What happens when I come in?
During hip surgery
Hip replacement and hip resurfacing operations take about an hour and a half, and are usually done using a spinal or epidural anaesthetic (the anaesthetist normally uses sedation or a general anaesthetic as well).
If you are having a hip replacement, the hip is dislocated and the head of the femur is removed. A new socket is placed into the pelvis. Some sockets are made of metal, which your bone grows into; others are plastic, and are fixed in place using bone cement. A hip replacement stem is cemented into the femur, and the soft tissues are then repaired.
If you are having a hip resurfacing, the hip is dislocated and the bone surfaces are prepared. The socket has a special coating into which your bone will grow. The femoral component is fixed into place using bone cement. If your bone is found not to be suitable for hip resurfacing during the operation, a conventional hip replacement will be used instead. The risk of this happening will be discussed with you during your consultation.
After your hip surgery
When the operation has finished you will be observed in the recovery room until the anaesthetist is happy that you can return to the ward. The physiotherapist will see you the next day and help you to get out of bed. Over the next few days you will learn how to walk and manoeuvre safely. Most patients will also have hydrotherapy.
After about five days you will be ready to go home. Your physiotherapy will continue for about a month, and after six weeks you will be seen in clinic. If all is well at this appointment you will be allowed to drive. The next follow up appointment is at the one year anniversary of your operation, and an X-ray is taken. Further follow appointments will be arranged every few years after that.
Driving and travelling after hip surgery
Major hip surgery will slow your reaction times. It's a good idea not to drive for six weeks after your operation.
You should avoid long journeys (over an hour) for six weeks because your hip will feel uncomfortable and stiff. Most airlines advise that you shouldn't fly within three months of surgery because of the increased risk of developing a deep vein thrombosis (DVT).
Returning to work after hip surgery
Most people find that they are tired for several weeks after hip surgery. Returning to work too soon isn't a good idea as you'll find it difficult to concentrate, and might have problems with your rehabilitation. You'll probably feel ready to go back to work about three months after your operation.
Playing sports and activities after hip surgery
Many people return to sports such as golf or sailing after about six months from their hip operation. For other sports you need to discuss your plans with your surgeon. You shouldn't take part in contact sports, but lots of patients play tennis and badminton. Some even return to skiing after hip surgery.
Possible complications with hip surgery
Hip surgery is a major operation, and as such there is a risk of complications. These are often minor and temporary, but sometimes they can be serious and occasionally life-threatening. If you have high blood pressure, heart disease or diabetes, there is an increased risk of having a heart attack or stroke after surgery. Your surgeon and anaesthetist will discuss the risks with you before your operation. The most common complications are usually bruising around, or oozing from the wound. Sometimes your leg will be swollen for several weeks after surgery.
Occasionally a blood clot can develop (around 2% of patients will develop deep vein thrombosis or DVT) which will need treatment with warfarin for several months. In rare cases, DVTs can travel to the lungs causing collapse and occasionally death. The risk of this happening is very low, approximately 1 in 1000 patients, and precautions are taken after surgery to minimise the risk.
Deep infection sometimes happens (1% of patients) and often requires further surgery. Sometimes the components will have to be removed to clear the infection.
If you twist your hip excessively or have a fall it is possible that the hip will dislocate. You will need to have a general anaesthetic to put the hip back in, and sometimes further surgery will be needed. The risk of dislocation is low (1% of patients) and becomes much lower beyond six months after surgery.
Sometimes the sciatic nerve can be injured during the operation, resulting in permanent pain and weakness in the leg. The risk of this happening is very low (0.002% of patients).
Your leg can be lengthened or shortened after hip surgery, and you might need a shoe raise to compensate for this (low risk, 1% of patients).