To address pain stemming from certain conditions hip replacement surgery is the right path to healing.
The hip is the largest joint in the human body, connecting the upper part of the legs, specifically the pelvis to the femur. It can be affected by various conditions that may be resolved through hip replacement surgery. Among these conditions are:
- arthritis
- rheumatoid arthritis
- osteoarthritis
- fracture of the femoral neck
- cancers.
What these conditions have in common (excluding the last two) is the damage to the joint cartilage, leading to inflammation and pain, which can become chronic over time.
In advanced stages joint deformity and stiffness may appear.
Hip replacement surgery is the right path to take to resolve the pain and return to everyday active life.
In this article we’ll explore:
- what hip replacement surgery entails and where to undergo it;
- the recovery timeline following hip surgery;
- whether sexual activity is permissible after hip surgery;
- any potential and rare complications post-operation.
All these questions will be answered as you continue reading.
1 – What does hip replacement surgery entail and where can it be performed?
Deciding to undergo hip replacement surgery is a significant step towards healing and returning to everyday life without pain.
That’s why it’s crucial to carefully choose the most suitable centre for your need.
Hip replacement is a surgery for well-being: its purpose is to insert a “new joint” to replace the damaged bone or cartilage.
The hip prosthesis is typically composed of 3 elements:
- a ceramic head placed on a metal stem, replacing the damaged head and neck of the femur;
- a socket (metal cup or acetabular cup) that replaces the worn cartilage;
- an insert made of polyethylene (or ceramic), which is the sliding surface.
The prosthesis can be cemented or uncemented.
The first one is indicated in patients with osteoporosis, elderly patients, or in case of particular anatomical conformations; the second one is indicated in young patients or those with good bone quality and regular anatomical conformation.
Where can you undergo hip replacement surgery?
Hip surgery is one of Dr. Vanni Strigelli’s specialties thanks to modern surgical techniques that preserve tissues and bone along with the use of biocompatible materials such as titanium alloys and ceramics. These materials ensure less wear and tear and greater longevity of the prosthesis over time.
Dr. Vanni Strigelli consults at various facilities in Florence and Pontassieve and performs surgical procedures at the Valdisieve Hospital, both privately and under the national health system (S.S.N.).
Dr. Vanni Strigelli specialises in patient-centred surgery, ensuring several benefits:
- a personalised approach: evaluation of the best surgical solution for both young patients and older individuals and selection of the most suitable prosthetic model;
- post-operative pain management: personalised pathways and anesthesiological and pharmacological techniques for post-operative pain management;
- Rapid Recovery: the protocol that allows immediate walking and stair climbing, quickly regaining joint movement;
- Minimally invasive surgery also for bilateral hip replacement: minimally invasive surgery allows for simultaneous bilateral hip replacement with a single operation;
- rehabilitation: in order to continue hospitalisation in a rehabilitation facility or at home through MyMobility application for a patient-specialist relationship that is increasingly connected.
If you want more information about the benefits of hip replacement surgery, read “Hip prosthesis surgery – Where to undergo it?“.
2 – What are the recovery times after hip surgery?
One of the questions most patients have is about the recovery times after surgery.
In the last ten years minimally invasive techniques have been developed that allow for the successful implantation of hip prostheses through smaller incisions.
The advantages are numerous:
- less muscle involvement;
- considerably reduced pain;
- minimal bleeding;
- no sutures, but glue;
- rapid restoration of mobility;
- quick return to daily life.
The success of hip replacement surgery depends not only on the implantation of the prosthesis itself, but also on adequate rehabilitation.
With Dr. Vanni Strigelli’s Rapid Recovery method you won’t have to stop walking at all, because you can get up and take the first steps just a few hours after the surgery.
Modern prostheses in fact have excellent stability right from the start and allow for full weight-bearing shortly after the surgery.
The complete recovery after hip replacement
The duration of recovery after a hip replacement surgery varies from person to person, but is generally quite short.
The body needs time to “get used to” the prosthesis and especially to integrate it with the patient’s bone, but typically with appropriate physiotherapy patients experience functional recovery in 30-35 days.
To alleviate symptoms it’s essential to maintain a balanced diet and weight and engage in regular physical activity to maintain good mobility.
The initial phase involves specific exercises aimed at regaining mobility and muscle tone, along with partial rest.
Stretching exercises improve the flexibility of the muscles around the hip, reduce trauma and prevent injuries.
Muscle strengthening exercises stabilise the joint and stimulate mobility, limiting pain and promoting correct posture.
Regarding sports activities there are no specific contraindications, but caution is the key: gradual resumption with varying timelines depending on the type of activity is recommended.
There are ideal activities to facilitate walking such as water exercises, swimming and cycling, which strengthen the core.
Is it necessary to have the prosthesis reviewed after a few years?
In most cases absolutely not.
The technologies employed and the use of innovative materials, increasingly resistant to wear, have been the most evident field of improvements to ensure the longevity of implants.
This way patients do not have to undergo further surgery to replace the prosthesis with a new one, because its durability has been confirmed to exceed 30 years.
If you would like more information on recovery times after hip surgery you can read “Hip Replacement: Recovery Times”
3 – Can you have sexual intercourse after hip surgery?
