Benefits and Risks of Hip Replacement Surgery

Hip replacement surgery is among the most common types of surgery performed in the UK. In fact nearly 70,000 people in the UK elect to undergo hip replacement every year and for good reason. 

Since the first hip replacements were performed some 50 years ago the procedure has been continually refined and perfected and is today perhaps the most effective method ever devised for improving mobility and relieving pain among those afflicted with degenerative joint conditions.

Hip replacement has become a relatively routine procedure. The patient is given general anaesthesia, an incision is made that allows the surgeon access to the affected hip joint and damaged or worn components are removed and replaced with artificial components typically made of metal and/or ceramics. But while nearly 200 of these operations are conducted on average every day of every year in the UK people still have questions including “What are the risks of hip replacement surgery?” So in this guide we’ll look at both the benefits and risks of hip replacement surgery.

Why People Have Hip Replacement Surgery

Hip replacement surgery is sometimes performed in response to injury or some form of birth defect. However, the vast majority of people who elect to have this surgery do so because they suffer from one of the following degenerative conditions:

• Osteoarthritis – With osteoarthritis the cartilage covering the end of the bones is worn away until bone grinds against bone in a manner that can restrict motion and be extremely painful.
• Rheumatoid Arthritis – Rheumatoid arthritis is caused by an overactive immune system that attacks the joints, creating inflammation and eating away at cartilage and bones. Deformation of the joints is common, pain is debilitating and movement can be significantly impaired.
• Osteonecrosis – With this condition blood supply to the ball of the hip joint is restricted which can lead to bone deformation and collapse.

When is it Time to Consider Hip Replacement?

It may be time to start weighing hip replacement risks and benefits if one or more of the following applies to your current situation:

• You have pain that is no longer responding to pain medication
• You have pain that interferes with your ability to sleep
• You are unable to climb or descend stairs under your own power
• You have difficulty rising from a seated position
• Pain is steadily worsening even though you are using an assistive device

How Long Does the Operation Take?

According to NHS statistics the average hip replacement procedure takes anywhere from 60 to 90 minutes (minus prep time and time in the postop recovery room). Complete recovery from hip replacement surgery will take anywhere from 6 months to a year depending on the particular patient’s overall physical condition.

The Benefits of Hip Replacement Surgery

For those wondering just what are the benefits of having a hip replacement those benefits are many and varied and include:

• Pain reduction – Most people can find a way to adjust to physical limitations. What is far more difficult to live with and adjust to is the type of chronic pain that comes with degenerative joint conditions and which only worsens with the passage of time. If something isn’t done to address the problem the pain can become so intense that people essentially become housebound. Even then they can’t escape it because simple things like standing up can be excruciatingly painful events. One of the major benefits of having a hip replacement is that it can alleviate most or all of the pain associated with degenerative conditions of the hip joint.
• Improved mobility – While alleviating pain is often first on the list of reasons why people undergo hip replacement surgery, the ability to restore mobility isn’t far behind. With a newly reconstructed hip people typically regain a normal range of motion for someone their age, along with the ability to climb stairs again, drive, perform the normal activities of daily life and exercise both to strengthen the new hip joint and to recover from the effects of being sedentary.
• Improved quality of life – Few things are more depressing than being immobilized by pain. People suffering degenerative joint diseases who may have led active, engaged lives slowly devolve into a spirit-crushing state that finds them unable to perform even the simplest physical acts like standing up. Following hip replacement surgery most of these people are able to fully re-engage with their lives, their normal routines and their friends and families. It’s one of the primary reasons people elect to have this type of surgery.
• High probability of success – All the myriad hip replacement benefits wouldn’t be of much value if the success rate for this type of surgery was 40 or 50 percent. Fortunately statistic indicate that 10 years after hip replacement surgery 90 to 95 percent of patients are still enjoying normal, active lives without complications or the need for revisions. This extraordinary high success rate is one benefit of this surgery many find very appealing.

The Risks of Hip Replacement Surgery

While hip replacement surgery has become commonplace and there are myriad benefits to undergoing this type of surgery it should never be assumed that it’s a risk free procedure. It is after all major surgery and so, like all types of major surgery, there are a full slate of hip replacement surgery risks and complications. The risks of hip replacement include:

• Dislocation – Once you get home from hospital it is important not to overextend the hip joint. If you do you run the risk of dislocation after hip replacement. Dislocation often occurs because in the immediate aftermath of surgery the muscles of the hip joint are still weak. So crossing your legs or bending too far can cause the ball of the joint to pop out of the socket. Work with your physical therapist to develop exercise routines that will strengthen the hip joint.
• Collateral damage – Another hip replacement risk is that on rare occasions bone around the surgical area may fracture after surgery. Hip replacement surgery in the elderly risks this type of collateral damage perhaps more than with younger hip replacement recipients. In the majority of cases the bone heals itself but in some instances corrective surgery may be required.
• Mismatched legs – It’s exceedingly rare but hip replacement operation risks also include ending up with one leg shorter than the other. This is typically due to weakness in the muscles around the surgically reconstructed hip joint. It is not necessarily a cause for excessive concern however as it can often be corrected by working with your physical therapist to strengthen the hip muscles.
• Limping – Hip replacement surgery risks include the chance that after getting back on their feet some patients will find themselves limping. Again this is typically due to weak muscles in the reconstructed hip joint and can typically be corrected via physical therapy.
• Continued pain – In the overwhelming number of cases pain is either greatly reduced after hip replacement surgery or completely eradicated. In a tiny number of cases however the patient may continue to experience pain and in an even smaller number of cases that pain may actually increase.
• Revision surgery – For most patients the components of the new hip joint will last many years. In some cases the new joint will last the rest of the patient’s life. But one of the risk factors for hip replacement is that some patients will need revision or a second hip replacement procedure if the joint has experienced extraordinary wear and tear.

The older you are the more important it is to discuss the benefits as well as potential hip replacement risks with your doctor prior to committing to this type of surgery so that you fully understand all of the potential risks of hip replacement in the elderly.

Additional Hip Replacement Risks and Complications

• Infection – As with any type of invasive surgery hip replacement carries with it the risk of infection. If the infection is mild it may respond to antibiotics. If the infection is serious the new hip joint may have to be removed until the infection is eradicated and it can be replaced.
• Wound haematoma – Wound haematoma or bleeding of the wound happens when blood collects in the surgical wound. It’s not all that uncommon and usually stops after a few days. However, in rare cases blood may continue to collect beneath the skin causing swelling.
• Allergic reaction to bone cement – A special bone cement is used to help fix the new components to the existing bone. In some instances a patient will have an allergic reaction to this bone cement. Should this occur the new joint and all the cement must be removed and second hip replacement risks will need to be weighed carefully.

Conclusion

In the vast majority of cases the benefits of hip replacement surgery will far outweigh the risks of total hip replacement surgery. Still, you need to be mindful of both the benefits and risks of hip replacement surgery before deciding whether or not this procedure is right for you.