It is very common, in the everyday work of the practice, for the orthopaedic surgeon to be asked to answer a series of patient questions about the operation of total hip arthroplasty. Many of these arise from certain "myths" that circulate on the internet, or from certain human fears about the operation on the patient's part. Below, Dr Tzaveas answers such common questions, which apply to most patients with hip osteoarthritis.
1. What is total hip arthroplasty? In total hip arthroplasty the hip is replaced, that is, an artificial joint is fitted. The result is that the pain disappears completely and the mobility of the hip returns to normal.
2. How successful is total hip arthroplasty? Studies have shown that more than 97% of patients who have undergone such an operation were very satisfied with the result.
3. Is the patient in pain during the hospital stay and afterwards? In most cases patients feel no pain at all, or occasionally very little pain, in the first hours and days after the operation. In the weeks that follow the pain is almost nil.
4. Is there a “bloodless” and “painless” technique for such an operation? As a surgical operation it cannot under any circumstances be painless and bloodless, since artificial materials have to be introduced into the body. However, as written above, the pain has now been minimised and is usually nil for the patient, while with the new techniques blood loss is usually very small.
5. When can I walk after the operation? The patient gets out of bed on the same day. The next day they take their first steps, and usually on the second day they are able to go up and down stairs. They can go to the toilet independently, without help.
6. When can I drive? It is generally recommended that driving begin a few weeks after the operation, not only for medical but also for legal reasons (e.g. involvement in a road traffic accident).
7. When can I return to work? For someone in office work, the return can be after 3 to 6 weeks. For manual work, the return is individualised according to the patient and the particular conditions of their job, but it is generally recommended that it be after 3 months.
8. How many days do I need to stay in hospital? The stay depends on the age of the patient and on any other medical problems that are present. In general terms, however, the hospital stay is 2 to 4 days.
9. Are muscles cut during the operation? The muscles are not cut but separated, and at the end of the operation they are returned to their original position. That is why the patient is able to stand and walk immediately after the operation.
10. Do I need to go to a rehabilitation centre after hospital? This is rarely necessary, especially in younger patients. In the case of elderly patients, however, or where there is no family support, it is preferable to stay in a rehabilitation centre for a few weeks.
11. Are there risks and complications from this operation? As with all surgical operations in medicine, there is always the possibility of some complications. Their rate is now very low, however, and ranges around 1 to 1.5%.
12. How long will the implants last in my body? Recent studies have shown that the overwhelming majority of patients, about 95 in 100, will keep these implants for 10 years. For some of the materials we use, studies have shown survival of up to 90% at 30 years. An average patient can therefore expect to keep their implants for 15 to 25 years.
13. Can I take part in sport after the operation? Patients can usually do everything. Non-impact exercise is generally recommended, however (e.g. avoiding basketball and football), together with less demanding activities (e.g. doubles tennis, cycling, dancing).
14. When can I resume sexual activity after the operation? It is recommended after a period of about 3 to 6 weeks, depending on the patient, and with care over position. After 3 months in particular, however, a person can return to normal sexual activity.
15. If I have osteoarthritis in both hips, what is the best strategy? Can I have them both operated on together? It is generally recommended that one hip be done at a time, and that the other side be operated on after 3 to 6 months. Both are rarely done together, because the patient's position after the operation is very difficult. After the first operation, however, the patient will notice that the operated side is longer than the other, since lengthening is almost unavoidable. This difference in leg length is usually not great, and is of course corrected when the other hip is operated on.
16. Does the above information apply to all patients? The information above gives a general idea of the total hip arthroplasty operation. However, as every patient is a unique case, you should discuss with your orthopaedic surgeon the particular conditions and risks that apply to you. Make an appointment with Dr Tzaveas in order to discuss all the particular features of your own case.