Hip replacement and resurfacing for arthritis

Who does this affect?

Hip osteoarthritis is common in older patients from a lifetime of wear and tear of the joint. It does also occur in younger patients with 'abnormally shaped' hip joints, where there is impingement and subsequent wear of the articular cartilage lining the joint. However it may occur earlier due to abnormalities within the hip, such as a previous injury, childhood hip disease or problems with the blood supply to the hip.

Occasionally hip replacements need to be considered in certain cases of hip fracture, inflammatory arthritis (eg rheumatoid arthritis), and even cancer.

Symptoms

Commonly hip arthritis causes groin pain, often going down the thigh to the knee. The hip is stiff, and the patient walks with a limp and has poor mobility. Reduced walking distance and difficulties in foot care are common symptoms. There is sometimes a leg length difference which exaggerates the limp. Loss of independence is often a major problem, especially if the patient lives alone and is self-caring.

Investigations

X-rays of the hip are virtually always required, and provide the information needed in the majority of cases. Scans such as CT and MRI may be used in complex cases.

Non-surgical treatment

Simple measures such as painkillers, weight loss, the use of a walking aid and activity modification may be tried in the first instance.

Surgical treatment

When a patient has severe arthritis and painkillers no longer effectively control the symptoms, a form of hip joint replacement is advised. This has the benefit of relieving the pain, and allowing the patient to return to a near normal level of activity. There are different forms of hip replacement (resurfacing, metal, cemented and uncemented, ceramic, hybrid and standard) and each one has a role to play depending on the patients' age and activity level. The risks and benefits of each type are best discussed with your surgeon.

Normally the operation takes 1 to 2 hours, and involves the patients staying in hospital for 5 to 7 days.

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