Hip Replacement Pain Groin Stiffness Arthroplasty Revision Fracture
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Please enjoy your new hip joint

After the recovery period (up to nine months) your hip joint should allow the vast majority of normal activities. The muscles will recover to provide strength and endurance, while the scar tissue will soften and allow a good range of movement. Most patients will not notice any functional limitations and about one third of patients will report that they "forget" they have an artificial joint.

Limitations to prevent dislocation

The natural hip joint socket (acetabulum) has a cut away to allow extra movement before the neck and rim touch. This allows "extra" movement forwards and across the body. Artificial joints are symmetrical, usually with full hemispherical coverage, and therefore cannot allow a "full" normal range of motion.

Hip joint range of motion - diagram Hip joint rim of acetabulum - diagram Hip replacement range of motion - diagram

When the parts of the artificial hip impinge (B) this can cause the hip to lever out of joint - dislocate. Activities likely to cause this complication are at the extremes of normal hip function:

  • Bending all the way down to touch the floor
  • Maximal flexion especially combined with internal rotation of the thigh
  • Extreme yoga / pilates positions

Recurrent dislocation may result from failure of normal muscle tension to hold the joint in place, or impingement during movements inside the normal functional range. More than three dislocations suggests the need for careful assessment and revision surgery.

Limitations to prevent early loosening

Excessive loading of the hip will increase the risk of early failure. Impact loading is considered to be the most harmful as energy is dissipated in to the implant, its fixation and the supporting bone.

Load impact graph showing absorbed energy (example not numerically correct)

Obesity is the commonly cited as a risk factor for early failure, this view is not well supported by research. Most surgeons advise patients to avoid impact loading to protect artificial joints:

  • Running for pleasure
  • Jumping sports
  • Skiing moguls

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