What is a Total Hip Replacement? Total Hip Replacements (THR) or Total Hip Arthroplasty (THA) are surgeries where damaged bone and cartilage connecting your lower limb to your torso is replaced with prosthetic components. Each year there are over 1 million total hip replacements performed globally; the prosthetics can routinely last up to 30 years. Osteoarthritis is one of the main indications for undoing this surgery and is responsible for 90% of cases. In the following article, we will discuss the processes of the surgery and the importance of physiotherapy both in preparation before and in the recovery period.
What should I expect with the suregry? THRs’ have three main surgical approaches, these are Posterior Approach (PA), Direct Anterior (DA) and Direct Lateral (Hardinge/Trans-gluteal). Posterior approaches are the most performed approaches due to its ability to avoid the hip adductor muscles, an incision is made alone the outside of the leg while the patient is lying on their back. Direct anterior is an approach which the patient lying on their back with an incision made down the front of their thigh, positives of this approach include a reduced chance for dislocation as well as shorter recovery times. Lastly the direct laterally approach is when the patient is lying on their side and an incision is made down the outside of their thigh. With each individual and their specific cases their responsible orthopaedic surgeon will assess which approach is needed. When undergoing a THR the ball and socket of the joint are altered, with the ball aspect being attached to the femur and the socket being attached to the pelvis. There are several options for the materials used in a THR, those include Metal-on-polyethylene, Ceramic-on-polyethylene, Ceramic-on-ceramic, Metal-on-metal.
How can I prepare for it? Before undergoing a THR it is important to partake in pre-operative physiotherapy to reduce the recovery time needed following the surgery, it also allows for the prospective patient to ready themselves for the surgery both physically and mentally by addressing any questions that may arise. With this a recovery can, be made easier by familiarising oneself with the exercises and the expectations following surgery.
What will happen after the surgery? Following the operation, a goal of returning to activities of daily life is paramount. This is completed through improving strength, mobility, flexibility and pain reduction. Usually after three days you wil be discharged from hospital although depending on each individual. During these three days the patient will be made aware (if not already) of transfer techniques such as how to get in and out of bed and chairs. In the first four weeks crutches will be used to reduced weight bearing but will be temporary while healing occurs, overall, a total hip replacement yields reliable results in making the quality of life better in those who undergo the surgery and physiotherapy is paramount in the process. During the months following physiotherapy will help you get the most out of your new hip!!
