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Hip replacement surgery
As we get older we become more prone to hip pain as this complex joint wears out or becomes damaged. Most people with hip problems don’t need surgery, but for the few who experience long term (chronic) pain and reduced mobility, a hip replacement operation can help. For example, if you’ve suffered a broken hip it may just need to be treated and set rather than replaced, whereas if you have advanced osteoarthritis you may benefit from a hip replacement.
If your leg and hip bones are generally good the surgeon may recommend hip resurfacing rather than a total hip replacement, in order to preserve as much natural bone in and around the joint as possible.
This kind of hip surgery is more commonly performed on younger patients, and involves replacing the damaged or diseased surface of the ball and socket joint in the hip with metal plating. Also known as metal on metal (MoM) hip resurfacing, the operation leaves the head and neck of the femur intact. After recovering from the operation, the patient will be able to enjoy good movement and participate in sports activities once again. The older the person the more prone the bone is to fracturing, so total hip replacements are thought to give better long term success rates for older patients rather than resurfacing. However, if you’re under the age of 65 and have advanced hip disease a hip resurfacing operation could be the right option for you.
Sometimes known as total hip arthroplasty or total hip replacement, this kind of operation is suitable for people with severe, chronic pain caused by osteoarthritis, deformity or disease. One of the most common hip operations performed in the UK each year, it brings great relief from pain, restores mobility, and gives a huge improvement in quality of life. The operation involves replacing the ball and socket joint of the hip with metal and plastic parts (sometimes referred to as hip implants). During the procedure the surgeon will remove the top end of the femur and insert a special metal stem with a ball on the end that will replicate the natural joint. At the same time the hip socket will be hollowed out and a plastic socket cup fitted to receive the metal ball on the end of the thigh bone.
A hip revision operation is undertaken when the original hip replacement operation fails, usually because the joint has become too loose. In about 2% of cases hip revisions are carried out due to bone infection. A hip prosthesis can last from anywhere between ten and twenty-five years, and because people are living longer they may need more than one hip replacement operation. A repeat operation is called a revision. It is a longer and more complex operation than the original, requiring specialist equipment and skills and is about 80% as good as the first hip replacement. During the operation the metal and plastic artificial ball and socket parts are removed, along with any damaged bone, and a new prosthesis is inserted and fixed into place.
Although not widely performed, some patients may need exploratory surgery to help the surgeon make an accurate diagnosis as to why they’re suffering from hip pain. A small camera is inserted through little holes in the skin and passed into the hip joint. It’s also possible for surgical instruments to be inserted so operations can take place. Hip operations undergone during a hip arthroscopy include repair or trimming of cartilage, loose bodies and bone fragments removed from the joint, removal of the synovium (the membrane lining the hip joint), and the biopsy or removal of tumours.