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Forum Name: Joint surgery

Question: Hip Replacement Surgery


 bgio - Thu Dec 09, 2004 7:57 pm

My father has seriously bad hips and his doctor has recommended hip replacement surgery for both sides. He is fairly reticent about it as my sister's wedding is in 9 months and he would like to be able to dance with her on that day. His fear is that if he has the surgery now, he won't be healed enough to dance with her. The pain has really effected his life from no longer taking walks and needing a cart to play golf to keeping him awake at night.

I would like an opinion on time-line, renowned replacement specialists, and pros/cons to doing one at a time or both at the same time.

I really want him to be able to dance with my sister at her wedding and at the rate his mobility is deteriorating, it is an unknown right now.

Any and all time you give this is much appreciated.
 Dr. A. Saif - Fri Dec 10, 2004 4:00 pm

User avatar Dear bgio,

I am sorry to hear about your dad. However Hip arthroplasty is generally a successful operation and quite effective in improving the mobility of the VAST majority of people who have the surgery.

Timescale
The timescale is variable...but generally for a single joint replacement the duration of stay for conventionally is around 5 days to a week, depending on preoperative physical condition. It is usually around 6 weeks before being able to completely mobilise un aided. "Minimal access" surgeons claim that the time to discharge from hospital is quicker, and the time to mobility is also greater. In the UK of course the wait to get to the top of the list for surgery is quite long (around 9 months to a year) that the time to recovery is not too bad. However in the US presumably things are quicker and provided everything goes ok I should imaginethe only thingdetermining his recovery is his preoperative physical state(If he is still playing golf then I would imagine his general condition is otherwise quite good). Having both hips done together may take longer to recover from but possibly overall (combined) time for recovery may be less.

Bilateral Hip Replacements
Hip arthroplasty is major surgery, with potential for significant morbidity( blood loss, clots, chest problems, fracture, nerve injuries etc). Most surgeons in the UK do not recommend doing both in one sitting, although some may allow the operations to be separated by a week, and both operations are done on the same visit to the hospital. It takes a while to get over the trauma and the anaesthetic, and potentially one may be doubling these causes of morbidity in attempting to do a second operation before allowing recovery form the first. It is matter of surgeon's choice and while I myself do not do bilateral hip arthroplasties simultaneously, I have colleagues who would do so in selected cases.

The complications of hip arthroplasty are rare, and occur on avergae in around 3-5% some I have already alluded to. The choice as to the timetable for surgery is a matter for discussion with the surgeon and the patient concerned, I guess and there really is no right or wrong answer. Usually the disease is more advanced in one hip than the other. If this is the case, then doing the worst hip first may give a sufficient boost to his mobility to allow a decent slow step with your sister, and the other could be done later...perhaps.

It is difficult to recommend one method over the other, without knowing the current mobility state, response to conservative measures such as anti-inflamatories, and also his own anxieties over the subject.

As for which surgeons to recommend.... most accredited surgeons can handle hip arthroplatsies, it is bread and butter for us. Personally, being based in the UK, I don't know any specialist across the pond as it were...over here one could recommend Sarah Muirhead-Allwood at the Royal National Orthopaedic...she did the Queen Mother's hips...

Hope this helps

Saif
 patrizia - Tue Sep 27, 2005 8:26 am

I am 46 years old and was diagnosised with AVN bilateral due to a quad accident in 1985.
My left hip was 4cm X 6cm, the right was 1cm X 1.1cm. My Dr. did a core decompression on the left and a bone graft on the right.
After 4 months the right leg got worse and I ended up with a total hip replacement. Now the left leg is 1.5 inches longer. Is there anything I can do to correct this problem other than a lift in my shoe? I am also concerned about developing back problems.
Is this normal???
Thank you for your time.

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