affects the cartilage in the hips.
Hip Arthritis Symptoms
The symptoms of hip arthritis include stiffness in the hip as well as either a sharp, stabbing pain, or a dull ache. Hip arthritis is often most noticeable when you walk, stand up from a seated position, climb stairs, or squat.
Diagnosing Hip Arthritis
Hip arthritis can sometimes be difficult to diagnose. This is because the pain can appear in different parts of the body, including the thigh, buttocks, knee or groin.
Hip Arthritis Treatment
Regular exercise and weight loss is recommended as initial treatments for hip osteoarthritis. Low-impact activities such as swimming, walking and pilates can be good options during the early stages of the condition.
Surgery for Hip Arthritis
If your hip pain is severely affecting your quality of life, your GP may refer you to a specialist. Most surgeries for hip arthritis aim to:
- Improve joint movement and flexibility to help you walk more comfortably
- Improve the alignment of your joints
There are different types of surgeries for treatment of hip arthritis, the most common type which has stood the test of time is:
- Joint Replacement (arthroplasty), involving the removal of the damaged joint surfaces and replacing them with metal, ceramic or plastic parts.
Total Hip Replacement
What is a Total Hip Replacement?
A total hip replacement (also called hip arthroplasty) is a safe and common procedure.
During a total hip replacement, Dr Shaun de Villiers will remove your damaged joint surface and replace it with an artificial implant. This procedure requires admission to hospital, anaesthesia, major surgery, and rehabilitation.
Why do I need one?
If your surgeon has suggested a total hip replacement, it’s probably because you are experiencing severe hip pain that cannot be controlled through diet, exercise or medication.
Most people who need a total hip replacement have experienced either:
- Hip arthritis
- A hip injury or fracture that has caused a reduction in blood supply to the area
- A hip dislocation
Deciding to have a total hip replacement is a big decision, and you should talk to your GP as well as our specialist orthopaedic surgeon and family members about what this will mean for you.
How long does recovery from a total hip replacement take?
Your recovery time will depend on your own individual situation; however, with regular physiotherapy, most patients find that they can walk short distances without pain within 4 to 6 weeks. Most patients can walk as far as they want to after about 12 weeks.
How should I prepare for a total hip replacement?
Taking the time to prepare for a total hip replacement can help you recover faster and ensure a successful result. Here are some tips on how to best prepare:
- Understand the procedure and ask questions
It can be hard to remember all your questions during your appointment. Try writing down your questions on a piece of paper and go in prepared. - Think about your job or other commitments
When you come to our rooms for your consultation, talk to Dr de Villiers about how total hip replacement surgery will affect your job or other commitments. Many people find that they need a few weeks off work. - Get in shape
A strong upper body will make using crutches or a walker a lot easier. If you can, it’s a great idea to spend some time in a pool or at the gym doing some ‘prehab’ strength building. Talk to your doctor about what’s right for you.
- Get family and friends to help
No one can recover from hip replacement alone. Talk to your family and friends about how they can help you. If you live alone, see if someone can stay with you for a few weeks. Talk to your doctor about other rehabilitation options if you don’t have a support system. - Rearrange your home
If you’re planning on recovering at home, you’ll need to think about how you will move about the house. If there are stairs in your house, consider moving your bed to the ground floor. Make sure you have things like phones, computers and TV remotes within easy reach. Remove loose rugs and tripping hazards and make sure that your home is easy to move around with a walker or crutches.
Direct Anterior Hip Replacement
What is a Direct Anterior Hip Replacement?
Direct Anterior Hip Replacement is a minimally invasive approach to total hip replacement. The procedure often results in a smaller incision, reduced muscle damage and faster recovery times for the patient. Unlike traditional hip replacement techniques which usually involve operating from the side (lateral) or back (posterior) of the hip, the Direct Anterior approach operates from the front.
By making an incision at the front of the hip, Dr de Villiers does not need to detach the hip’s muscles or tendons.
Is a direct anterior hip replacement right for me?
At your consultation in our rooms, Dr de Villiers will advise you on whether this approach is best for you. As with all medical procedures, it is important to discuss your options with your surgeon, your GP and your family.
How long will I be in hospital?
The hospital stay for Direct Anterior Hip Replacement is usually shorter. Most people who have a Direct Anterior Hip Replacement are in hospital for two to three days. Dr de Villiers will discuss your individual hospital stay with you at our rooms prior to surgery.
What is the recovery time?
Recovery time for a Direct Anterior Hip Replacement takes between two to eight weeks. This is considerably shorter than the expected eight to sixteen-week recovery time of traditional (posterior or lateral) hip replacements.
What are the advantages of having a Direct Anterior Hip Replacement?
There are several advantages to having a Direct Anterior Hip Replacement, including:
- Reduced hospital stays
- Faster recovery
- Reduced pain
- Lower risk of hip dislocation
- Smaller incision point / scar
- Fewer precautions need to be taken post-surgery (you can generally sit or sleep in whichever position is most comfortable for you.
What results should I expect?
Most patients can expect pain-free walking, bending, kneeling, and stair climbing after the first six to eight weeks. You should also be able to return to low-impact sports such as swimming, golf, cycling, and most gym exercises. Talk to Dr de Villiers about what your individual expectations should be after surgery.
Revision Hip Replacement
What is a Revision Hip Replacement?
Hip replacement surgery is one of the most successful procedures in modern medicine, however, problems can develop over time.
If problems occur, Dr de Villiers may recommend that you have a second operation to remove and replace some or all of the original prothesis. This procedure is called a Revision Hip Replacement.
What happens during a Revision Hip Replacement?
There are different types of hip revision surgery, and Dr de Villiers will talk to you about what will happen in your surgery. In some cases, only parts of the prosthesis need to be replaced. In other cases, the entire prosthesis needs to be removed and the bone around the hip needs to be rebuilt.
In most Revision Hip Replacements, our specialist hip revision surgeon will use special implants to compensate for any areas of bone or soft tissue damage that may be present.
What are the benefits of Revision Hip Replacement?
As with a total hip replacement, the main benefit of Revision Hip Replacement is relief from pain. Many patients find that this surgery also improves their mobility, coordination and strength.
Some patients find that they can eventually return to normal activities. It is important to remember that the success of the procedure also depends on your commitment to completing a rehabilitation program after surgery.
How long will I be in hospital?
Most people who have a Revision Hip Replacement are in hospital for 4 to 5 days. Your surgeon will discuss your individual hospital stay with you at your consultation at our rooms prior to surgery.
What is the recovery time?
After surgery, you will probably use a walker or crutches. You will also need to have regular physiotherapy and rehabilitation appointments. Normal activities such as climbing stairs and getting into a car will be difficult to begin with.
Most patients who undergo Hip Revision Surgery can resume fairly normal activities after 6 weeks. After approximately 6 months, most patients can walk without pain or a limp.
What results should I expect?
Most patients who have Hip Revision Surgery experience great results, including relief from pain, improved stability and better hip functionality. It’s not always possible to completely remove pain and some patients still experience lower level pain and dysfunction after surgery.