Welcome to the South West London Hip Clinic

Will I have a lot of pain?

Modern anaesthetic and pain relief techniques are very advanced nowadays, and although there will be discomfort around the incision, you will be very quickly aware that your arthritis pain has gone.

Will I need a blood transfusion?

Blood transfusion is a very safe practice, but we try and avoid it if at all possible. It is unusual now to need a blood transfusion after a routine total hip replacement. You may well be given iron medication after your surgery in order to help your body make up the inevitable lost blood. In complex or long procedures we will try and salvage your own blood during the surgery and return it you via an intra-venous infusion. This is a very safe technique and avoids all of the potential problems of blood transfusions with donated blood.

When can I drive?

Usually at 6 weeks following surgery if all is going well.

When will the stitches be removed?

Between 10 and 14 days following surgery unless dissolving sutures have been inserted under the skin – in which case removal is not necessary.

How long will the scar be?

The simple answer to this is as long as it needs to be in order to perform your surgery as safely and successfully as possible. Generally the scar will be about 12-15 centimetres long.

When can I sleep on my side?

We prefer you to sleep on your back for at least the first 6 weeks to minimise the risk of dislocation. However, if you must sleep on your side we would prefer it if you sleep on the operated side, with a pillow between your legs.

What are the risks of total hip replacement?

The risks specific to total hip replacement include:

1. Dislocation. This is where the ball of the femoral component comes out of the socket. This requires patients to return to hospital to have the hip reduced back into joint again. It can lead to the need for further operative procedures in order to prevent recurrent dislocation, but this is very rare.
2. Infection. Deep infection of a hip replacement is very bad news, often requiring removal of the prosthesis. Infection can usually be eradicated and a hip replacement can usually be re-implanted, but not always. The risk of deep infection following hip replacement is approximately 1%.
3. Leg length discrepancy. After your hip replacement, your legs may not be exactly the same length, although they usually are. It is extremely rare for this to cause any significant problem.
4. Deep vein thrombosis and pulmonary embolism. These occur because small blood clots can form in the leg veins during surgery and these may get bigger afterwards. If a thrombosis in the leg breaks off and moves to the lungs, this is an embolism and can be very serious, occasionally causing death. The risk of death after hip replacement is very low, approximately 1 in 300. You will be given daily injections after surgery until discharge, as well as compression stockings for 6 weeks, to minimise the occurrence of deep vein thrombosis. If thrombosis or embolism does occur then you will need treatment with warfarin to thin your blood. This treatment would be monitored by our haematology colleagues.
5. Nerve, bone or blood vessel damage. This is exceedingly rare.
6. Long-term wear and loosening. As explained above, hip replacements do not last forever, and the rate of wear/loosening is affected by your age, weight and activity level. The Exeter hip stem has been reported to last up to 30 years in up to 95% of patients.

When can I expect to be back to normal?

We would hope you would be able to walk, free of pain and crutches by about 6 weeks and you would be completely over the procedure by 3 months. Return to work obviously depends on occupation. Return to sports will normally be at about 6 weeks for swimming/exercise bike and 3 months for other more vigorous pastimes.

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