Hemiarthroplasty at Exeter Hospital

As one of the largest joints in the body, your hip joint supports your upper body as you walk, stand, run, bend and stretch. Sometimes called the “ball and socket” joint, your hip joint includes a rounded head of the femur (thighbone) that fits into the acetabulum (a socket in your pelvis).

A hemiarthroplasty is a procedure used to replace the femur part of your hip joint. It is primarily used when the femur is broken - especially if the break appears near your hip joint.

What happens during hemiarthoroplasty?

A variety of anaesthetic techniques are used. Prior to your operation the anaesthetist will discuss these options with you.

During this procedure your surgeon will remove the broken head of your femur. It will be replaced with a metal stem and ball made of (ceramic or plastic) that will fit securely into your acetabulum.

The surgical approach (area where the incision or cut is made) and the length of incision will depend on your own circumstances. Your wound will be closed with stitches, staples or steri-strips.

After your hemiarthroplasty

Once your operation is over, you’ll be taken to the recovery room where you will wake from the anaesthetic. Your wound, blood pressure and pulse will be checked carefully. You will have a large dressing covering your wound. Be sure and let our Healthcare Team know if you are in any pain.

You may have a small tube coming out of your wound, this is to drain away any excess fluid from the inside of the wound. You may also have a drip (infusion) going into your arm. This will keep you hydrated until you are able to drink, and it can also be used to give you pain relief.

When you are stable and comfortable, a nurse will take you back to your room.

Back in your room

While you are in bed, you may have help with the circulation in your legs, in order to prevent blood clots (DVT). The first day or so you may wear boots on your legs that are inflated with air. You will also wear support stockings to help your circulation and may have daily injections or tablets to help prevent blood clotting which may continue for up to 6 weeks. We may encourage you to move your legs if you are able.

You may have some deep breathing exercises to do, to help prevent any chest problems after surgery. The day after surgery you will have an X-ray of your new hip to check its position.

Going home after hemiarthroplasty

A physiotherapist will give you some exercises to help get your new hip moving. These are important to help you make a good recovery. You may be using crutches or a walker.  When you are able to walk up and down stairs, you can go home. You won’t be able to drive, so you will need someone to come and take you home from the hospital, once you have been discharged.

It’s usual to return to see your consultant as an outpatient after your operation. You may also need to have stitches removed. You’ll be given information about these appointments before you go home. We’ll also give you some pain relief medication to take with you.

When you get home, will be tired and should rest. However, it’s also important to aim to gradually increase your physical activity each day, so you should continue with the exercises the physiotherapist showed you. These will help to reduce stiffness and strengthen your legs. Keep using a walker, crutches or a walking stick until you feel confident.

To help you regain mobility, it’s recommended that you take any pain relief medication we have prescribed. Continue taking this until you are pain free.

So you don’t damage your new hip and to help your wound heal, you may be asked to follow a few restrictions for the first six weeks of your recovery:

• Avoid bending your new hip beyond 90 degrees
• Avoid rolling your leg towards the other leg
• Avoid crossing your legs
• Avoid twisting on your new hip when standing
• Use the shower instead of the bath
• Keep wearing your support stockings - you may have to do so for four to six weeks.

If you have any questions or concerns about your restrictions be sure and ask a member of the Healthcare Team or the Physiotherapist.

Most people make a good recovery and return to normal activities following hemiarthroscopy. As with any surgery there can be complications:

• Pain
• Bleeding
• Infection of the surgical site (incision)
• Scarring
• Blood clots (DVT - deep vein thrombosis)
• Difficulty passing urine
• Chest infection
• Heart attack
• Stroke

Specific complications of hip revision might include:

• Split in the femur
• Nerve damage around the hip
• Damage to the blood vessels around the hip
• Infection in the hip
• Loosening of the replacement
• Bone forming in muscles around the replacement
• Dislocation
• Leg length difference
• Death (rare).