Arthritis of the hip is a very disabling and painful condition which has been successfully treated with total hip replacement for almost 40 years. With the pioneering work of Sir John Charnley at Wrightington Hospital leading the way in the development of hip replacements. 

Further advances have been made in joint replacement surgery and currently a vast array of different implants and options are available.  Commonly used replacements include traditionally cemented cups and stems, entirely un-cemented hip replacement systems (which are press fit and rely on bone in-growth into the implant for stability and long term fixation).  Additionally some cemented implants have been developed which are polished and tapered and are designed to sink within the cement and therefore stabilise themselves further.  The bearing surface traditionally was a metal on polythene design. Studies have shown shown that when ceramic is used in conjunction with polythene less wear occurs. 

Other bearing surface options include hard on hard bearings, usually ceramic on ceramic or metal on metal.  Each of these bearing surface combinations has advantages and disadvantages and depending upon the age and activity level of the patient different options may be appropriate.  Mr Hoad-Reddick always discusses the appropriate options with his patients before deciding with them which combination to implant.  He commonly uses the C Stem cemented hip replacement (a highly polished taper) with either metal or ceramic heads in conjunction with either a cemented (polyethylene) cup or an un-cemented cup (press fit metal shell), which allows for alternate bearing surfaces to be used, namely either ceramic on ceramic or metal on metal.  He also offers his patients resurfacing hip replacements where appropriate.  The details of this procedure are found on a separate page.

Whenever surgery is performed there is a small risk of complications.  The risk of complications related to hip replacement surgery include: 

Pulmonary Embolism

Clots in the calf (Deep Vein Thrombosis) occur relatively commonly, rarely these clots can go to the heart and lungs and cause pulmonary embolism (the same as economy class syndrome).  The risks to life from this complication following hip replacement is 1/400.  Mr Hoad-Reddick uses low molecular weight Heparin to try and prevent clots from forming.  He also mobilises his patients as soon after the operation as possible as immobility may be linked to the formation of these clots.

Infection

Infection following total hip replacement is a very serious complication.  The risk of this occurring is in the region of 1%.  If this does occur, then further surgery is required and often the hip replacement needs to be taken out and replaced with a new one, either during the same operation or more commonly at a second operation.  Mr Hoad-Reddick uses antibiotic loaded bone cement, his patients are given antibiotics at the time of operation to reduce the risk of infection and also as is fairly routine, his operations are all performed in special operating theatres with bacterial filters. 

Dislocation

There is a small risk of dislocation following total hip replacement.  The overall risk is in the region of 5%.  The highest risk time is in the first three months after a hip replacement operation and during this time you will be given instructions as to how to minimise your risk of dislocation, particularly avoiding crossing your legs and sitting on low chairs.  You will be seen by an Occupational Therapist prior to discharge from hospital to make certain that you understand the appropriate do’s and don’ts.

In addition to the above risks, there is also a small chance of a leg length difference occurring following hip replacement surgery, Mr Hoad-Reddick tries to avoid this from occurring by careful pre-operative templating (measuring x-rays and deciding on the size of implant to use).  On occasion leg length difference cannot be avoided, as the prime aim of joint replacement surgery is to leave a well functioning joint that does not dislocate. Other small risks include damage to nerves around the hip and also rarely there are of medical complications in relation to surgery.  There is a small risk to your life from strokes and heart attacks during or soon after the operation.  It is routine in Mr Hoad-Reddick’s practice for patients to be assessed prior to surgery by a Specialist Nurse and an Anaesthetist to ensure that the risks of surgery are acceptable.