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Hip replacement Perth

Anterior hip replacement is one of the most successful operations in orthopaedic surgery - here’s why

On this page, we chat about hip replacement surgery, why I love this operation, and the benefits of performing it through an anterior approach. We talk about how to manage hip arthritis without operating, as well as types of surgery and ways to speed up your recovery.

hip replacement Perth

What is hip replacement?

What is it and when is it recommended?

The hip is a universal joint: a ball that moves in a socket. We call the operation a ‘total hip replacement’ because we replace both the ball and the socket.

In hip arthritis, the joint wears out, loses cartilage and causes pain. Hip arthritis pain can be very disabling but is sometimes difficult to diagnose. This area is “anatomically crowded”, and referred pain pathways can sometimes make the pain feel like it is in a different area. Over the years I have seen patients who have undergone hernia, knee or back surgery because that’s where they felt pain, and – while they had pathology in these areas – the surgery  did not resolve their pain as it was originating from their hip. 

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Mark Hurworth - Orthopaedic surgeon Perth

Mr Mark Hurworth, Orthopaedic surgeon Perth

“This is the most common misdiagnosis I see in my practice; as a patient, it can be difficult to get your head around the fact that your knee, groin or buttock pain may be coming from your hip. In these situations we often arrange an injection to clarify the source of pain for both the patient and surgeon.”

If you experience pain when you put weight on your leg, pain when you move the hip joint, or pain when you rotate your hip joint internally in flexion, it is important to consider that you may have a hip-related problem.

If your pain is disabling, keeps you awake at night, and if it limits your ability to walk comfortably, then hip replacement may be a sensible option. 

Success rates for hip replacement

Is this type of surgery successful?

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Mark Hurworth - Orthopaedic surgeon Perth

Mr Mark Hurworth, Hip surgeon Perth

“Hip replacements are popular with orthopaedic surgeons because they are a successful operation; there is a lot of competition amongst surgeons to promote themselves – something useful to be aware of as a patient. You will hear a lot about the ‘best new techniques’ and other marketing taglines.”

It’s important to bear in mind that hip replacement surgery has always been successful. It is understandable that every orthopaedic surgeon will want to promote themselves in this area. However anything new, innovative and potentially unproven should be regarded with a certain degree of suspicion (in the sense that an operation with such a high success rate is actually very difficult to improve upon).

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Videos about hip conditions and surgeries

Types of hip replacement

What are the different types of hip replacement?

I almost always use a titanium uncemented stem and cup that are backed up by 30-years of medical literature.

There are different approaches to performing a hip replacement. Roughly 95% of the time I use anterior hip replacement as a technique. It is associated with faster recovery and involves less damage to the muscles around your hip.

The other technique I use is called posterior hip replacement, which is my go-to option if doing revision surgery, or if we are repairing the muscles on the side of your hip (gluteus medius and minimus).

Avoid hip replacement surgery

Can I avoid surgery? What are the risks?

With hip arthritis, the pain is typically more disabling than with knee arthritis, as all the weight goes through the area that is most worn out. In addition, hip replacement is seen as the most effective procedure in orthopaedics. It often dramatically improves someone’s quality of life, which is a key consideration when we discuss the pros and cons of planning a hip replacement procedure.

There are alternatives to surgery in some situations. These include losing weight, and following an exercise program centred around ‘closed chain’ exercises such as cycling, exercising on the elliptical trainer or swimming. Surgery can sometimes be avoided or postponed with medication such as anti-inflammatories. 

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Mark Hurworth - Orthopaedic surgeon Perth

Mr Mark Hurworth, Hip surgeon Perth

“When we talk about your choice to have surgery or not, we will also discuss the risks. Hip replacement surgery is known to be highly successful 95% of the time.”

As with all implant surgery, this operation has occasional complications and risks – sometimes serious and even life-threatening – and you need to be aware of them:

  • Risk of hip joint infection: 1 in 100 for men, 1 in 200 for women.
    • Infection is not easily dealt with and often involves multiple further surgeries, prolonged hospital stay and antibiotics, and suboptimal outcomes. This is average risk, and is lower in younger and healthier patients, and tends to be higher in patients with obesity, on immunosuppressive medication, and other risk factors.  
  • Blood clots and embolisms: 1 in 50 for DVT (Deep Vein Thrombosis), 1 in 10,000 risk of fatal embolism
  • Dislocations and fractures: 1 in 100
  • Major neurological injury: 1 in 300
    • Major nerves around the hip – sciatic and femoral – can result in significant disability if injured
  • Numbness around the scar: relatively common, around 17% – will improve for 2 years after surgery

Your leg may tend to feel slightly longer rather than shorter after surgery. This is because, to balance the small risk of dislocation (due to us putting in a smaller head than your native head) we will typically tend to err on the side of slightly longer rather than shorter. I will explain this in more detail as part of your consultation. Whilst your leg may start up feeling longer, it would be unusual for this sensation to last beyond 3 months.

Statistics around risks are important to consider, but this operation is also my favourite as the benefits of surgery are often profound for my patients.

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Recovery after hip replacement

What can I do to recover quickly?

We all want to recover fast and minimise the risks. This is why I tell all my patients that it is important to be in the best shape possible before you plan your hip surgery, both physically and mentally. Part of the preparation is about developing resilience and learning to deal with as much pain before surgery as you can.

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Mark Hurworth - Orthopaedic surgeon Perth

Mr Mark Hurworth, Hip surgeon Perth

“I would expect you to be able to stand on the day of surgery, once your spinal anaesthetic has worn off. Then it is walk, cycle, as soon as possible.”

If you are motivated and sensible, and are hitting some simple targets, you will be allowed to go home the day after surgery. In other situations, you may be looking at a short hospital stay.

This is what to expect of your recovery after a hip replacement:

  • You would typically need crutches for a few weeks.
  • Wounds: take around 2 weeks to heal up.
  • Driving: check with your insurance but if you are comfortable, sleeping well and mobile, I am happy to give you the all-clear, although if this is before six weeks then best contact my office to arrange a certificate.
  • Blood-thinners: I normally send you home on Aspirin for four weeks.
  • Flights: I don’t recommend flights of longer than 3 hours for six weeks (increased risk of DVT).

Patients around Perth who have had hip or knee replacements will know that I often talk about the static bicycle as a rehabilitation tool. Generally, I advise my patients to get on a static bicycle before surgery, and then as soon as possible afterwards.

Hip replacement surgeon Perth

Why choose Mr Mark Hurworth in Perth?

This is core business for me, and the operation that I am happiest doing. We always aim to discuss the bigger picture of your situation, not just the surgery. We look at how to prepare, how to make the most of your recovery and how to work together so you can get back to the activities you love in the best condition. Most of my patients thrive in this context – knowing what they can to to prepare and improve.

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