Hip prosthesis operations at Swiss Medical Network

Hip prosthesis

The use of an artificial hip joint is one of the most frequently performed orthopaedic procedures in Switzerland. A prosthesis is considered particularly in cases of advanced osteoarthritis when conservative treatments no longer lead to the desired results.

Anyone who decides to have a hip prosthesis usually has a long ordeal behind them. The aim of the artificial joint is to enable you to cope with everyday life again. Pain is alleviated and physical function is improved.

Quick facts  

  • Use: A hip prosthesis is used in particular for advanced osteoarthritis when conservative therapies no longer lead to the desired success.

  • Hospitalisation: After the insertion of an artificial hip joint, you will spend an average of 2-5 days in the hospital.

  • Aftercare: Movement is at the centre of aftercare. You will be mobilised again just a few hours after the operation. You will be dependent on walking sticks for balance and safety for approx. 4-6 weeks.

Reasons for a prosthesis

A hip prosthesis is used when the hip joint is so severely damaged or worn that conservative treatment can no longer be carried out. Severe wear and tear of the hip joint results from degenerative changes, diseases or injuries to the joint.

Osteoarthritis refers to the wear and tear of the joint cartilage and is the most common reason why a prosthesis has to be considered. As a rule, there are various influences that lead to wear and tear, such as old injuries to the joint, infections or the natural ageing process. At an early stage, osteoarthritis mainly leads to joint inflammation, while mechanical problems can occur later on due to cartilage reduction.

Osteoarthritis is accompanied by joint pain, which often occurs in the groin, side or buttocks and often radiates to the lower back and legs.

Causes of osteoarthritis, Swiss Medical Network

Causes of osteoarthritis

  • The natural ageing process
  • Accidents
  • Congenital misalignments
  • Overweight
  • Inflammation (e.g. rheumatism)
  • Metabolic diseases
  • Sports that cause stress to the joints

Hip osteoarthritis is irreversible, but its progression can be successfully slowed down with conservative measures.  At an early stage, conservative methods such as GLA:D, a joint-friendly lifestyle, sufficient exercise and further physiotherapy are the treatment of choice. Conservative non-surgical therapies include physiotherapy, but also infiltration therapies with corticosteroids, autologous conditioned blood plasma or hyaluronic acid.

A hip prosthesis is therefore only considered if other therapies no longer lead to the desired success and the quality of life is severely restricted.

Diagnosis

Various clinical pictures can lead to hip joint pain, including rheumatic diseases and inflammation, a slipped disc, osteoarthritis of the small vertebral joints or the sacroiliac joint. Hip joint pain should therefore always be distinguished from other differential diagnoses.

The insertion of an artificial hip joint is therefore preceded by extensive examinations. However, whether a hip prosthesis is ultimately required depends not only on the stage of the disease, but above all on the level of suffering of the person affected. The aim is to improve the quality of life again with a prosthesis.

Surgical procedure

With surgical treatment, an operation is carried out to remove the diseased femoral head and parts of the femoral neck.

The natural hip socket is then prepared so that a new artificial hip socket can be anchored to it. The prosthetic head is then attached to an artificial shaft and the artificial hip joint is constructed.

Thanks to the advanced method of keyhole surgery, which helps to preserve the tissue, the stabilising hip muscles are only pushed to the side, rather than being severed as they were before. In this minimally invasive procedure, the artificial hip joint is introduced from the front. An incision of about eight centimetres is made in the skin, through which the artificial hip joint is inserted without injuring the tissue.

The hip operation takes up to two hours and the hospital stay is around two to five days.

What happens during a hip prosthesis operation?

  1. Exposure of the hip joint: Minimally invasive procedure in which the affected hip joint is exposed without damaging the tissue, and the joint capsule is removed.
  2. Removal of the femoral head: A saw is used to separate the worn femoral head and femoral neck from the femur itself.
  3. Preparation and replacement of the hip socket: The surgeon begins reconstructing the hip using the new artificial hip joint. The hip socket is prepared and the old capsule and cartilage tissue are removed from the socket. Then the new hip socket and the corresponding inlay (cartilage replacement) are inserted.
  4. Preparation of the femur and insertion of the shaft: The hollow interior of the femur (marrow cavity) is prepared. Trial hip repositioning – the stability of the hip is tested using trial components. If stability is guaranteed, the new hip prosthesis is used. If the quality of the bone means that the it cannot be anchored without cement, then the prosthesis is cemented in place.
  5. Repositioning of the new artificial hip: The artificial hip joint is repositioned and the flexible connection between the shaft and socket is restored.

Aftercare

After the operation, you will stay in hospital for between two and five days. It is important that you are not bedridden after an operation, as immobilisation can lead to post-operative complications such as an increased risk of thrombosis. For this reason, early mobilisation is carried out so that you are back on your feet just a few hours after the operation. In the days that follow, you will learn how to walk and climb stairs safely.

After leaving the clinic, you continue your physiotherapy consistently. An inpatient rehabilitation or spa stay is only necessary in very few cases. You will be dependent on walking sticks. These are primarily used as a balance aid and for safety.

In the first 3-4 months after the operation, the focus is on restoring joint function, building up muscles and increasing mobility. A definitive healing result can be expected after approx. 1 year.

hip prosthesis, swiss medical network

Timeline of rehabilitation

  • 2 weeks after the procedure: stitches removed by your GP

  • 4-6 weeks after the procedure: Follow-up appointment (with X-ray) with the surgeon. Further follow-up appointments will be given to you at this consultation.
  • Regular physiotherapy: Continue to exercise regularly and go to physiotherapy. The aim is to improve mobility, stability, strength and endurance and to reduce swelling. The duration of physiotherapy treatment will be agreed with your surgeon.

