Total Hip Replacement
The goal of total hip replacement is to provide a pain free hip that allows you to return to most pursuits. The procedure has been widely accepted as one of the most successful surgeries ever invented, improving your quality of life.
When performing hip replacement Dr Fleming is aiming at providing you with a joint that will last a lifetime however it is currently difficult to predict the exact longevity of an implant. It is best to look after your new joint avoiding injury as the first surgery will usually carry the best outcomes.
Anterior or Posterior Approach
There are numerous ways to perform hip replacement surgery, Dr Fleming has been trained in direct anterior, posterior, anterolateral and direct superior approaches but prefers using the minimally invasive direct anterior approach for 98% of his patients.
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Should your anatomy or arthritic pattern make anterior approach surgery unfeasible or should you require revision surgery Dr Fleming performs these surgeries through the posterior approach.​
Benefits of Anterior Hip Replacement
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The surgery is performed whilst the patient in lying supine (on your back) - this gives me an excellent appraisal of the functional position of the pelvis allowing individualised cup position.
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The muscles and tendons are not removed from the femur during surgery facilitating less pain and faster recovery.
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The surgery is inherently stable with a lower dislocation rate than posterior approach.
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The Australian and New Zealand Joint Registry reports lower infection rate with anterior surgery.
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Use of mobile xray and associated navigation whilst performing surgery allowing accurate assessment of leg length, offset, cup & stem position and sizing.
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This is done using image-based navigation that seamlessly pairs with my pre-operative planning.
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Pain has been reported to be lower than other hip replacement techniques.
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Recovery is quicker with better patient reported outcomes published during the first 6 weeks following surgery.
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The scar is usually very small. ( Although the scar is on average 8 cm long, it is visible when looking in the mirror. 10% of patients will have a small area of numbness on the outside of the scar. )
Animation of surgical technique
How severe is your arthritis?
Recovering
from
hip replacement surgery
Despite the recovery being faster, Dr Fleming is conservative when is comes to early exercise. Dr Fleming advises short gentle walks both on land and in the pool in the first 6 weeks following surgery.
There is no benefit to attending formal rehabilitation in the first 6 weeks.
Returning life and sport
Return to daily demands
During the first 6 weeks after surgery you will gradually increase walking duration. This forms a gentle and safe way to recover after hip replacement.
Driving
If you drive an automatic you may choose to return to driving if you have good control of your right foot. this may be after 2 weeks in some. It is important to be in full control to be able to react in case of an emergency. It is advisable to practice driving in non-peak times with a companion when returning to the wheel.
Caring for kids or grandkids
Young children who need picking up should be cared for once you can safely balance on the hip in a single leg stance and you are stable and pain free. This may be between 6 and 12 weeks after surgery depending on your progress.
Bush walking and distance walking
The date of return depends from one person to another depending on how deconditioned you are prior to surgery.
It is best to wait until after the 6 week post-operative visit to be guided on the appropriate timing.
Pilates and Yoga:
It will be safe to return to gentle yoga/pilates after 6 weeks. A remedial instructor will prove to be helpful during the first 4 months.
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Golf
Putting and chipping from 4 weeks, half swing from 6 weeks, full swing 3 months, return to reasonable competitive play at 4 months.
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Surfing
Paddling a large volume board for exercise at 6 weeks, dry land practice of your ‘pop’ into surfing stance is best started at 10 weeks, surfing small waves by 12 weeks, and bigger, more challenging waves by 4 months.
Expect the flexibility and control to improve for a year after surgery. I advise avoiding surfing critical waves for at least 9 months.
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Don't live with pain any longer
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​Dr Fleming will ensure urgent cases are seen within 2 weeks.
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Remember you will need a GP referral in order for medicare to refund part of your costs.
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Dr Fleming’s secretary will ask what investigations you have to date, and help arrange a specific style of Xray prior to seeing Dr Fleming.
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If you have terrible hip pain, need surgery and are medically fit, Dr Fleming will endeavour to arrange an early surgical date (within 2 weeks).
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Should your medical health need optimisation you will be referred to a physician for medical optimisation prior to your surgical date.