In England and Wales the NHS alone performs over 50,000 total hip replacement procedures every year with many more being carried out in the private sector. The cost of the procedure under the NHS is usually between £4,000 and £7,000. Private patients, however, can expect to pay around double this amount.
The need for hip replacement surgery
Chronic hip pain is an indicator that replacement surgery may be required. Most commonly it is caused by one of several forms of arthritis: osteoarthritis (caused by the wearing away of the hip cartilage and most common in those over 50); rheumatoid arthritis (the result of inflammation of the synovial membrane that leads to damage of the articular cartilage; and, traumatic arthritis (damage to the articular cartilage caused by injury.
Other degenerative diseases like avascular necrosis (loss of blood supply to the femur that causes it to die) and hip fractures also commonly result in the need for hip replacement surgery.
Types of implant
There are dozens of different types of artificial hip available. Most have been thoroughly reviewed by the National Institute for Health and Clinical Excellence, which recommends that only those with a proven life expectancy of at least ten years should be used.
One type that should be avoided, however, is the DePuy hip. This is a metal-on-metal system that has been found to cause elevated levels of cobalt and chromium in the blood. It has now been withdrawn from use and patients with DePuy implants should be monitored regularly.
Total hip replacement surgery involves the complete removal of the top portion of the femur. A metallic alloy stem is then inserted down into the remaining bone and cemented into place. At the top of the stem is a metal ball that fits into a plastic cup that is placed in the bone of the pelvis, replicating the natural hip joint.
Are there any risks?
All surgical procedures carry an element of risk. Hip replacement patients need to be particularly aware of the possibility of post-operative infection. This is the result of bacteria in the area of the implant. It can lead to considerable pain and requires urgent treatment. Unfortunately, however, bacteria are difficult to eliminate from implants and often the only way to halt the infection is to remove the implant.
Replacement hips should last at least ten years although in younger people who try to return to their previous vigorous activities the life of the joint is likely to be shorter. According to national Joint Registry statistics, only 2% of total replacement hips fail within five years of surgery, this figure rises to 5% for resurfacing implants.
Movement is crucial to recovery from the surgery. Physiotherapists and occupational therapists will be there to help but much depends on the patient’s own efforts. The time for full recovery varies from case to case and can take several months. It is important to take regular exercise but high impact activities should be avoided.
Hip replacement helps to restore the quality of life and improves the physical function of those prepared to undergo the surgery. The benefit for personal well-being, self confidence and independent living cannot be overstated.
My name is Matthew Morris and I’m a PR consultant at Circle UK. The hip surgery unit at Circle Partnership is renowned throughout the UK for both high level consultancy and specialist treatments.