Inspired by the lectures on prosthetics, the impact that hip placements have on a patient’s quality and satisfaction of life really struck me. According to the arthritis society, 7% still suffer from moderate limitations and 20% report severe limitations 5 years post-surgery. Despite undergoing a second surgery, only 70% of patients reported that they were doing well.

So why are the 30% still suffering?

There are many minor reasons that hip replacements may fail:

• Wear and Tear: Constant wearing of prosthetics can cause the joint to become loose, requiring further surgery if the problem is severe
• Joint stiffening: soft tissues around the hip replacement become stiff and lead to reduced mobility
• Sensitivity to metal: inserting a ‘foreign’ substance into the body  

However, unfortunately, there are more serious factors which may be at play too:

• Aspect loosening: breakdown of the joint between implants, components and body. It can often cause the release of small particles and debris when the joint starts to wear out. The patient’s body may recognise the hip placement as a ‘foreign’ object. The patient’s immune system will identify these particles and attack them causing inflammation  
• Formation of blood clot: increases risk of thrombosis (including deep vein thrombosis and pulmonary embolism)

A Personal View Point

Wanting to learn more, I contacted a family friend who has recently had her first hip replacement just over 5 months ago to understand what impact the replacement had on life post-surgery.. Prior to her surgery, she lived in discomfort for a long time, but recognised that her hip replacement had an extreme benefit on her quality of life (e.g. her low back pain  has reduced and she is able to sleep better. Recently, she had a second hip operation and is currently recovering. After having the second surgery, she remarks on the great benefit of the first hip replacement on her flexibility and mobility.  

However, despite the positives, she commented that the rehabilitation process is long, frustrating and slow. Your daily routine is disrupted from having to always sleep on your back, being unable to drive or exercise and work being impacted if you are unable to work from home.  Moreover, whilst she was happy with her access to pain relief, she suffered adverse events on opioids of constipation, which she argued was more painful than the hip operation itself.

The most interesting point we discussed was access to physiotherapy. She was fortunate enough to receive her hip replacement on the NHS, however, when comparing herself to a friend who had their hip replacement privately, she commented they had better access to in-person physio and rehabilitation help. I can’t help but think this raises all sorts of ethical issues due to socio-economics factors. But does the NHS have the capacity to do more?

My Final Thoughts ….

Further to having a discussion, there were two points that stuck out to me. I’d love to research more into the rehabilitation process from start to finish (e.g a strict exercise regime to strengthen muscles, and improve balance and blood circulation). A good link for more about this topic is: Hip replacement recovery: timeline, tips and information | Spire Healthcare  . But finally, the most provoking revelation that I encountered was the equal access to healthcare during the rehabilitation process . The final parting question I have is – why doesn’t everyone receive the same level of treatment?