Sexual intercourse is an important aspect of life that contributes to the physical and mental well-being of individuals, but it’s often seen as an uncomfortable topic to discuss with the doctor.
Being concerned about sexual activity, both for yourself and your partner after hip replacement surgery is perfectly normal and common.
Expressing these concerns to the surgeon is an excellent way to safely resume sexual activity after hip surgery or in the case of arthritis, as it can help prevent complications.
The surgical treatment, pain and stiffness due to arthritis can certainly hinder or even prevent regular physical activities like sexual intercourse.
I must say that resuming sexual activity after hip replacement surgery can occur shortly after the procedure, following necessary timelines and precautions.
How long after surgery can you return to sexual activity?
To engage in sexual activity safely, you need to pay attention to a series of movements until your hip is considered out of the risk of dislocation. There are different “approaches” to the hip: each approach (anterior, lateral, or posterior-lateral) has a different risk of dislocation.
Let’s consider the posterior-lateral approach.
Once the prosthesis is implanted you can walk and climb stairs with your full body weight on the operated leg; it is immediately supportive of the bone and there is no risk of moving it or damaging it with sexual activity.
There is a minimal risk of implant dislocation, especially during combined movements of flexion, adduction and internal rotation, but this is an unnatural movement.
Patients are trained during their hospital stay on which movements to avoid.
Therefore there is no risk in sexual activity; you just need to be careful and avoid certain movements that could expose you to the risk of hip dislocation.
In fact most patients experience an overall improvement in their sexual life after hip replacement, but there are commonly some fears about engaging in sexual activity A study published in the Journal of Arthroplasty recommends avoiding the following positions:
- on knees with partner behind;
- on knees over partner;
- side by side, face to face.
As a general rule the partner with the hip prosthesis should avoid extreme flexion of the joint, especially if associated with adduction and internal rotation of the hip.
The safe position is to keep the hip slightly abducted and externally rotated, and relaxed and passive positions are also recommended for the initial period.
General recommendations
The fundamental recommendation is to proceed with caution and stop if you experience pain or feel unsure.
Because hip replacements are among the most successful surgical procedures performed today, but it takes time for the body to adjust to the new joint.
For more information read this article How to approach sex calmly after hip surgery.
4 – Possible and rare complications after surgery
Hip replacement surgery is one of the safest and most effective procedures in modern medicine, transforming the lives of millions of patients.
The percentage of risks and complications is extremely low, but for the sake of accuracy and completeness it’s important for you to be aware of them.
These are rare events, often temporary and treatable, especially if promptly recognized.
Being aware of these potential complications means being prepared and informed, allowing you to navigate the post-operative period with confidence.
Let’s review them together:
- infection: this can occur with any surgical procedure, but is very rare. Extensive preventive measures are taken before, during and after the surgery. Swelling, redness and increasing pain in the hip are the main signs of infection. Superficial infections can be treated with antibiotics, while deeper infections may require wound cleaning and sometimes removal of the prosthesis to heal;
- dislocation: this happens when the head of the implant comes out of its natural socket (the cup). The risk is highest in the first month post-operatively. Preventive strategies include correct positioning of the prosthetic components, balancing the soft tissues and educating the patient;
- thromboembolic complications: these are reduced through the use of heparin starting the evening before surgery and continued for about four weeks, preoperative and postoperative angiological visits with Doppler ultrasound of the lower limbs, elastic-compressive stockings if indicated and early mobilisation of the patient. When a blood clot develops in the veins of the legs, it is called deep vein thrombosis; if it occurs in the lungs, it is called pulmonary embolism;
- bleeding: this is a common complication in many surgical procedures. In the Rapid Recovery pathway many strategies are employed to prevent bleeding and less than 1% of patients require a transfusion;
- fracture: most fractures typically occur at the femur, but they can also happen at the acetabulum. Minor fractures can heal spontaneously or be treated with screws, wires or cerclage. Major fractures may require revision of the components, bone grafts and additional fixation devices;
- nerve injury: the most common nerve injury is to the sciatic nerve, particularly the fibres of the common peroneal nerve, resulting in an inability to lift the foot. This is rare and is usually temporary;
- leg length discrepancy: many patients feel that the operated leg is longer, a sensation that typically diminishes over time. Unfortunately in some cases it may be necessary to slightly lengthen the leg to ensure greater stability of the prosthesis;
- thigh swelling and hematoma: swelling in the thigh and sometimes a hematoma around the wound is expected after any prosthetic operation;
- prosthetic wear: wear and its consequences are inevitable phenomena typically occurring 20-25 years after the surgery.
How to protect the prosthesis after surgery?
With some precautions you can protect and maintain your prosthesis in the best possible way:
- maintaining a proper weight;
- engaging in light and regular exercise;
- keeping the right strength and mobility in your hip;
- taking precautions to avoid falls and injuries;
- periodically consulting your orthopedic surgeon to evaluate progress;
- getting follow-up X-rays.
Despite the rare complications, which you can explore further in this article, hip surgery remains one of the most successful medical procedures and ensures recovery from osteoarthritis.
