Hip Replacement : A Guide

Making the choice – when is surgery right for me?

Dr Ellis will consider your need for surgery based on your level of pain, your functional capacity, your medical history and physical capability. Your decision to go ahead with surgery should be considered when you feel fully informed. Hip replacement surgery is a major procedure, and it is important that you consider both its risks and benefits.

You should have exhausted all other effective treatments before choosing surgery.

 

A healthy hip:

The hip is one of your body’s largest weight-bearing joints. It consists of two main parts: a ball (femoral head) at the top of your femur that fits into a rounded socket (acetabulum) in your pelvis. Bands of ligaments connect the ball to the socket and provide stability to the joint.

 

Why do I need my hip replaced?

In a healthy hip, the bone surfaces of your femoral head and acetabulum have a smooth durable cover of articular cartilage that cushions the ends of the bones and enables them to move easily. All remaining surfaces of the hip joint are covered by a thin, smooth tissue called synovial membrane.

The parts work in harmony so that you can move easily without pain. As arthritis develops, this smooth movement becomes painful and restricted, until you reach the stage where you feel the effect of arthritis every day.

Hip - better copy about-menu
Repixelled hip

What can I expect from hip replacement?

Hip replacement is a major procedure and requires effort and commitment to your recovery, both by you and your surgeon, Dr Ellis. Most people who have hip replacement surgery feel a dramatic reduction of pain and a major improvement in their ability to achieve everyday activities of daily living.

 

After surgery, you can expect that your hip pain will be improved, that your range of motion increases with physiotherapy as you strengthen any muscles that might have deconditioned, and to return to most activities and exercises that you enjoy. However, it’s important to know that you will be advised to avoid certain activities for the rest of your life, like long distance jogging and high-impact sports.

 

Even with normal use and activities, an artificial joint develops some wear over time. High impact sports accelerate wear and may cause the prosthesis to loosen and become painful, leading to further surgery later on.

Getting fit and ready for surgery

Keeping fit with low impact exercise or physiotherapy (prehab), stopping smoking and maintaining a healthy weight are simple methods to personally improve your outcome. Look out for your skin, avoid cuts and abrasions to prevent infection.

What are the risks?

Hip replacement is considered a highly predictable and safe procedure but its risks are real and should be carefully considered by prospective candidates. Most patients are highly satisfied with their outcomes, but some can be disappointed with their choice or the result. You should be aware that serious complications do occur and may necessitate further surgery and/or treatment slowing your recovery.

 

These include:

 

two-img

Both you and Dr Ellis will work together to avoid adverse results from surgery. You can help by informing Dr Ellis of your other health conditions, regular medication or concerns that you have prior to surgery. Blood thinners, arthritis and diabetes medications are examples. If you have further questions, please ask!

My pathway through hip replacement

Once you’ve made the choice to proceed to hip replacement, you can expect pending your health issues to have your surgery within four to six weeks.

STEP

01

Imaging

Our prosthesis engineers use special CT/x-rays to design your surgical plan and choose an implant tailored to your specific biomechanics. We will book this radiology appointment for you well prior to surgery. Please ensure to attend this appointment, and remember to collect your x-rays afterwards.

STEP

02

Preadmission

It’s important to attend preadmission at North Shore Private to assess your fitness for surgery. Any health issues that might affect your recovery should be discussed with the team, and a general health assessment will take place to make sure your pathway is a smooth one. Please complete a hospital booking form online prior to preadmission. Dr Ellis’ staff with arrange a time for you to attend.

STEP

03

Preoperative Check

You’ll see Dr Ellis for a last check roughly a week before your date of surgery. At this appointment, you will review with Dr Ellis the results of preadmission and your imaging, and make sure that everything is ready. This is a good opportunity to ask any final questions.

STEP

04

Surgery

Admission is usually on the day of surgery. Dr Ellis and his anaesthetist will see you before your operation to check your condition and answer any last questions. The operation lasts about two hours and you will stay in the operating room for 4 – 5 hours. Dr Ellis will ring your nominated relative at this time, to let them know that all is well. You will begin to walk on the day of surgery or early the next day with the hospital physiotherapists.

STEP

05

Discharge

Your hospital stay will last roughly two to five days. Once fit to leave, you have several options. Rehabilitation as an inpatient is one choice, but you can also recover well with physio at home or by attending an organised outpatient program. There are many options for home based rehab. Please discuss this with Dr Ellis’ staff and your insurer to find out.

PDF Pathway of Total Hip Replacement

How can I improve my recovery?

Being diligent about rehabilitation and physiotherapy in the first weeks will hugely improve your outcomes.

