What you need to know about hip replacement surgery

Hip replacement surgery is common in Australia, with more than 50,000 of us booking in for one each year.¹

If you’ve decided to have a hip replacement or revision, the pain is probably having a big impact on your quality of life.

You’ve likely exhausted other non-surgical options like:

• weight management
• regular exercise to improve joint movement and muscle strength
• physiotherapy
• walking aids (such as walkers and canes)
• pain management/medication.

For some, a new hip joint may mean a new lease on life, relieving pain and getting you back on your feet.

But it’s a major surgery, so recovery will take time and patience. It will include rehabilitation, either in your home or in a rehab hospital, to help you recover and get the full benefit of the surgery. It’s important to ask your treating team about the risks, benefits, rehab options and any alternatives to the operation.

If you are having hip replacement or hip revision surgery, knowing exactly what you’re in for each step of the way can take some of the worry out of it. Here’s what you need to know.

Hip replacement: When a hip joint that has been damaged or worn away is replaced with a man-made joint. You might need a total hip replacement where the ball and socket are replaced, or a partial replacement which only affects the ball on the end of the thigh bone.

Hip revision: When an artificial hip joint needs to be replaced, also known as a repeat hip replacement. This may happen if the joint has become loose, infected or worn out.

Hip replacement and hip revisions are major operations, but they’re commonly performed and are generally considered safe.

Complications are rare but can include:

• an unexpected reaction to the anaesthetic
• excessive bleeding or developing a blood clot
• infection
• joint dislocation
• difference in leg length
• hip fracture
• unstable joint
• nerve damage.

Talk to your treating team to understand your level of risk.

Your doctors will give you advice on how to prepare in the weeks and months before surgery, which may include:

• seeing a physio for rehabilitation prior to surgery, commonly known as prehab. This helps you build strength and gives you a head start on your rehabilitation journey
• quitting smoking
• stopping or cutting back on some medications
• weight management.

Your treating team will let you know what you need to do the day before your surgery.

This may include:

• fasting (pausing eating and drinking before surgery)
• what to bring to hospital (such as comfortable clothes, a phone charger, toiletries and books)
• any paperwork or billing information that needs to be completed.

You may need a support person who can take you home after your surgery. Make sure to have their number in your phone or on your hospital paperwork.

While recovery times are different for everyone, you will need some help with daily tasks for a while. It’s important to ensure you have the support you need, and also to prepare your home to make life a little easier.

While every person (and every operation) is different, a total hip replacement surgery can take an hour or 2. A hip revision can be more complex because the existing artificial hip joint will need to be removed first.

A hip replacement or revision is usually performed under a general anaesthetic, meaning you won’t be awake during the surgery. You are usually given antibiotics before the surgery to help prevent infection.

You might also be asked to wear a compression stocking on the unaffected leg for the surgery to help prevent blood clots forming in your veins (deep vein thrombosis, or DVT) during the operation.

Your surgeon will make a cut over your hip and thigh to remove the damaged ball and/or socket, and replace it with a man-made joint (usually made from metal, ceramic or plastic).

When the surgery is finished, your surgeon will close the cut with stitches or clips and cover it with a dressing.

When you wake up after the operation, you’ll be given time to rest while the anaesthetic wears off. Depending on how you are feeling, you may need some pain relief.

A special pillow might be placed between your legs to avoid positions which may cause dislocation.

You can expect a visit from a physiotherapist who will guide you through exercises to help your recovery. In most cases, you’ll be encouraged to get up and walk with support as soon as possible after the operation. Your treating team might also suggest calf pump cuffs or hourly foot and ankle exercises to keep your blood flowing to prevent DVT ‘blood clots’.

It’s likely you’ll stay in hospital until you can walk safely with the aid of sticks or crutches.

You might stay up to 5 days, but if you’re fit and well you may be able to go home earlier.

Before you are discharged, make sure:

• you have any medications you need
• you’re clear on your rehabilitation exercises
• you have a date for a follow-up appointment
• all your questions have been answered.

Recovery is different for everyone, but the first 6 weeks are crucial to help build strength and start moving around, as recommended by your physio.

You might need a walking stick or crutches for a few weeks, and it may take up to 6 weeks before you can drive again, depending on which side your operation was on and the type of vehicle you drive.

By the 3-month mark, you should be back to normal activities, but it can take up to 12 months to feel the full benefit. A commitment to regular rehabilitation can make a big difference to your overall recovery.

NSW Government Health’s Patient Roadmap is a handy step-by-step guide to preparing for and recovering from surgery.

Pain Australia works towards improving the quality of life for those living with pain. Visit their website for resources and support, including their National Pain Services Directory.