Hip Replacement Surgery In Singapore

Total hip replacement, also known as total hip arthroplasty, is a surgical procedure designed to alleviate pain and restore function in severely diseased hip joints.

 

  • Are your hip pain symptoms affecting your quality of life? Consult our MOH-accredited hip replacement specialist for a comprehensive diagnosis of your condition & a personalised treatment plan.
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Dr Poh Seng Yew

MBBS

MRCSEd

MMED (Ortho)

FRCSEd

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What is Total Hip Replacement?

Total hip replacement, also known as total hip arthroplasty, is a surgical procedure designed to alleviate pain and restore function in severely diseased hip joints. This surgery involves removing damaged bone and cartilage and replacing them with a prosthetic hip, consisting of a ball and socket.

The primary goal of this procedure is to enable individuals to return to their daily activities without the limitations and discomfort caused by hip arthritis or other degenerative hip conditions​​​.

Reasons for Total Hip Replacement

Total hip replacement can help individuals experiencing hip pain and mobility limitations. The procedure can be beneficial for those who experience the following:

  • Hip Pain Limiting Daily Activities
    Severe hip pain can hinder basic activities like walking or standing, affecting an individual’s quality of life. Hip replacement aims to alleviate this pain, enabling easier movement and increased independence​​.
  • Persistent Hip Pain, Even at Rest
    Continuous hip discomfort, regardless of activity level, suggests advanced joint damage. This persistent pain, often unaffected by rest or conservative treatments, may warrant the consideration of hip replacement.
  • Stiffness Limiting Movement
    Hip stiffness that restricts motion, such as difficulty putting on shoes or getting in and out of a vehicle, indicates joint degeneration. Replacement surgery can help restore a more normal range of motion.
  • Insufficient Pain Relief from Other Treatments
    When non-surgical interventions fail to provide adequate pain relief, hip replacement becomes a viable option. This includes cases where physical therapy, anti-inflammatory drugs, or walking support have been ineffective.

Assessing Suitability for Total Hip Replacement

The suitability for total hip replacement can be determined by a series of diagnostic techniques and considerations:

  • Medical History Review
    The hip surgeon reviews the patient’s medical history, focusing on past treatments and their effectiveness. This evaluates hip pain and its limits, assessing if a total hip replacement is needed.
  • Physical Examination
    The hip surgeon conducts a physical examination of the hip, assessing the range of motion, strength of surrounding muscles, and overall joint function​​.
  • Imaging Tests
    X-rays are used to visualise the extent of damage or deformity in the hip joint. In certain cases, an MRI or CT scan may be necessary to provide detailed images of bone and soft tissues​​.

Planning for Total Hip Replacement

Proper planning can help lead to a successful surgery and a smooth recovery process. This involves several steps:


  • Medical Assessment: This assessment includes consulting with the hip surgeon to review the general health condition, do blood tests, a chest X-ray, and an electrocardiogram to assess fitness for surgery​​.
  • Anaesthesia Plan: The type of anaesthesia to be used during the surgery will be decided. The most common options are general anaesthesia, which induces sleep, or regional (spinal) anaesthesia, which numbs the body from the waist down​​​​.
  • Pre-surgical Lifestyle Preparations: Patients may need to make certain lifestyle adjustments before surgery. This can include discontinuing certain medications, managing overall health conditions, and possibly losing weight to minimise stress on the new hip. Home preparations, such as arranging for care and installing support features like handrails, can help prepare individuals for the post-surgery recovery period.
  • Deciding Implant Options: The implant components will be discussed and chosen before the surgery. Implants typically consist of a ball made of highly polished strong metal or ceramic and a socket made of durable plastic, ceramic, or metal. The decision on whether to press or cement these components into the bone depends on the individual’s bone quality and strength​.

Surgical Procedure

The total hip replacement procedure encompasses several steps:

  • Incision
    The surgery begins with an incision over the hip, through which the hip surgeon accesses the hip joint.
  • Removing Damaged Components
    The diseased and damaged femoral head is removed, and replaced with a metal stem.
  • Implanting the Prosthesis
    A metal or ceramic ball is implanted into the upper portion of the stem to replace the removed femoral head. The damaged cartilage surface of the socket (acetabulum) is replaced with a metal socket. This ball-and-socket mechanism replicates the function of the natural hip joint.
  • Securing the Components
    The components of the prosthesis may either be pressed into the bone, allowing natural bone growth onto the components, or screwed or cemented into place, depending on the bone’s quality and strength.
  • Insertion of a Spacer
    A spacer made of plastic, ceramic, or metal is placed between the ball and socket to ensure smooth and natural movement of the new joint.

The surgical procedure typically lasts between one to three hours, depending on the complexity of the case​​.

The procedure benefits from modern surgical techniques and design improvements in implants, which have increased the longevity and efficiency of hip replacements. These advancements include accurate positioning of hip components and bearing surfaces, along with designs that improve stability and range of motion​​​​.

Benefits of Total Hip Replacement

Total hip replacement offers several benefits for patients suffering from severe hip pain and mobility issues.

Pain Relief

The primary benefit is pain reduction. By replacing the damaged hip joint with an artificial one, patients often experience a dramatic decrease in pain.

Improved Mobility and Function

The procedure enhances mobility and function, allowing patients to perform daily activities more comfortably and effectively. This includes walking and engaging in low-impact recreational activities. Patients are also often able to return to hobbies and activities that were previously hindered by hip pain.

