Hip Replacement
Osteoarthritis is common and it affects 1 in 11 Australians. Nobody likes being in pain, as it can affect your mood, mental health, work and family life. Until it is quite severe it can be invisible to others.
Hip arthritis can be treated with pain relief, exercise and lifestyle modifications but sometimes this will not be enough to relieve pain and symptoms.
Hip replacement surgery can be an effective way of managing hip arthritis
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When a patient’s hip joint has worn cartilage to a point where the hip has become sufficiently painful, and non-surgical treatments are no longer effective, surgery to replace the worn hip can be considered. Joint replacement surgery removes the arthritic parts of the hip and replaces them with an artificial joint.
While often a successful treatment option for hip arthritis, there are several factors which need to be considered and discussed with Dr Stevens before undertaking this procedure.
Although you cannot reverse arthritis there many treatments that are extremely effective and can help manage the condition. These range from minimally invasive treatments to joint replacement surgeries, including:
- Painkillers
- Alternative therapies,
- Physiotherapy Weight loss
- Joint injections
- Hip replacement surgery
If you already have an artificial hip replacement and surgery is required to replace or revise the joint, this is called revision hip replacement. Dr Stevens has expertise in the field of revision hip replacements and has also published research on how to remove the old replacement while preserving bone for the new one. Dr Stevens has undertaken subspecialty training in revision hip replacements through the Royal College of Surgeons Edinburgh at the Royal Infirmary of Edinburgh Hospital (NHS).
Surgical Fact sheets
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Hip Replacement
Arthritis of the hip is common in Australia. It is usually as a result of the aging process and ‘wear and tear’. If your hip is causing significant problems in your day-to-day life you may be suffering from a condition which could be helped with hip replacement surgery. Dr Jarrad Stevens is a fellowship trained hip replacement surgeon in Melbourne who regularly assess patients for hip conditions and can recommend hip surgery when required.
Hip arthritis causes significant problems for many people. Hip joint replacement is a good surgical solution for people who cannot find relief for their arthritis by using other treatments.
Dr Stevens will look at x-rays of your hips and pelvis to determine the amount and site of arthritis. MRI and CT scan are sometimes used to assess the arthritis in hips to determine if hip surgery is advisable. These scans can also help in the planning of difficult hip replacements.
Most people will try ways to help their arthritic hip ‘get by’. When physiotherapy, pain relief medications, weight loss and other alternative treatments are no longer working, specialist hip replacement may be able to help. It is normally advised that people try ways of dealing with their arthritis before contemplating surgery. Although hip replacement surgery is often used to treat arthritis of the hip, there are other treatments that the team at Victorian Bone and Joint Specialists can help you with.
If you and Dr Stevens decide that surgery is the best option for your arthritic hip, Dr Stevens will organise for a review by a specialist physician to make sure surgery will be as safe as possible. Blood test, a heart trace as well as other investigations maybe organised.
What to Expect after Surgery:
Once you have had your hip replacement, you may be able to begin to move the hip, ankle and knee under the instruction of Dr Stevens. Hospital physiotherapists will aim to safely have you mobilising after your surgery. This is important for your hip and general health.
A dressing will be placed over the hip following surgery. As the tissue and bone heal, a small amount of blood may appear on the dressings. This is normal. Sometimes, replacing the bandage is required to reinforce any areas that continue to bleed.
Elevate the leg for the first few days following surgery. You may be placed on blood thinning medications such as aspirin to help reduce the risk of clots.
Discharge home: After your surgery you will stay in hospital overnight and potentially for a few days. You will be discharged with pain relief tablets. If you need longer to safely walk, rehabilitation can be organised.
Pain relief: After surgery it is normal to have some pain or discomfort. The amount of surgery you have had will influence how much pain you can expect and how long you will need pain relief for. You will be given pain relief tablets to take home with you when you leave the hospital. Take these over the next week or so as you need.
Looking after the Dressing: You will need to keep the dressing clean and dry for two weeks.
Movement after surgery: You can move your foot, ankle, knee and hip straight away after surgery. Your hip will slowly be able to bend in the days that follow your operation. You may experience some pain in the weeks following surgery. You will need crutches or a frame to walk after surgery.
