A total hip replacement (total hip arthroplasty) is a quality of life operation. It involves replacing the worn ball and socket of the hip with metal, ceramic and plastic (highly cross-linked polyethylene) components.
A hip replacement is one of the most successful operations that any orthopaedic surgeon does, and once done should last for decades (90% are still functioning after 20 years).
Adults, usually over the age of 50, with a degenerate hip causing all or some of:
These symptoms would usually have been present for many months or even years, often getting worse over time. Non-operative measures should have been tried, including weight loss, activity modification, regular analgesia. Once these are no longer enough, and the hip is having a significant impact on your quality of life, then a total hip replacement can be considered.
Once the decision has been made to proceed with surgery, Dr Ferguson will explain the procedure and the risks (see below). A date for surgery is usually planned but can be deferred. A booking form will be completed and you will be asked to sign a consent form. These forms are then taken to the Armidale Private Hospital where the administration staff will process the paperwork and check health fund details and eligibility. They will arrange for you to come to the pre-anaesthetic clinic (PAC) to see the anaesthetist and nurse, usually a couple of weeks prior to surgery.
Dr Ferguson will also give you a referral for a CT scan which you can take to i-Med Radiology (or Inverell Diagnostic Radiology) to get a scan that is used for the Mako SmartRobotics 3D planning. This scan should be done at least 2 weeks prior to surgery.
The operation itself is usually done under a spinal anaesthetic with sedation. The procedure usually takes about 60-90 mins. After spending some time in recovery you will then be transferred back to your room on the ward. The physiotherapist will visit you later in the day to get you to stand and to take some steps.
As the local anaesthetic wears off, the pain will increase. You will be prescribed both long-acting and short-acting narcotic pain killers to control this. On the day after surgery, you will have a routine blood test and an x-ray. Dr Ferguson will show you the x-rays to help explain what he has done. The physiotherapist will visit twice a day to show you exercises to help with your walking. Initially, you will be walking with a frame, but usually, progress to a single walking stick by discharge.
Discharge home is usually on day 3.
Adults, usually over the age of 50, with a degenerate hip causing all or some of:
These symptoms would usually have been present for many months or even years, often getting worse over time. Non-operative measures should have been tried, including weight loss, activity modification, regular analgesia. Once these are no longer enough, and the hip is having a significant impact on your quality of life, then a total hip replacement can be considered.
Once the decision has been made to proceed with surgery, Dr Ferguson will explain the procedure and the risks (see below). A date for surgery is usually planned but can be deferred. A booking form will be completed and you will be asked to sign a consent form. These forms are then taken to the Armidale Private Hospital where the administration staff will process the paperwork and check health fund details and eligibility. They will arrange for you to come to the pre-anaesthetic clinic (PAC) to see the anaesthetist and nurse, usually a couple of weeks prior to surgery.
Dr Ferguson will also give you a referral for a CT scan which you can take to i-Med Radiology (or Inverell Diagnostic Radiology) to get a scan that is used for the Mako SmartRobotics 3D planning. This scan should be done at least 2 weeks prior to surgery.
The operation itself is usually done under a spinal anaesthetic with sedation. The procedure usually takes about 60-90 mins. After spending some time in recovery you will then be transferred back to your room on the ward. The physiotherapist will visit you later in the day to get you to stand and to take some steps.
As the local anaesthetic wears off, the pain will increase. You will be prescribed both long-acting and short-acting narcotic pain killers to control this. On the day after surgery, you will have a routine blood test and an x-ray. Dr Ferguson will show you the x-rays to help explain what he has done. The physiotherapist will visit twice a day to show you exercises to help with your walking. Initially, you will be walking with a frame, but usually, progress to a single walking stick by discharge.
Discharge home is usually on day 3.
The way a surgeon cuts the soft tissues to get down to the hip is called the surgical approach. Two of the most common approaches are the “Posterior Approach” and the “Direct Anterior Approach”. Dr Ferguson has been trained in the use of both approaches.
Through a combination of personal experience, performing both approaches, and reviewing the current research evidence (for those inclined to review themselves, links to some high-quality research are provided below), it is Dr Ferguson’s opinion that the only significant consistent difference between the two approaches is the position of the scar!
A well-done hip replacement is a fantastic operation, in terms of pain relief and improved quality of life, regardless of which approach is used.
All operations have risks, and hip replacements are no exception. Dr Ferguson will outline these to you before you sign the consent form. They include:
Apart from pain, most patients don’t have any of these problems. The risk of a complication is about 5 in 100. The risk of a serious complication, such as deep infection, is less than 1 in 100.
Although the risk of dislocation is low, Dr Ferguson advises you to adhere to the following advice for the first 6 weeks after surgery: