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How do I know hip surgery is right for me?
If you experience hip pains, you should first contact your general physician. If he advises you to see a specialist in orthopaedic surgery,
you will be referred to one on an outpatient basis.
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The specialist will make a diagnosis and judge if surgery is necessary. Some preparations could be advisable before seeing the specialist. You might consider the following questions:
• Where is my pain located?
• When does it hurt?
• For how long have I had the problems?
• Is the area of pain red and swollen?
• Which daily task do I have problems performing?
• Have I ever had an injury in my hip?
• Does anyone in my family have similar problems?
• Any special incidence when the pain first occurred?
Normally, all our joints function well, and we can move around without pain. Disease or injuries may interfere with the normal functions and cause:
• Pain
• Reduced muscle function
• Reduced mobility
The state that often cause this is called an arthrosis and implies that the cartilage of the joint is worn down resulting in the bone surfaces of the joint getting in direct contact with each other. These are less smooth than the surface of the cartilage - and friction increases. Arthrosis is the most common cause of hip problems and normally occurs after the age of 50. In most cases it is difficult to tell what has caused this condition. It may be caused by great strain on the joint over a long period, but can also be due to inherent abnormalities of the hip. Genetic causes may also influence your likelihood of having arthrosis.
Hip surgery can be a good treatment for people who suffer from arthritis.
For how long will I be hospitalised?
The length of hospitalization depends on several factors - e.g. age and general physical condition. Traditions also vary from country to country. In general, total hospitalization time is approximately one week. Normally, the patient can stand and walk with some help within a couple of days after surgery. As the days pass, you will become more and more independent, while using crutches or a walking chair. You will receive instructions how to get out of bed, use the bathroom and how to get dressed.
Must I have special training after the surgery?
Most patients will start training within a couple of days after surgery. A physiotherapist will instruct you how to get out of bed, how to sit, stand etc. After getting home from the hospital a physiotherapist in your town will continue guiding you and the training will become more extensive. The aim is that you shall regain your full muscle strength and good mobility of your joint. Depending on your physical condition, it may take up to 6 months before you have regained full mobility and strength.
Can I have hip surgery in my age?
After the age of 80 some people feel that they are too old for hip surgery. Age will, however, not exclude you from having hip surgery if you are in great pain and otherwise in sufficient physical condition to go through surgery. Earlier hip surgery was confined to people above 60 years of age, but because current implants and surgical techniques are better than before, a growing number of younger patients receive hip prostheses. 1/3 of all operations are today performed on patients less than 65 years of age.
What is the risk of complications linked to such an operation?
The risk of complications is limited. Serious complications - as infections in the joint - occur in less than 2 % of the procedures. A thrombosis in the legs is the most common complication, but this is normally not dangerous and will not cause lasting problems. In order to avoid thrombosis, you will receive injections to dilute your blood for approx. 2 weeks after surgery. In addition it is advisable to use special stockings to compress your leg. In some cases the prosthesis will luxate (pop out of place), normally in case of a fall or when doing extreme movements. Some patients will also experience that the leg with the operated hip will become somewhat longer than the other leg after the operation. A lengthening of up to 1 cm (1/2) is normally not noticeable, but it may - in case of greater difference in leg length - be necessary to use an extra insole. With the Unique® hip system, we correct the leg length in order to avoid such differences.
Are there limitations to what I can do after the operation?
Most patients who have surgery experience a significant reduction in pain. They will also find that they will be much more able to take part in daily life. Still, in any case, you will not be able to be more active than you were before contracting a joint problem. Generally, we advise to avoid activities that lead to repeated strains to the joint (e.g. running). You should also avoid contact sports as football, handball etc and other extreme activities. Ordinary leisure activities as walking, hiking, skiing and golf are all possible with an artificial hip. Your specialist will advise you what level of activity you should strive for, and will also tell you when you can restart driving a car.
How long will the prosthesis last?
It is not possible to forecast exactly how long the prosthesis will last. In several countries (e.g. Norway) there are official statistics on the survival of orthopaedic prostheses, and these statistics show that less than 5 % of the patients have to have a replacement operation within the first 10 years after the primary hip replacement surgery. Indications are that most hip replacement surgery will provide a good result for many years!
The risk, that your prosthetic implant has to be replaced, depend on:
• Age
• Weight
• Level of activity
• Quality of the bone tissue
• Type of prosthesis
• Surgical technique
Loosening of the prosthetic implant is the most common cause for replacement surgery. It is important to follow up with regular controls and X-ray examinations - this because the loosening can occur before causing special symptoms. This is not a problem in the beginning. If the problem continues without actions being taken, this can lead to more difficult replacement surgery and increased risk of complications.
What is the difference between cemented and uncemented prostheses?
There are two main types of prosthetic implants; cemented and uncemented. A cemented prosthesis is fixated by the use of acrylic bone cement. An uncemented prosthesis normally has a porous coating on the surface allowing the surrounding bone tissue to grow into the surface of the prosthesis - thus fixating the implant. In this way the implant becomes an integrated extension of the bone. Many orthopaedic surgeons use both types of implants, and will advise you what is the most suited for you.
How important is the type of prosthesis for the outcome?
Certain characteristics of the design show that some implants are better than others. There are many designs and makes of implants on the market. Some are more suited than others. It is generally important to make sure that the implant recommended by your specialist, has a proper documentation, and that the implant fits your hip. As a patient you are entitled to require a special prosthesis and to demand that your specialist can explain why his recommendation is to your advantage.
Why should I use Unique?
Unique is an uncemented prosthesis, where each prosthetic implant is custom designed to fit the individual patient in such a way that the joint after the operation can function as much as a healthy joint as possible, and that the implants fits perfectly into the cavity of the thigh bone (femur) to ensure optimal fixation. This is important in order to secure high quality of life and a long survival of the implant.
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