It is a good idea to keep moving even after your surgery, it helps your blood circulation and stops your body getting too weak. Avoid any strenuous activity for the first 2 weeks, but gentle movement and walking with your crutches is advised.
Wound review: After 2 weeks you will have an appointment with Dr Stevens to have your wound checked, any stitches will be removed. Dr Stevens will then give you advice on exercises and physiotherapy.
Driving: You cannot drive until you have had your first review appointment with Dr Stevens. He will give you an indication then when you are likely to be able to drive again
Returning to work: This depends on the type of work you do. Most surgeries will need 4-6 weeks off work, some will require longer, especially if you have a manual job.
A hip replacement operation is major surgery. Despite excellent results there are risks associated with this procedure. Fracture, dislocation, infection and damage to nerve or blood vessels are some of the more significant risks. Dr Stevens will discuss with you the risks of surgery.
+ Fever
+ Heavy bleeding or ooze from the wound
+ Increased swelling and redness around the surgery site
+ Pain in the calf muscles or difficulty breathing
If you have any of these problems, please call Dr Stevens or his rooms on 03 5752 5020
Revision Hip Replacement
Dr Jarrad Stevens is a fellowship trained hip replacement surgeon in Melbourne who regularly assess patients for hip conditions and can recommend hip surgery when required. Revision hip replacement surgery is a special interest of Dr Stevens.
In 2019, Dr Stevens was awarded the University of Edinburgh University medal for research into revision joint replacement surgery. This type of surgery is complex and often requires significant planning to ensure the best outcome.
If you have a problematic hip replacement it may require revision surgery (surgery to replace parts of the artificial hip). For this surgery to be successful a cause for the original hip replacement problem must be found.
Dr Stevens will look at x-rays and scans of your hip replacement to determine the position and look for any signs of loosening. CT scans are sometimes used to assess the alignment and size of the hip replacement to see if this is causing any issues. Bone scans may be organised to check for infection or loosening of your hip replacement.
If no cause for your problematic hip replacement can be found, surgery is unlikely to be successful and may not be offered.
When physiotherapy, pain relief medications, weight loss and other alternative treatments are no longer working, are other options can be considered.
If surgery is required to revise the hip replacement then specialist planning imaging (CT scans and X-rays) will be organised. Surgery to remove the old hip replacement and place in a new hip replacement will be performed. The results of this type of surgery are typically good.
If you and Dr Stevens decide that surgery is the best option for your problematic hip replacement, Dr Stevens will organise for a review by a specialist physician to make sure surgery will be as safe as possible. Blood test, a heart trace as well as other investigations maybe organised.
In general, patients who have hip replacement surgery have relief from their symptoms of arthritis and good movement of the hip. Sometimes there are issues with the hip replacement – these issues are not always able to be fixed with further surgery.
Ongoing pain, stiffness, dislocation and dissatisfaction may result from revision hip replacement surgery – despite a good technical outcome.
Each person will recover from hip surgery in a different way. Some people will have little symptoms and good movement soon after surgery. Other patients may take longer for the hip to function at its best. This is due to many factors. Age, the type of hip replacement, the reason for the revision hip replacement, general health and other genetic conditions will all play a role.
Revision surgeries are considered more complex and harder to recover from then the first hip replacement.
What to Expect after Surgery:
Once you have had your revision hip replacement, you may be able to begin to move the hip, ankle and knee under the instruction of Dr Stevens. Hospital physiotherapists will aim to safely have you mobilising after your surgery. This is important for your hip and general health.
A dressing will be placed over the hip following surgery. As the tissue and bone heal, a small amount of blood may appear on the dressings. This is normal. Sometimes, replacing the bandage is required to reinforce any areas that continue to bleed. Sometimes a drain to collect excess fluid will be placed into your hip at the time of surgery – this is normally removed after 2 days. You may be placed on blood thinning medications such as aspirin to help reduce the risk of clots. Special vacuum dressings can help seal the wound as it heals.
Discharge home: After your surgery you will stay in hospital for several days. You will be discharged with pain relief tablets. If you need longer to safely walk, rehabilitation can be organised.
Pain relief: After surgery it is normal to have some pain or discomfort. The amount of surgery you have had will influence how much pain you can expect and how long you will need pain relief for. You will be given pain relief tablets to take home with you when you leave the hospital. Take these over the next week or so as you need.
