The Risks and Benefits of Hip Replacement Surgery
Hip replacement surgery is one of the most common medical procedures for those over the age of 65 in the UK. According to figures for England, Wales and Northern Ireland from the National Joint Registry, over 90,000 people have the operation each year, and the vast majority are successful.
Indeed, since the surgery was introduced in the 1960s it has been one of the most effective medical procedures in the country and most patients feel the benefits of hip replacement surgery, reporting improvement in terms of both mobility and pain reduction after the treatment.
However, as with any form of medical treatment, hip replacement surgery is not without its risks. This is why it is important to be aware of not only the positive ‘success stories’ associated with the operation but also the potential negative outcomes which, although unlikely, can still occur.
Hip Replacement Surgery: A Brief Guide
Hip replacement is a relatively straightforward procedure. Patients are given general anaesthetic or epidural then an incision is made to the hip to allow the surgeon to access the hip joint. They will then remove the damaged or worn joint and replace it with a metal or ceramic prosthesis.
However, as with many other forms of surgery, there are pioneering treatments currently gaining popularity including hip resurfacing, where the damaged surfaces of the hip bone are removed and replaced with metal, and computer aided surgery, where technology is used to create a replica hip joint.
According to the NHS, an average hip replacement operation takes between 60 to 90 minutes in total. Recovery can take anything up to a year; though the first two to three months are the most significant in terms of regaining mobility and managing pain.
Benefits of hip replacement surgery
As one of the UK’s most successful procedures it is unsurprising to know that hip replacement surgery offers a number of advantages. Of course the most significant is the reduction in pain. In severe cases hip pain can be debilitating and even the most gentle of movements can leave the sufferer in agony.
Most hip replacement operations reduce the pain dramatically and in some cases eradicate it entirely.
The ability to walk and move without suffering excruciating and chronic pain is the main benefit of hip replacement surgery.
Hip pain can lead many people to stop doing the activities and hobbies they used to enjoy. After hip surgery many of these same people are able to resume activities such as walking, swimming, cycling and golf, giving them a new lease of life.
Other advantages include:
- Improved mobility. A new hip joint can bring with it a far greater range of movement, enabling the patient to move with far greater ease. This is especially noticeable when climbing stairs or undertaking more rigorous activity.
- Better quality of life. Most patients report that hip replacement brings with it a far better quality of life. Sleep is improved, largely due to the reduction in pain, and related problems such as depression are eased significantly.
- Excellent chance of success. Hip replacement surgery has one of the highest success rates with greater than 95% of patients experiencing relief from hip pain. This is also reflected in the long term figures whereby after 10 years, the success rate remains between 90 – 95% and after 20 years, 80 – 85%.
In addition to this, mortality rates associated with the operation are very low, and have decreased further in recent years.
- Secondary benefits. Hip replacement surgery reduces the risk of chronic health conditions such as heart failure, diabetes and depression.
Risks Associated with Hip Surgery
Whilst the treatment has excellent success rates, there are still risks involved.
The risks include:
- Blood clots. As an invasive procedure, there are always risks but these can often be treated with blood-thinning medications.You will be encouraged to move soon after your surgery to minimise the risk of blood clots and compression stockings can also help.
- Infection. Most infections can be successfully treated with antibiotics.
- Fracture. Sometimes, healthy sections of your hip joint may fracture as a result of surgery. In most cases, the bone will heal by itself. However, there are occasions where the fracture needs to be corrected which may involve further surgery.
- Unequal leg length. Again, this is rare, but can happen. If one leg is shorter than the other after surgery, this is normally a result of weakened muscles surrounding the joint. The problem can normally be resolved with physiotherapy treatment to help strengthen the muscles over time.
- Dislocation. Dislocating the ball of the new hip joint is always a risk, especially soon after the procedure. Normally, your surgeon will recommend steps you can take to avoid this, such as not bending more than 90 degrees from your hip and not crossing your legs too ‘high’. Dislocation can normally be resolved by wearing a brace. However, if it keeps occurring, you may need further surgery to correct it.
- Limping. Some patients are left with a limp after the operation. This is normally due to weakened muscles and can generally be corrected with muscle strengthening exercises.
- Loosening. This is rare in newer implants but surgery may be needed if the implant becomes loose over time.
- Continued pain. As previously mentioned, the vast majority of patients’ pain is greatly reduced, or even eradicated entirely. However, for a small proportion, the operation will not make a difference, or may even make the pain worse.
- Nerve damage. This is rare but can cause numbness, weakness and pain in the area where the implant is placed.
There is a risk of death, and some patients are at a higher risk of mortality than others. According to the study carried out at the universities of Bristol, Oxford, East Anglia and Exeter, it’s actually not overweight people who are at greatest risk; in fact overweight people seem to be at lower risk than their healthy-weight counterparts. However, those with liver problems are in the higher risk category, as are those who are more likely to suffer infection, for instance, diabetes or rheumatoid arthritis sufferers.
Most modern prostheses are designed to last many years and for a large number of patients the replacement joint will last for the rest of their lives. However, the prosthesis is prone to wear and tear and you may require a second replacement surgery after some time.
As with any medical procedure, it’s important to talk to your surgeon before committing in order to understand fully the potential benefits of hip replacement surgery and the risks involved.