Hip replacements are just for old people
I'm too young for a hip replacement
Hip replacements only last a few years
As patients have become more active, they are less willing to accept a life of compromise and painkillers. Modern ceramic bearings wear out at a fraction of the rate of traditional metal on plastic hip replacements making it increasingly likely that hip replacement is a once in a lifetime procedure at whatever age it is performed. Whilst hip replacement is not entirely without risk, deterioration in function and increasing pain from an arthritic hip are inevitable.
I will need a blood transfusion for my total hip replacement
Blood transfusion is now a rare event after a total hip replacement and is necessary in less than 5%. This is due to a number of factors. Surgery is performed more efficiently through smaller incisions and spinal anaesthesia with sedation reduces bleeding during the operation further. Blood loss is fairly predictable in primary hip surgery so the higher the level of haemoglobin in the blood prior to surgery, the higher the level will be afterwards.
The haemoglobin level should ideally be at least 13.5g/dl to remove the risk of a transfusion completely. Female patients, in particular, may benefit from iron tablets in the few weeks before surgery. If unpredictable blood loss is encountered the cell-saver machine recycles blood lost during the procedure and returns it to the patient thereby reducing the possibility of transfusion even further.
I have to sleep flat on my back and can't flex my hip more than a right angle for the first six weeks after a total hip replacement
I'll never be able to swim the breast-stroke after a hip replacement
Both these relate to stability and avoidance of dislocation after surgery. There is a lot of traditional advice about avoiding dislocation after surgery based on Charnley's practice in the 1960's and 1970's. His implant had a head diameter of 22mm and so was much more likely to dislocate than the ceramic implants in use today with diameters of 32mm or 36mm. In addition surgical technique and other elements of implant design have advanced to make hip replacements generally more stable. Patients can sleep on either the operated or non-operated side straight after surgery provided there is a pillow between their knees.
In addition flexion beyond 90ยบ is encouraged after two or three weeks to stop the hip getting too stiff and to allow patients to get down to their shoes and socks. Return to swimming varies between individuals and the facilities at the swimming pool. Clearly patients can get back in the pool sooner is there is step rather than ladder access. Crawl kick should be used initially but, as familiarity and fitness return over the first two or three months, breast-stroke kick can be resumed.