First of all, both hips were cemented in. I wasn’t sure why this decision was made, so I was encouraged to investigate the pros and cons of cemented hips, which I’ve summarised into the table below [1].

My nan was in her 50s at the time of the operation. A cementless implant would be a favourable choice for someone her age, especially considering cementing hips in makes replacing them later more difficult. However, the reason she was having her hips replaced was due to having level 4 osteoarthritis in her hips, so her bones may not have been strong enough for a cementless replacement. Unfortunately, her left hip had dislocated 3 months after the operation. This meant more bone had to be removed to replace the dislocated hip.

Simultaneous hip replacements have a higher risk of blood clots compared to staged replacements due to the increased time on the operating table [3]. The increased risk of complications means this surgery is typically saved for younger patients in good health. However, simultaneous hip replacements have their advantages, as you only need to enter the operating room once. This means only one dose of anaesthesia, shorter overall recovery time and is less expensive than staged operations [4].

Implants have seen drastic improvement since my nan’s surgery, especially for polyethylene. While 3-4mm of polyethylene is still used, the standard polyethylene wears 0.2mm annually, meaning after 15-20 years, the polyethylene would be completely worn away [5]. The new cross-linked polyethylene only wears 0.04mm annually, meaning it’d take over 75 years to wear [5]. This allows younger patients to get their hip replacements sooner without worry of needing another replacement. The cross-linked polyethylene is more robust due to the additional bonding between chains, which we can see in the diagram to the right. This allows patients to perform high-demand activities after surgery without increasing further complications. If my nan had access to cross-linked polyethylene, she might not have dislocated her new hip nor needed any further hip replacements.

My nan’s hips have once again degraded, but as she is now in her 90s, she’s too old to be operated on again. However, with materials and technology used in hip replacements rapidly advancing, we are getting closer to prosthetics that won’t need replacing. The next generation will have access to safer and more efficient surgeries thanks to her and the millions of others who have undergone joint replacement surgeries.