 

Home-based Rehab: A popular solution, these programs are usually covered in the majority by your health fund. If you choose not to go to rehab, they offer in home supported care, physiotherapy and online consultations, often with prehabilitation sessions before your surgery. Check with your insurer if you are eligible. Options include 360med.care and Ramsay Connect.

 

Wound care: You will have stitches along your wound or a suture beneath your skin. The stitches will be removed two weeks after surgery, usually by your GP. The dressing applied at surgery will also be removed at this time.

 

Avoiding problems after surgery

Blood clot prevention: Follow the advice of Dr Ellis carefully to reduce the possibility of developing blood clots, which can occur in the first weeks of recovery. Take the prescribed medication and wear your TED stockings for six weeks.

Look out for:

  • Pain in your calf and leg, unrelated to the incision.
  • Tenderness or redness of your calf.
  • Swelling of the thigh, calf, ankle or foot.

 

Warning signs that a clot has travelled to your lung include shortness of breath and chest pain, particularly with breathing.

Notify Dr Ellis immediately if you develop any of these signs. If it’s an emergency, call an ambulance or go to the nearest hospital.

 

Avoiding falls: A fall during the first few weeks after surgery can damage your new hip and may result in a need for more surgery. Listen to your physiotherapist and keep using your walking stick, frame, crutches or handrails until your flexibility and strength are improved.

Week 1-6: Recover and rehabilitate

This is the time to work hard with your physio and rehab team. Some movements will be restricted in the first six weeks to protect the surgical wound and your new hip as it heals. You will be on crutches, a frame or using a stick for the first few weeks. Whether you’re at home, attending a day program, an inpatient or working with private physios, it is vital that you keep active and moving.

 

Please note that you will not be able to drive for the first four to six weeks after surgery. With the anterior approach, driving can often occur at four weeks.

 

Be prepared to be in some pain but as time passes, you will wean off your pain medication.

 

Dr Ellis will see you at 6 weeks post-op with an x-ray, but is always available if you have any concerns.

imag-2

Week 6-12: Normalise and strengthen

During this time, you’ll start to be able to recommence your normal recreation, exercise and social activities. As you regain your strength, your new hip should now allow you to do the things you might have stopped because of pain.

 

Just keep in mind that your prosthesis and bone is healing, so avoid activities that place twisting forces on the leg and hip – breaststroke swimming should be avoided for the first six months.

 

Dr Ellis will see you again at the 12 week mark, making sure that you’ve made it through the first three months. Most people will return to full time work early in this period.

PDF Brochure Total Hip Replacement with Dr Ellis PDF Anaesthesia and Total Hip Replacement

Hip replacement – the specs

Every year, new advances are made to orthopaedic technology and surgical techniques. Dr Ellis’ years of experience and new engineering innovations will come together to give you a safe and reliable prosthesis.

 

Implant Designs – The hip joint is a ball-and-socket joint, where the spherical head of the femur moves inside the cup-shaped socket, or acetabulum, of the pelvis. Your implant will be a combination of ceramic against polyethylene or ceramic as the bearing surfaces. The ‘bearing surfaces’ are the parts that move together (the ball and socket). The parts use to support the bearings are made of titanium or high grade stainless steel.

 

Three components are required in a hip prosthesis to duplicate the joint:
1. The stem (which fits into the femur and provides stability)
2. The ball (which replaces the spherical head of the femur)
3. The cup (which replaces the worn-out hip socket)

 

Dr Ellis uses an innovative alignment system to place the implants into your hip joint. This system is a patient specific plan, 3D printed cutting guide and laser guided alignment, based on analysis of the special CT scans taken prior to your surgery. It is designed to ensure that your new joint mimics the natural position of your hip joint when sitting, standing and bending forward. as closely as possible, to prevent possible complications such as edge loading of the prosthesis, restriction in range of motion or possible dislocation due to malalignment.

Direct anterior approach versus the posterior approach?

Dr Ellis will discuss the surgical approach (i.e. where and how the incision for surgery is made) with you before surgery. Depending on your biomechanics and other health conditions, he will choose an approach that gives you the best outcome. Research shows that the different approaches have negligible discrepancy in outcomes in the long term, though the direct anterior approach has a lower rate of dislocation and less restrictions in the first six weeks.

How much does hip replacement cost?

Your private health insurance should cover the majority of your care. Check your level of cover to ensure that the stay in hospital, the prosthesis and rehabilitation are all covered.

 

Dr Ellis will discuss his fees with you. Well before surgery, you will be provided with a quotation for surgery for informed financial consent. Dr Ellis uses the AMA schedule of fees as the basis of his part of the professional costs of the operation. He works closely with a specialist anaesthetist of great experience, who will charge separately and whose likely fees can be confirmed preoperatively.

 

Your surgical fee will cover postoperative follow-up appointments for a period of five months.