Questions
Questions and answers
24 questions, grouped by topic. If your question is not here, call me and it will not go unanswered.
6 questions
Arthritis and diagnosis
Do I have to put up with arthritis because of my age?
No. Osteoarthritis is indeed more common with age, but there is no need to live with the pain. There are several steps of treatment, and most of them have nothing to do with surgery. Age in itself is neither an indication for surgery nor a reason against it.
Are hyaluronic acid injections effective?
In some patients injection therapy reduces pain and improves movement, especially in the early and middle stages. It is not cartilage regeneration and the effect is temporary. In the advanced stage, when the joint space has almost gone, the benefit drops sharply. The question is decided case by case.
Can I do sport with hip arthritis?
Movement is necessary and not harmful. On the contrary, inactivity makes the joint worse. What matters is the type of activity: swimming, cycling and walking on level ground are usually well tolerated, while jumping, running on hard surfaces and heavy weights increase the load. The specific regime is set after an examination.
Why does my knee hurt if the problem is in the hip?
This is referred pain. The nerve supply of the hip joint is arranged so that pain often spreads down the front of the thigh and is felt in the knee. That is exactly why an orthopaedic surgeon also examines the hip joint when a patient reports knee pain.
How quickly does osteoarthritis progress?
This is very individual. In some patients the changes barely increase over years, in others they worsen sharply within a few months. The speed is influenced by the cause, weight, the type of loading, the original geometry of the joint and other conditions. That is exactly why follow-up X-rays are scheduled at intervals.
Do both hips need to be X-rayed?
Yes. As standard, both hip joints are captured on one image, taken standing. This allows the sides to be compared and the pelvic tilt and any leg length difference to be assessed. For planning surgery this is critical.
6 questions
Treatment and the decision
Can I avoid surgery altogether?
Some patients can. It depends on the stage of the arthritis, the severity of the symptoms, age, and how consistently weight control and exercise are carried through. In the early stage conservative treatment is often enough for years. In the advanced stage, unfortunately, it gives only temporary relief.
How long should I try conservative treatment before surgery?
There is no single timeframe. What matters is not the calendar but the result: if pain and function have not improved after three or six months of properly delivered treatment, it is worth talking to an orthopaedic surgeon again. Waiting a year while nothing works brings no benefit.
Do cartilage supplements work?
Supplements containing glucosamine and chondroitin are widely used, but study results are inconsistent and cartilage regeneration has not been confirmed with them. Some patients report less pain. If you take them, tell your doctor, especially if you take other medication as well.
Will PRP therapy help?
Platelet-rich plasma therapy is less studied in the hip than in the knee, and the evidence is mixed. It does not restore cartilage. The question is considered case by case and the decision should be made with realistic expectations.
My doctor recommended surgery but I am afraid. What should I do?
Fear is natural and talking about it is part of the consultation. Two practical steps help. First, find out exactly what happens on the day of surgery and in the first weeks, because the unknown is always more frightening than the known. Second, get a second opinion. A good doctor never takes that as an insult.
Do both joints have to be operated on at the same time?
No, it is not necessary, and in most cases the joints are replaced in stages. Simultaneous bilateral surgery is considered in selected cases, but that is an individual decision and depends on general condition, age and other illnesses.
6 questions
Surgery and the anterior approach
How long does the operation take?
The procedure itself usually lasts one to two hours. Preparation and waking up are added to that, so the total time spent in the operating suite is longer. The duration depends on the state of the joint and the particulars of the anatomy.
What kind of anaesthesia is used?
Most often spinal anaesthesia, frequently together with sedation. This means the lower body has no sensation while the patient is calm and often asleep. The final choice is made by the anaesthetist after talking to you and reviewing your tests.
Can I walk through a metal detector with a hip replacement?
Yes. A hip implant may set off a metal detector at an airport. In international practice a special card is no longer required; it is enough to tell the security officer. MRI is also possible, but you must tell the radiologist about the implant in advance.
Does every patient get a bikini incision?
No. The type of incision is chosen individually according to anatomy, weight, the condition of the skin and any deformity of the joint. In selected cases a vertical incision is safer, and then that is what is done. Safety comes before cosmetics.
Why is there no drain and no dressing change?
Current evidence shows that a drain brings no benefit in most cases, while it increases discomfort and hinders early mobilisation. Modern wound closure technique and a special dressing allow the patient to get through the first days without daily dressing changes. This applies to standard cases, not to everyone.
Can I get a second opinion?
Of course. A hip replacement is elective surgery and the decision is yours. Getting a second opinion is a normal and sensible step. If you need it, I will give you my assessment and the templating in writing.
6 questions
Recovery
How long will I need crutches?
Usually for the first one to two weeks. Many patients use two crutches at first, then one, then a walking stick, and finally nothing. The transition is gradual and follows pain and stability, not the calendar.
Do I have to go to a rehabilitation centre?
In most cases no. After the anterior approach a large share of patients continue rehabilitation at home, with the exercises given on discharge. A specialised programme is considered individually, for example for an elderly patient living alone or where there are other illnesses.
Can I lie on the operated side?
Usually as soon as it becomes comfortable, often after the first two weeks. At the start many patients sleep on their back or on the healthy side with a pillow between the legs. This is a matter of comfort, not a prohibition.
Which exercises should I do?
On discharge you get a specific list for your case. The basic principle: short sessions several times a day rather than one long one. Exercise should not cause severe pain. Mild tension is normal, sharp pain is a signal to stop.
Why is my leg still swollen after a month?
Swelling is a normal reaction of the body to surgery and can continue for several weeks or even months, especially at the end of the day. Elevating the leg while resting and compression stockings help. If the swelling suddenly increases, is one-sided and painful, that is already a reason to call.
When is the first follow-up visit?
The first visit is usually two weeks after discharge, the next at six weeks, then at three months. The schedule after that is individual. You get the exact dates in writing on discharge.
Your question is not here?
Call me or fill in the booking form. At the consultation we look at your X-ray and talk about your case specifically.