What to expect in the first few days after surgery

Swelling

The swelling may increase over the next few days and extend to the whole leg. It usually subsides within 2-3 weeks. The swelling can restrict mobility in the joint.

  • Cool the affected area.
  • Continue to move and do the exercises you have been given by your physiotherapist.
  • Raise your legs regularly

Pain

Take your medication as prescribed. Adequate medication will help you to be mobile and perform the exercises. This is very important for the healing process. Medication should be reduced gradually.

Haematoma

A haematoma may form in the operated area after the procedure. The haematoma may also develop or increase in size after the operation. It may take 2-4 weeks for the haematoma to subside completely.

Bandage

Keep the surgical suture clean and dry. The dressing can be left in place until the suture material is removed, provided it holds and is dry.  If the dressing becomes wet or comes loose, you can apply a new plaster.

Exercise

Follow the instructions received from your doctor. Carry out the exercises shown to you by your physiotherapist. Exercise regularly, but in moderation.

Signs of thrombosis

  • Swelling (leg, lower leg, ankle, arm)
  • Feeling of tension/pain in the extremities
  • Overheating of the affected extremity
  • Discolouration of the skin
  • Shortness of breath (may indicate a pulmonary embolism)

Contact your doctor/emergency service.

FAQs

How long does a prosthesis last?

According to the latest studies, the average lifespan of a prosthesis is 20 years. In the event of infection or loosening, an earlier prosthesis replacement or revision surgery may be necessary. However, younger and very active patients may have a shorter lifespan due to increased wear and tear.

Can I do sport (again) with a hip prosthesis?

In principle, there are no restrictions. Which sports are suitable for you depends on your overall personal situation and your general condition. However, sports with an increased risk of falling should be avoided if possible. Your surgeon will advise you on your options.

How long will I be unable to work?

If you have a sedentary job you will be unable to work for approx. 4-6 weeks, for jobs with medium to heavy strain between 3-4 months.

When can I start driving again?

Approximately 6 weeks after the operation. If you have had surgery on your left hip and have an automatic car, you can resume driving earlier if you are fit to drive. However, please note that your muscles must be sufficiently trained for this.

Services for patients living outside Switzerland

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Doctors with this specialisation

PD Dr med Stefan Rahm

Specialisation
Orthopaedic surgery, Hip surgery, Hip osteoarthritis, Hip impingement, Hip prosthesis View more

Dr. med. Daniel Wüst

Specialisation
Orthopaedic surgery, Hip surgery, Hip osteoarthritis, Hip prosthesis, Knee pain and knee surgery, Osteoarthritis of the knee, Knee arthroscopy, Knee prosthesis, Cartilage damage, Cruciate ligament tear, Meniscus tear, Foot/ankle surgery, Achilles tendon rupture, Heel pain, Hallux valgus, Morton’s neuroma, Osteoarthritis of the ankle View more

Dr. med. Matthias Hendrik Schmied

Specialisation
Orthopaedic surgery, Hip surgery, Hip osteoarthritis, Hip impingement, Hip prosthesis, Knee pain and knee surgery, Osteoarthritis of the knee, Knee arthroscopy, Knee prosthesis, Cartilage damage, Cruciate ligament tear, Meniscus tear View more

Dr. med. Alexa Schmied-Steinbach

Specialisation
Orthopaedic surgery, Shoulder surgery, Hip surgery, Frozen shoulder, Hip osteoarthritis, Hip impingement, Hip prosthesis, Calcific tendonitis of the shoulder, Osteoarthritis of the shoulder joint, Shoulder impingement, Shoulder dislocation, Shoulder prosthesis View more

PD Dr med Fabian von Knoch

Specialisation
Orthopaedic surgery, Hip surgery, Hip osteoarthritis, Hip impingement, Hip prosthesis, Knee pain and knee surgery, Osteoarthritis of the knee, Knee arthroscopy, Knee prosthesis, Cartilage damage, Cruciate ligament tear, Meniscus tear View more

PD Dr med Florian Naal

Specialisation
Orthopaedic surgery, Hip surgery, Knee pain and knee surgery, Hip prosthesis, Osteoarthritis of the knee, Knee arthroscopy, Knee prosthesis, Cartilage damage, Cruciate ligament tear, Meniscus tear View more

Dr. med. Stephan Plaschy

Specialisation
Orthopaedic surgery, Hip surgery, Hip osteoarthritis, Hip impingement, Hip prosthesis, Knee pain and knee surgery, Osteoarthritis of the knee, Knee arthroscopy, Knee prosthesis, Cartilage damage, Cruciate ligament tear, Meniscus tear View more

Prof. Dr. med. Christoph Erggelet

Specialisation
Orthopaedic surgery, Hip surgery, Hip osteoarthritis, Hip impingement, Hip prosthesis, Knee pain and knee surgery, Osteoarthritis of the knee, Knee arthroscopy, Knee prosthesis, Cartilage damage, Cruciate ligament tear, Meniscus tear View more

Dr. med. Dirk Markus Lehnen

Specialisation
Orthopaedic surgery, Sports medicine, Knee pain and knee surgery, Hip surgery, Foot/ankle surgery, Osteoarthritis of the knee, Knee arthroscopy, Knee prosthesis, Hip osteoarthritis, Hip impingement, Hip prosthesis, Achilles tendon rupture, Torn ligaments/ligament injuries, Osteoarthritis of the ankle View more

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