Longevity of the Prosthesis

Advances in the materials and design of hip prostheses have extended their lifespan. Modern implants, made of metal, plastic, and ceramic parts, can continue to function well after many years, greatly reducing the likelihood of needing repeat surgery​​.

Restored Natural Movement

The prosthesis is designed to mimic the natural movement of the hip, ensuring a smooth and natural range of motion.

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Consult our MOH-accredited hip replacement specialist for a comprehensive diagnosis of your condition & a personalised treatment plan.

Possible Complications of Total Hip Replacement

While total hip replacement is generally a safe procedure, it is not without its risks and complications.

  • Infection: Infections can occur at the incision site or in the deeper tissue near the new hip.
  • Blood Clots: The formation of blood clots in leg veins is a risk. These can be dangerous if they travel to the lungs, heart, or brain.
  • Nerve Damage: There is a small risk of nerve damage around the implant area, which can result in numbness, weakness, or pain​​.
  • Hip Fractures: During surgery, there is a risk of fracturing healthy portions of the hip joint.
  • Leg Length Inequality: Occasionally, a new hip can result in one leg being longer or shorter than the other, though this is often temporary and can be managed with muscle strengthening and stretching exercises​​.
  • Dislocation and Instability: The new joint may dislocate, particularly in the initial months post-surgery.
  • Loosening of the Implant: Though rare with modern implants, there is a possibility of the new joint not becoming firmly fixed to the bone or loosening over time, which can cause hip pain and might necessitate further surgery​​.

Though risks and complications may occur, they are uncommon. Serious complications occur in less than 2% of patients.

Recovery and Outlook

The recovery process following a total hip replacement generally begins immediately, with most patients starting to walk and potentially returning home on the day of the surgery.

The rehabilitation process can include:


  • Physical therapy: This starts soon after the operation and continues regularly, focusing on strengthening and regaining mobility. It includes several exercises suggested by the hip specialist to train and strengthen the muscles. Assistive devices can be used until the patient can walk without limping. Generally, patients can resume light activities in 3 to 6 weeks.
  • Pain and Swelling Management: Pain and swelling are common initially, but with effective pain management and rehabilitation, these symptoms gradually decrease. Medications such as paracetamol, non-steroidal anti-inflammatory drugs, and opioids may be prescribed by the hip specialist to provide temporary pain relief.
  • Preventing Surgical Complications: Surgical complications such as blood clots can be avoided with inflatable leg coverings and blood thinners. Movement in the foot and ankle can also improve blood flow, reducing the risk of these complications.
  • Avoidance of Activities Leading to Hip Instability: Activities and postures that could make the hip more susceptible to instability can be avoided, to reduce the risk of falls and injuries.
  • Avoiding Wetting the Wound: Avoid getting the wound wet and follow any instructions given by the hip specialist to reduce the risk of wound infection.

The average recovery time varies, ranging from two to four weeks, influenced by factors such as pre-surgery activity levels, age, and overall health. Full recovery, marked by pain reduction and improved joint function, typically occurs within three months, although improvements may continue throughout the first year.

Total hip replacement generally has a positive outlook, lasting for many years and effectively reducing pain and increasing mobility​​​​​​.

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Dr Poh Seng Yew

MBBS

MRCSEd

MMED (Ortho)

FRCSEd

With over 20 years of experience, Dr Poh Seng Yew is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.

  • Former Director of Sports Service, Department of Orthopaedic Surgery, Singapore General Hospital
  • Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany
  • Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
  • Master of Medicine (Orthopaedic Surgery), National University of Singapore
  • Member, Royal College of Surgeons of Edinburgh (MRCSEd)
  • Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore

 

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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
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Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
Sundays and Public Holidays: Closed

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    Mount Elizabeth Novena Specialist Centre
    38 Irrawaddy Road, #08-62/63
    Singapore 329563

    Frequently Asked Questions (FAQ)

    What is the Best Age to Get a Total Hip Replacement?

    Total hip replacement is not age-restricted and can benefit a wide range of patients, including those aged between 50 to 80 years. Individual suitability is determined by the hip surgeon based on several factors, including overall health and bone quality​​.

    Can I Bend My Hip After Total Hip Replacement?

    After a total hip replacement, bending your hip is possible but should be approached with caution, especially in the initial weeks. Your hip surgeon will guide you through safe movements and limitations to ensure proper healing and avoid dislocation.

    What Is the Fastest Way to Recover from a Hip Replacement?

    Adhering to your physical therapy regimen, maintaining a balanced diet, and following your hip surgeon’s post-operative instructions can help the hip recover faster.

    Is It Better to Sit or Lay Down After Hip Replacement Surgery?

    Post-surgery, it is best to alternate between sitting and lying down to avoid stiffness and improve circulation. Your hip surgeon will suggest the best positions to ensure comfort and support the healing process.

    Is Total Hip Replacement Surgery Painful?

    While some discomfort is expected post-surgery, pain management techniques and medications are used to control pain effectively. The long-term benefits of pain reduction and improved mobility far outweigh the temporary discomfort experienced during recovery.

    What Happens If I Delay Total Hip Replacement?

    Delaying a total hip replacement can lead to increased pain, further joint damage, and reduced quality of life. If you are experiencing persistent hip pain and limited mobility, consulting with our hip surgeon can help you understand the benefits of timely intervention.