Hip Surgeon Sydney
If you have severe arthritis of the hip causing pain and limitation of your activities and lifestyle, that has not responded to conservative treatments you may be a candidate for total hip replacement.
Hip replacement replaces a painful arthritic hip with a functional pain free joint that allows patients to resume normal activities.
Total Hip Replacement replaces the worn out ball and socket joint with new durable implants.
What is Hip Arthritis?
Osteoarthritis, also called degenerative joint disease is the most common form of arthritis. It occurs most often in older people. This disease affects the tissue covering the ends of bones in a joint (cartilage). In a person with osteoarthritis, the cartilage becomes damaged and worn out causing pain, swelling, stiffness and restricted movement in the affected joint. Although osteoarthritis may affect various joints including hips, knees, hands, and spine, hip joint is most commonly affected.
How is the hip joint structure?
The hip joint is one of the most important joints in the body. The hip joint is a “ball and socket” joint. The head of the thigh bone makes up the ball portion and the “socket” is made up by the cup shaped acetabulum of the pelvic bone.
A smooth articular cartilage covers the bone ends to allow pain free motion in the joint. Normally, the hip joint allows movements such as flexion, extension, abduction, adduction, internal and external rotation including circumduction.
Hip joint is a weight-bearing joint and prone to damage by wear and tear, sports injury, motor vehicle accidents, degenerative disease or major falls. In all these cases you can experience pain and functional limitation. Hip pain is usually felt in the groin region but can also be experienced in front of the thigh, the knee and buttocks. Therefore it is essential for your doctor to assess the exact cause for the pain to treat accordingly.
What are the causes of Hip injuries
A tear in the muscle fibres caused by either a fall or direct blow to the muscle, overstretching and overuse injury is called a strain. Muscle strains often occur in the hip region whenever a muscle contracts all of a sudden from its stretched position. It can be mild, moderate or severe and depends on the level of injury.
Osteoarthritis: The most common form of damage in the hip is caused by wear on the articular surfaces of the bones causing pain as the bones rub directly on one another.
How is a typical hip replacement performed?
In hip replacement surgery, the diseased bone with its worn cartilage is removed and replaced by an artificial prosthesis made of hard-wearing materials such as ceramics and metals.
There are generally four parts to an artificial hip prosthesis.
On the pelvis side, there is a hemispherical titanium socket which replaces the worn out socket. Inside this titanium, a socket is a liner made for rubbing against the new artificial ball or head. This liner is made of long-wearing material such as a special ceramic or plastic, or metal. There are many pros and cons of each material which your surgeon would be happy to discuss with you.
On the femur (thigh bone) side of the joint, a metal stem made of a special alloy (usually titanium) is inserted into the canal or hollow channel in the center of the femur. On top of the stem is attached the new ball or head which is made of a hard-wearing material such as ceramic or metal.
The surgeon uses special tools to shape the bone of the pelvis and the femur to accept the prosthesis. As people are of different shapes and sizes, the bones also vary in shape and size. The surgeon sizes the socket and femur during the operation and selects the appropriate size for that patient. There is a large range of sizes and shapes of prostheses available “on the shelf”, that the surgeon can use to custom fit the patient.
The chosen prosthesis can then be fixed to the bone by one of two methods. The first option is to cement the prosthesis to the bone using a special acrylic bone cement. The other option is to use a prosthesis that has pores on it surface and/or a special calcium coating to which the bone will adhere to.
At the end of the operation the surgeon checks that the various components are positioned correctly, the hip is stable and the legs are the same length. The wound is then closed.
Hip injuries symptoms which lead to hip surgery
Patient-specific hip replacement surgery is indicated to treat inflammatory and non-inflammatory degenerative joint diseases, and restore your mobility and regular activities. The treatment is also used for the following:
• Pain while bearing on the affected hip
• Radiating pain in the groin, lower back and thighs
• Stiffness in the hip while walking
• Inadequate or no response to non-surgical treatment and medications
What is the diagnosis for Hip pain?
• Imaging tests such as X-ray, magnetic resonance imaging (MRI), and computed tomography (CT) scan can determine the extent of bone damage and if the disease has spread to the surrounding tissues.
• Bone scan: A small amount of radioactive material is injected into a blood vessel and collects in the bone. A special camera takes pictures of the affected areas of bone.
• Biopsy: A tissue sample is removed and sent for microscopic examination to rule out the presence of cancer cells in the bone.
What is a Total Hip Replacement?
Total Hip Replacement (THR) procedure replaces total or part of the hip joint with an artificial device (prosthesis) to alleviate pain and restore joint movement. The hip is a ball and socket joint which connects your thigh and hip bone. It is a crucial part of your anatomy that bears a large amount of force.
Total Hip Replacement replaces the worn out ball and socket joint with new durable implants.