Looking after the Dressing: You will need to keep the dressing clean and dry for two weeks.
Movement after surgery: You can move your foot, ankle, knee and hip straight away after surgery. Your hip will slowly be able to bend in the days that follow your operation. You may experience some pain in the weeks following surgery. You will need crutches or a frame to walk after surgery. It is a good idea to keep moving even after your surgery, it helps your blood circulation and stops your body getting too weak. Avoid any strenuous activity for the first 2 weeks, but gentle movement and walking with your crutches is advised.
Wound review: After 2 weeks you will have an appointment with Dr Stevens to have your wound checked, any stitches will be removed. Dr Stevens will then give you advice on exercises and physiotherapy.
Driving: You cannot drive until you have had your first review appointment with Dr Stevens. He will give you an indication then when you are likely to be able to drive again
Returning to work: This depends on the type of work you do. Most surgeries will need 6 weeks off work, some will require longer, especially if you have a manual job.
A revision hip replacement operation is major surgery. Despite good results there are risks associated with this procedure. Fracture, dislocation, infection and damage to nerve or blood vessels are some of the more significant risks. Dr Stevens will discuss with you the risks of surgery.
+ Fever
+ Heavy bleeding or ooze from the wound
+ Increased swelling and redness around the surgery site
+ Pain in the calf muscles or difficulty breathing
If you have any of these problems, please call Dr Stevens or his rooms on 03 5752 5020
Hip Injection
If your hip is painful and causing significant problems in your day to day life you may be suffering from arthritis. Dr Stevens regularly assess patients for hip conditions and can recommend hip surgery when required. Sometimes it can be difficult to know how many of your symptoms are coming from the arthritis, especially if you have back pain, knee pain or pain which is not typical for arthritis.
An injection of local anaesthesia and corticosteroid into the hip can help.
Injections can aid in both diagnosing and treating hip pain.
Dr Stevens can inject medications directly into the hip joint to help you with your symptoms.
A procedure performed in theatre using an x-ray machine helps to locate the perfect area to place the corticosteroid. You will have sedation so that you feel comfortable during the injection.
Most people will try ways to help their painful hip ‘get by’. When physiotherapy, pain relief medications, weight loss and other alternative treatments are no longer working, specialist hip replacement surgeons may be able to help. It normally advised that people try ways of dealing with their arthritis before contemplating injections or surgery. Although hip replacement surgery is often used to treat arthritis of the hip, there are other treatments that Dr Stevens Specialists can help you with including hip injections.
What to Expect after your Procedure:
Once you have had your hip injection, you may be able to begin to move the hip, ankle and knee under the instruction of Dr Stevens. Hospital physiotherapists will aim to safely have you mobilising after your surgery. This is important for your hip and general health.
A dressing will be placed over the injection site.
Discharge home: After your procedure you will stay in recovery until you can sit up and safely begin to move around. When you are comfortable you can be discharged home with pain relief tablets.
Pain relief: After injection it is normal to have a small amount of pain or discomfort. You will be given pain relief tablets to take home with you when you leave the hospital. Take these over the next two to three days as you need. You mind find the hip feels good for the first 12-24 hours before the normal hip symptoms return. This is normal. The steroid will take up to a week to begin to work.
It is a good idea to keep moving even after your surgery, it helps your blood circulation and stops your body getting too weak. Avoid any strenuous activity for the first 2 weeks, but gentle movement and walking is advised.
Review: After 2 weeks you will have an appointment with Dr Stevens to have your injection site checked. Dr Stevens will then give you advice on exercises and physiotherapy.
Driving: You can drive the day after your injection if your hip feels strong enough.
Returning to work: This depends on the type of work you do. Most injections need 1-2 days off work.
A hip replacement operation is major surgery. Despite excellent results there are risks associated with this procedure. Fracture, dislocation, infection and damage to nerve or blood vessels are some of the more significant risks. Dr Stevens will discuss with you the risks of surgery.
+ Fever
+ Heavy bleeding or ooze from the wound
+ Increased swelling and redness around the injection site
+ Pain in the calf muscles or difficulty breathing
If you have any of these problems, please call Dr Stevens or his rooms on 03 5752 5020