Hip

Dr Matthew Broadhead has a subspecialty interest and training in treating hip pain. He will ensure that all conservative options are considered prior to surgery using an evidence-based approach. He has experience in hip surgery for traumatic, inflammatory and degenerative conditions of the hip, with additional Fellowship training in direct anterior approach hip replacement, complex primary hip replacement and revision hip replacement surgery. 

When do I need a hip replacement?

Hip replacement surgery is typically recommended for people who have severe hip arthritis and have not had relief from less invasive treatments, such as medications, physical therapy, or assistive devices. The goal of hip replacement surgery is to reduce pain and improve mobility and function in the hip joint. Dr Broadhead may recommend hip replacement surgery if you have:

• Severe pain in the hip joint that interferes with daily activities, such as walking or standing
• Limited range of motion in the hip joint
• Difficulty standing up from a seated position or climbing stairs
• Swelling or tenderness around the hip joint
• A limp or change in the way you walk

Dr Broadhead will consider a number of factors when deciding whether or not to recommend hip replacement surgery, including your age, overall health, and level of physical activity. It is important to discuss all treatment options to determine the best course of action for your specific situation.

How is a hip replacement performed?

Hip replacement surgery is a procedure in which the damaged ball-and-socket joint of the hip is replaced with a prosthetic implant. The surgery is typically performed under spinal and/or general anesthesia, meaning the patient is unconscious during the procedure.

There are two main approaches, used by Dr Broadhead, for hip replacement surgery: the posterior approach and the direct anterior approach. The appropriate approach for a given patient will depend on the individual’s specific medical need. During the surgery, an incision is made in the skin over the hip joint and then the damaged ball-and-socket joint is removed. The bone surfaces of the pelvis and femur (thigh bone) are then prepared to receive the prosthetic implants, which may be made of metal, ceramic, or plastic. Once the implants are in place, the incision will be closed with sutures and a dressing applied to the wound. The patient will then be taken to the recovery room to wake up from the anesthesia.

What are the differences between posterior and direct anterior approach hip replacement surgery?

There are two main approaches, used by Dr Broadhead, for hip replacement surgery: the posterior approach and the direct anterior approach.

The posterior approach involves making an incision on the back of the hip and involves splitting and detaching some of the muscles from the bone in order to access the hip joint. The surgeon then removes the damaged ball-and-socket joint and replaces it with a prosthetic implant. 

The direct anterior approach involves making an incision on the front of the hip and does not require detachment of the gluteal muscles. This approach has gained popularity in recent years because it may result in a faster recovery time and less pain after surgery, although the evidence for these benefits is mixed.

Both approaches have their own advantages and disadvantages, and the appropriate approach for a given patient will depend on the individual’s specific medical needs. It is important for patients to discuss the options and to make an informed decision about the best approach for their individual circumstances.

What is a hip replacement made of?

There are several different types of implants that can be used in a hip replacement, and they are typically made of materials that are durable, biocompatible (able to be tolerated by the body), and resistant to wear and tear. The main types of materials used in hip replacement implants are:

• Metal: Many hip replacement implants use metal alloys, such as cobalt-chromium or titanium, for the ball and socket components. These materials are strong and durable, and can withstand the forces placed on the hip joint during movement.
• Plastic: Some hip replacement implants use plastic or polyethylene for the socket component. This material is smooth and wear-resistant, and helps to reduce friction between the ball and socket.
• Ceramic: Ceramic materials, such as zirconia or alumina, can also be used in hip replacement implants. These materials are hard, smooth, and wear-resistant, and may be used for the ball or socket component.

Dr Broadhead will discuss the different implant options with you and help you choose the best one for your needs.

How long does a hip replacement last for?

The lifespan of a hip replacement can vary depending on a number of factors, including the type of implant used, the patient’s age and activity level, and the presence of any underlying health conditions. In general, hip replacements can last for many years, and many people are able to return to their normal activities after surgery. According to the National Institutes of Health (NIH), most hip replacements last for 15-20 years or more. In 2023, the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) reported that the cumulative percent revision rate, for conventional total hip replacement performed for hip osteoarthritis, was 8.1% at 20 years.

What are the risks of hip replacement surgery?

Like any surgery, hip replacement surgery carries some risks. Some possible complications of hip replacement surgery include:

• Infection: There is a risk of infection after hip replacement surgery. This can be treated with antibiotics, but may require additional surgery to clean the wound and remove the implant.
• Blood clots: There is a risk of blood clots forming in the leg or lung after hip replacement surgery. These can be treated with blood thinners.
• Dislocation: The artificial hip joint may become dislocated after surgery, which can cause pain and limit mobility.
• Loosening: Over time, the artificial hip joint may become loose and may require revision surgery to tighten or replace the implant.
• Fracture: There is a risk of the thigh bone or pelvis breaking during or after hip replacement surgery.
• Nerve or artery damage: There is a risk of damage to the nerves or arteries around the hip during surgery.
• Allergic reaction: There is a risk of an allergic reaction to the materials used in the artificial hip joint.
• Implant failure: There is a risk that the artificial hip joint may fail, either due to wear and tear or a manufacturing defect. Dr Broadhead will discuss the risks of hip replacement surgery with you and will work with you to minimize the risk of complications.