Robotic-assisted hip replacement surgery
Hip arthritis is a commonly reported issue that can significantly impact a person’s daily life. The objective of treatment is to alleviate pain and restore functionality. The most frequently performed treatment for advanced arthritis is undergoing hip replacement surgery utilising modern technology. 95% of hip replacement patients are satisfied with the outcome of surgery.
Overview
Many different conditions can adversely affect the hip joint. The most common by far is wear and tear arthritis-osteoarthritis. The vast majority of hip replacements in the UK are performed to relieve patients from pain caused by osteoarthritis of the hip joint. The hip joint is a ball-and-socket joint with an acetabulum (socket) and femoral head (ball), which articulate with each other. If the hip joint wears out, it is particularly painful as the joint takes the full weight of the body when walking. Every step can result in excruciating pain and be very debilitating.
Causes
The underlying cause of osteoarthritis is not fully understood. It occurs more frequently with age, and some propose that it is a case of wear and tear causing the degeneration of the joint. This over-simplifies the nature of the disease as there is a significant genetic component. Symptoms appear gradually until it reaches the point that the patient is unable to tolerate the pain and seeks relief through medical help.
Symptoms
The most common symptom is pain radiating from the hip joint. The pain is felt in the groin, buttock, side of the hip and down into the thigh. It often begins gradually, steadily becoming more frequent, intense and then disabling. Referred pain may also be experienced down the leg and often into the knee joint. The pain frequently intensifies at night, which may interfere with sleep. Daily activities become more difficult, and the pain may limit the ability to walk distance and affect pace. As time passes, the hip joint will typically stiffen, making it difficult to reach down to the foot from an upright position on the affected side. Putting on shoes and socks and tying shoelaces may be a challenge or become impossible. The joint tends to become stiff as the osteoarthritis advances.
Diagnostics
Diagnosis of osteoarthritis of the hip is made using standard X-rays of the hip joint. There is, generally, no need for an MRI scan to identify advanced osteoarthritis, though one may be requested if there is an indication of a soft tissue problem in the hip joint or the X-ray has failed to diagnose the source of the problem. In some cases, a steroid injection into the joint may be applied to confirm a diagnosis that the hip joint is the source of the pain.
Treatments
Non-operative strategies
Initially, painkillers, physical therapy, weight loss and walking aids may be experimented with to alleviate the pain from osteoarthritis in the hip. However, once osteoarthritis is established, these therapies become less effective and surgery may be required.
Hip replacement
Total hip replacement is a very successful operation in relieving osteoarthritis pain. It can also be used to treat other conditions of the hip such as rheumatoid arthritis, avascular necrosis and pain from past hip surgeries. A hip replacement involves replacing the socket and ball of the hip joint. Many different designs exist, with different materials and modes of implant fixation: the type of joint replacement can be tailored to suit different characteristics.
Hip resurfacing
Hip resurfacing is a form of total hip replacement that replaces the socket of the hip joint and resurfaces the femoral head rather than replacing it. Hip resurfacing is still a valid form of treatment, particularly in younger, more active patients.
Recovery
A total hip replacement operation takes approximately two hours to perform, from the time the anaesthetic is applied, through to waking up in the recovery room. Depending on the time of the surgical procedure, the patient may be mobile on the same day. The physical therapy team will then set to work, initially on tasks involving standing and walking short distances, then graduating to longer distances and eventually climbing a flight of stairs, before discharge from the hospital. The typical hospital stay is two to three days post-operation. Driving a car is possible at about the six-week mark once walking aids are no longer needed. Sleeping on one’s back during the first six weeks is recommended, and by the sixth week, a patient can expect that the use of additional precautions and aids can cease.
Has hip pain started to limit your daily life?
If you have advanced hip arthritis and non-surgical treatments are no longer providing relief, speak to a specialist about whether hip replacement may be the most appropriate option.