• Your hip surgeon Sydney will send you for routine blood tests and any other investigations required prior to your surgery
• You will be asked to undertake a general medical check-up with a physician
• You should have any other medical, surgical or dental problems attended to prior to your hip surgery
• Make arrangements around the house prior to hip surgery
• Cease aspirin or anti-inflammatory medications 10 days prior to surgery as they can cause bleeding
• Cease any naturopathic or herbal medications 10 days before your hip surgery
• Stop smoking as long as possible prior to your hip surgery
Who will do your Hip surgery (Dr Stephen Rimmer, Hip surgeon Sydney)
Dr Stephen Rimmer hip surgeon Sydney schedules a CT scan a week or 2 prior to the surgery to obtain images of your hip. Using these images, a 3D model of your hip joint is created. Using this information, your surgeon decides on the optimal placement of the implant.
The patient-specific procedure is performed with a robotic arm interactive orthopaedic system. On the day of the surgery, the implants are positioned in the body with the help of the robotic system. The robotic systems provide real-time images during the surgery which help your doctor control the position and alignment of the implant accurately. Accuracy plays a major role in the success of the surgery and life span of the implant.
You will be admitted to the hospital usually on the day of your hip surgery.
Your Stay in the Hospital
You will wake up in the recovery room with a number of monitors to record your vitals. (Blood pressure, Pulse, Oxygen saturation, temperature, etc.) You will have a dressing on your hip and drains coming out of your wound.
You will spend the first post-operative day in bed and most likely stay in the hospital for several days and also prescribe physical therapy to help strengthen and improve range-of-motion in your hip joint. Once you are stable and awake you will be taken back to the ward.
You will have one or two drips in your arm for fluid and pain relief. This will be explained to you by your anaesthetist.
On the day following surgery, your drains will usually be removed and you will be allowed to sit out of bed or walk depending on your surgeon’s preference. Pain is normal but if you are in a lot of pain, inform your nurse.
You will be able to put all your weight on your hip and your Physiotherapist will help you with the post-op hip exercises.
You will be discharged to go home or a rehabilitation hospital approximately 5-7 days depending on your pain and help at home.
What happens after you go home?
A post-operative visit will be arranged prior to your discharge.
You will be advised about how to walk with crutches for two weeks following surgery and then using walking aids for another four to six weeks.
Remember this is an artificial hip and must be treated with care.
AVOID THE COMBINED MOVEMENT OF BENDING YOUR HIP AND TURNING YOUR FOOT IN. This can cause DISLOCATION. Other precautions to avoid dislocation are
• You should sleep with a pillow between your legs for 6 weeks. Avoid crossing your legs and bending your hip past a right angle
• Avoid low chairs
• Avoid bending over to pick things up. Grabbers are helpful as are shoe horns or slip on shoes Elevated toilet seat helpful
• You can shower once the wound has healed
• You can apply Vitamin E or moisturizing cream into the wound once the wound has healed
• If you have increasing redness or swelling in the wound or temperatures over 100.5° you should call your doctor
• If you are having any procedures such as dental work or any other surgery you should take antibiotics before and after to prevent infection in your new prosthesis. Consult your surgeon for details
• Your hip replacement may go off in a metal detector at the airport
Hip Fracture Prevention
Hip fractures refer to any kind of breakage or damage in the thigh bone (femur). People over the age of 65, especially women, are highly vulnerable to hip fractures. You will require assistance after hip fractures from family members as well as health professionals and may also be required to be admitted to the hospital for further assistance. Hip fractures can be caused due to weak bones (osteoporosis) or froma fall. Osteoporosis is due to various factors such as age, gender, nutrition, lifestyle or heredity.
Prevention of Hip Fractures
Healthy lifestyle choices in early adulthood help in building high bone mass and reduce a risk of bone-related diseases in later years. Some of the methods of prevention of hip fractures are:
• Home Safety: Most hip fractures occur due to falls. Fall can be prevented by taking care of small things such as removing clutter from the floor, clearing out excess or unwanted furniture, keeping electric cords away from the floor, using enough lighting in the house, using grab bars in the bathrooms and removing throw rugs
• Exercise: Exercise helps to maintain muscle strength and can slow bone loss. It also improves your balance and coordination. Exercises such as walking increase bone density in your body. Some other exercises include climbing stairs, jogging, dancing, swimming, and weight training. Balance training can be used to decrease falls and the risk of hip fractures as balance tend to reduce with age
• Reduce Smoking and Drinking: You can maintain your bone density by avoiding excessive use of alcohol and by reducing smoking. Too much alcohol can impair your balance and increase the risk of falls
• Check Your Eyes: Get your eyes tested every year if you have any eye disorders or diabetes
• Watch Your Medications: Certain medications can have side effects, such as weakness or dizziness and can make you more prone to falls. Please consult with your doctor regarding the medications you take
• Hip Protectors: These are designed in order to decrease the impact of a fall and prevent hip fractures in older people. The device has padding and plastic shields to help absorb the shock of the fall and divert the impact away from vulnerable areas of the hip
As you grow older your bones may become weak due to hormonal loss, genetic factors exercise or nutrition. However, you can maintain your bone health with good nutrition and appropriate activity levels. You can also take osteoporosis medications if required.