Total Hip Replacement

What is a Total Hip Replacement?

A Total Hip Replacement (THR) is where a damaged hip joint is replaced with prosthetic components in the aim of improving movement, decreasing pain and providing better function and quality of life.

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JL PhysioFit

Anatomy of the Hip Joint?

The hip joint is one of the largest joints in the body and is classed as a ball-and-socket joint. It is comprised of the articulation between the top of the femur (thigh bone), which is the ball, and the acetabulum of the pelvis (socket). The ends of these bones are covered with smooth articular cartilage, a substance that protects the bone and also aids movement.

Between the joint space lies the labrum, which is a ring like structure that provides smooth movement and shock absorption. Surrounding the whole joint is the joint capsule, it is through this structure that the joint is nourished with synovial fluid (WD-40).  

Then we have a number of strong ligaments that attach in and around the hip joint to provide stability. A ligament attaches bone to bone. Similarly, we have various muscles that attach in and around the hip joint that allows us to move the hip. 

Who needs a THR?

The vast majority of people that end up having a THR are those in which arthritis has damaged the joint severely. It is also common in elderly people and those that have fallen and fractured their hip. Other conditions like childhood hip disease, rheumatoid arthritis, osteonecrosis and post traumatic arthritis are common causes that can make you a candidate for surgery.

The decision to have THR surgery should be one which is considered carefully and in consultation with medical professionals like your doctor, physiotherapist and consultant.

Avenues like physiotherapy are very important to try as a first measure as they are non-invasive, very effective and help to strengthen your hip, which is critical to both pre and post op rehabilitation outcomes. 

Generally, if you are needing a THR you will have pain when walking or sitting for long periods, and first thing when you wake that can last for hours. You will most likely struggle with daily activities like housework and getting in and out of the car, and your general quality of life will be suffering. Medications for pain relief and anti inflammatories will not have a great effect anymore.

An x-ray is the gold standard for determining the severity of arthritis in the hip joint and is classed as mild, moderate or severe. It must be stressed however, that even if an x-ray deems to show severe OA, this might not correlate to the patient experiencing the same level of pain/discomfort. It is very important to take into consideration your goals and motivations for having a THR, and this would be discussed with your physiotherapist. 

How is it done?

Each surgeon may have different or preferred methods so it is important to ask about this prior to your operation. Below is an example of how a typical THR is done:

  1. The damaged ball of the femur (thigh bone) is removed and replaced with a metal stem that goes down the middle of the bone.
  2. The surgeon then replaces the head of the femur (ball of the joint) with a metal or ceramic ball.
  3. Then the original damaged socket (acetabulum) will then be replaced with a metal one.
  4. A plastic, metal or ceramic spacer is then fitted between the new ball and the socket, before the ball is fixed in place. This helps with mobility and stability of your new hip joint and acts as your new labrum (cartilage).  

Pre and post operation Physiotherapy at JL Physiofit?

We work with clients both pre and post-surgery. This allows a number of benefits: 

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Pre surgery:

Following an initial detailed assessment, we will be better placed to form a plan that suits your needs and works around your life.

We provide all of our clients with a ‘THR Surgery Booklet’, so they are more prepared for surgery, what it entails and the likely aftercare they need, and what milestones they should be aiming for.

Clients are able to maintain and strengthen the muscles around the hip joint so that it makes recovery more manageable and aids better outcomes.

Forming a team between patient and physio helps to provide a lot of support both physically and mentally for what can be a stressful period of life.

Some patients may improve to the point where they delay their operation.

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Assessment of the hip, how it is moving and feeling along with gentle exercises to begin with.

Clear plan in place to start rehabilitation of the hip and working towards key milestones.

Our ‘THR Surgery Booklet’ will be given to patients and this will help them to understand more about what to do and what not to do as they progress from the early stages of recovery, right through to end stage rehab.

We have the facilities to guide patients through the whole process to ensure best possible outcomes for them.

How long will we work together and what will it look like?

Pre operatively, we will most likely work together for 3-6 months (largely dependent on when your operation is) to ensure we have the best chance of strengthening the hip as much as we can before the operation.

