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Total Hip Replacement - Posterior Approach

A total hip replacement is a surgery in which the hip joint is completely replaced by an artificial hip.

The posterior approach is when the surgeon makes a cut behind part of the upper thighbone as the patient is lying on their side. [1]

Hip replacements are commonly performed on patients who have damaged hip joints that cause pain and reduced mobility that affects their quality of life.

An artificial hip will typically last for about 15 years before it may need to be replaced again.

There are various types of artificial hip (prosthesis) that can be used.

Hip replacements can be indicated for many reasons, the most common conditions are osteoarthritis, rheumatoid arthritis or hip fractures.

The operation usually takes 1-2 hours to complete.



Why is it done?


Surgery can reduce pain and increase mobility in the joint which may lead to an improved quality of life.

A hip replacement may prevent the symptoms of pain and reduced mobility from worsening.


Will I need to do any preparation?

The patient will typically have to have a pre-operation assessment.

The assessment is done to check for any medical conditions that may complicate the surgery or affect post operation care.

The tests will commonly include blood tests, urine samples, an X-ray, infection swabs and an electrocardiogram.

The team will advise on whether there needs to be any medication changes before the surgery.

Technique

The patient is positioned so they are lying on their side so that the surgeon has access to the back of the leg.


A cut is made at the top of the leg.

One of the muscles (gluteus maximus) in the leg is cut to provide access to the joint.

The surrounding ligaments and fatty tissue are removed to expose the bone.

The socket of the joint (acetabulum) is replaced with an artificial cup.



[3]


The head of the femur (thighbone) is removed and an artificial head is inserted.


The wound is closed with stitches and dressed.




Anaesthesia

The operation is commonly performed under general anaesthetic which the patient will be asleep during the operation.

The operation can be performed using an epidural or spinal anaesthetic which only acts on the lower body.



How long does it take?

The surgery team will endeavour to get the patient home as soon as possible however a short stay in hospital after the operation is usually necessary for 3-5 days.

The team will assess you medically and give any fluids or pain relief that may be needed.

The team will assess how the new hip is functioning and advise a personalised rehabilitation plan for the following months to help recovery. This will involve a physiotherapist and an occupational therapist.

The doctor or physiotherapist will be able to advise on when it is safe to return to normal activities which can differ from patient to patient. A rough guide is 6 weeks before returning to light activities and driving.

The patient will be seen 6-12 weeks after the operation as an outpatient appointment to review how they are coping with the new hip. [5]

Post procedure follow up


The surgery team will endeavour to get the patient home as soon as possible however a short stay in hospital after the operation is usually necessary for 3-5 days.

The team will assess you medically and give any fluids or pain relief that may be needed.

The team will assess how the new hip is functioning and advise a personalised rehabilitation plan for the following months to help recovery. This will involve a physiotherapist and an occupational therapist.












What follow up care is needed?

The doctor or physiotherapist will be able to advise on when it is safe to return to normal activities which can differ from patient to patient. A rough guide is 6 weeks before returning to light activities and driving.

The patient will be seen 6-12 weeks after the operation as an outpatient appointment to review how they are coping with the new hip. [4]

 



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