As we get older we become more susceptible to Arthritis and the complications and issues that it causes us. Hip replacements are one of the most common procedures performed on individuals who suffer with Arthritis. Our Chartered Physiotherapist from our Dundrum clinic, Sinead Tracy looks at the area of Hip Replacements in further detail.

Anatomy of the Hip Joint

The hip joint is a ball and socket joint. The ball is formed by the round head of femur located at the top of the femur or thigh bone. This ball fits snugly into a cavity in the pelvic bone which forms the socket and is called the acetabulum.

How have I ended up needing a hip replacement?

The most common cause of chronic hip pain and disability is arthritis, below are the three pathways to getting hip arthritis.

Osteoarthritis

- 50 years of age and older
- A family history of arthritis
- Over use of a specific joint over years

In this form of disease, the articular cartilage cushioning the bones of the hip wears away. The bones then rub against each other, causing hip pain and stiffness. The affected leg may become shortened, muscles may weaken and a limp may develop.

Rheumatoid Arthritis

It is an auto-immune disease in which the synovial membrane surrounding the hip becomes inflamed, producing too much synovial fluid and damages the articular cartilage, leading to pain and stiffness

Traumatic Arthritis

It can follow a serious hip injury where the articular cartilage becomes damaged over time causing pain and stiffness. It can also follow a fracture of the hip which causes damage to the blood supply to the head of the femur which dies and eventually collapses causing pain in the hip.

The Three Types of Hip Replacement

Total Hip Replacement

The painful parts of the damaged hip are replaced with artificial parts known as a prosthesis, a device that substitutes or supplements the joint. The prosthesis consists of a socket, ball and stem.

Hemi Replacement

In which only the ball of the femur is replaced. The prosthesis is made of a metal stem that fits into the hollow marrow space of the femur. It has a metal ball that fits into the socket of the hip joint. The acetabulum remains as is.

Surface Replacement

It is still a total hip replacement but a newer technique where bone is conserved leaving the femoral neck and head attached and hence sparing them. So rather than removing the arthritic femoral head, the surface of the head is shaved off and reshaped and resurfaced with a mushroom like cap.

After surgery is there any precautions I need to be aware of?

For 6 weeks post-surgery following standard hip replacements:

Do not bend hip past 90 degrees
Do not cross legs or bring the operated leg across the midline of the body
Avoid sudden twisting or turning movements on the operated leg
Remain sleeping on your back until instructed otherwise by your surgeon or physiotherapist
Do not reach down to feet (e.g putting on shoes or socks)
When sitting, the knee should always be below hip level

Rehabilitation

Exercises are important after a hip joint replacement as the leg muscles on the affected side are often weak and tight, as pain and stiffness in the arthritic hip has limited normal movement. Also as a result of the surgery, the muscles around the hip joint have been cut, divided, and/or detached and hence are very weak and so do not provide the strength and control that is needed.

Progressive strengthening exercises will promote healing, range of movement and strength to the new hip joint. Consultation with a Chartered Physiotherapist will help ensure you are correctly doing these exercises correctly and progressing at an appropriate pace.

If you have had a Hip replaced recently or are soon to get one and you do need to visit one of our Physios you can get in contact with us by booking an appointment.