Post operatively, we work with clients a minimum of 3 months but usually beyond this as well. This gives us time to make sure we are on the right track and you are progressing as you should be.

Often in the first few weeks we will be helping you regain movement and ease pain using various hands-on techniques, whilst also building exercises in a manageable way. You will be very clear on what you need to do outside of the sessions. 

As the weeks progress, we will develop your exercise programme as well as work with you 1:1 in the rehab room and carry out exercise sessions together.

Once the initial 3 months are up, clients are a lot more confident with their hip and what needs to be done to continue the good work. At this stage we have a conversation about how to manage things going forward.

Often clients end up working with us longer as they want to continue to strengthen under the guidance of a physio. Some clients choose to join one of the Physio Led Pilates classes that we teach here, to continue strengthening and get the most out of their new hip.

How do I get started?

The first step is to book an initial Physiotherapy assessment/first appointment. This will allow us to determine the most appropriate pathway for your situation.

If you are ready to book in then you can either phone the main desk on 0191 814 9717, or use our easy online booking system by clicking here and selecting the ‘Physiotherapy Assessment/First Appointment’ option at a day and time that suits you. You will usually be offered an appointment within 48 hours.  

Like to speak to someone first?

No problem, please call the main desk and if needed we can have a physio call you back to discuss your specific situation. 


What Our Clients Say

Paul Scrafton
Paul Scrafton
Physio linked to additional stretches/exercises and Pilates at JL Physiofit have improved my core strength and flexibility.
Rebecca Lowes
Rebecca Lowes
Michael helped me with leg pain leading up to my first half marathon. I ended up running the whole distance with no pain and was able to enjoy the experience by taking his advice and getting treatment the week before the big run. Would recommend to anyone.
Neil Taylor
Neil Taylor
Hi , i have had individual physiotherapy by Bev for my back and feet (plantar fascia )and have subsequently been able to join a beginners Pilate class run by Bev . The class is demanding , enjoyable and appropriate to my physical capability.
Alison Bailey
Alison Bailey
I thoroughly enjoyed my Pilates class this morning. I found my teacher to be very thorough, aware of each pupils ability and very encouraging. Highly recommended. Thank you .
Sharon Oldroyd
Sharon Oldroyd
Started treatment in September 2022 after hospital appointments with consultant and scans on my left knee. I booked to see Michael as I was having major pain/grinding noise and unable to do exercise or even walk up/down the stairs properly. He assessed my mobility and strength and developed a tailored, gradual rehab program that has helped me to build strength and confidence in my knee as well as helping me slowly get back into exercising. It's made a vast difference working with Michael as I'm not an easy person to work with and always push myself too far. All my exercises were shared via email and accessible via an app. Now I'm exercising 5 times a week, spinning, strength, cardio, HIIT, rowing and running (I can finally use my home gym). Thank you for your patience and understanding my needs. Would highly recommend Michael and JL PhysioFit.
Diana Robertson
Diana Robertson
I am really enjoying beginners Pilates and feel like I have made good progress. The trainers are very good and it is a positive low-key atmosphere and everyone is friendly and welcoming.
Julie Tough
Julie Tough
Enjoying this physio type class, definitely feeling the benefit.
Moira Luccock
Moira Luccock
Good class today with Michael. Well taught by Michael with options to suit our abilities. Stretching so feel I have progressed. Light hearted banter too - what more could you want! Moira
Lesley Hughes
Lesley Hughes
Good team that listen to what clients have to say before doing each Pilates class, so if you have a niggle they work with it. Exercises are testing but doable, even if at the time you are not sure about it, and if you can't then they come up with a variation for you to do. Friendly classes and staff.
Nick Winslow
Nick Winslow
I attend pilates regularly and cannot overstate how much I value the advice ,motivation,and fun this provides.There is a real rewarding sense of progression.JL himself is my usual instructor ,but the entire team have an infectious enthusiasm that fosters self improvement.
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Ready to Book?

All of our appointments can be easily booked online or if you’d prefer to discuss your needs prior to booking in then please call 0191 814 9717 and we will be happy to chat.