Welcome to Parminder J Singh’s patient guide to Total Hip Replacement. To help assist in your recovery following your hip replacement surgery, it is important for you to know about the surgery prior to you arriving at either St Vincent’s Private East Melbourne, Epworth Eastern Private Hospital, Epworth Richmond Private Hospital or Waverly Private Hospital.

The overall cost of a hip replacement surgery is inclusive of the surgeon’s fees, hospital fees, anaesthetist and surgical assistant’s fees.

Surgeon’s fees: Dr. Parminder J Singh follows the Australian Medical Association ( AMA ) fees guidelines for all of his surgeries.
Hospital fees: This cost is covered entirely by your private health insurance. If you are uninsured, our staff will assist you with providing an estimated quote for your surgery
Anaesthetist and Surgical Assistant Fees: Dr. Singh has his own team of assistants and anaesthetists who also follow the AMA guidelines.

Following your consultation with Dr. Singh, our staff will go through the exact cost of your surgery in detail.

This guide is designed for patients who have already decided to have joint replacement surgery. Every patient and every operation is unique and therefore this guide will not be able to answer all your questions. This guide is not a substitute for obtaining medical advice from your surgeon. However, this guide may assist you to get a better understanding of what to expect and it may help you think of questions to ask Mr Parminder Singh. If this patient information guide does not answer your questions, remember that Mr Parminder Singh will do his best to do so at your consultation. Mr Singh and his surgical team will practice in accordance with the ethical standards defined by the Australian Medical Council.

Aim of Hip Replacement

The principle aim of hip replacement is to reduce your pain, correct any deformity, enhance your mobility that is impeded by your hip and improve the quality of your life. This can be achieved in up to 95% of cases. Replacement of hip involves replacing a hip joint that has been damaged or worn away, usually by arthritis or injury.

For further information please refer to Dr Parminder Singh’s: HIP REPLACEMENT GUIDE

WHAT IS ARTHRITIS?

Osteoarthritis is characterised by joint pain and mobility impairment associated with the gradual wearing of cartilage. The wear and tear of the joint frequently results in pain, stiffness and reduced movement. The clinical diagnosis is usually based on the presence of joint symptoms and evidence of a reduction of joint space seen on the x-ray. There are different types of arthritis causing joint pain for example osteoarthritis, rheumatoid arthritis and post traumatic arthritis.

                               

HOW COMMON IS ARTHRITIS?

Osteoarthritis is the most common form of chronic arthritis and the hip is the second most commonly affected joint in the body. The condition affects approximately 1.4 million Australians, or approximately 7.3% of the population. The prevalence of osteoarthritis increases with age. Osteoarthritis most commonly develops between the ages of 45 to 90 years. Less commonly osteoarthritis occurs under the age of 45 years of age and may well be associated with an underlying risk factor for the development of premature arthritis. The pain and disability associated with osteoarthritis affects approximately 10% of men and 18% of women over 60 years of age. The incidence and prevalence of osteoarthritis will continue to rise as the population ages.

THE HIP JOINT

The hip joint is a ball and socket joint. The hip joint allows movement to occur between the thigh bone (femur) and the hip bone (pelvis). The pelvis contains the socket (acetabulum) and the ball shaped head of the femur fits into the acetabulum.

FEMORAL HEAD

The outer surface of the femoral head and the inside surface of the acetabulum are covered with cartilage which allows low friction free movement between the two surfaces. The hip joint is covered by ligaments that help stabilise the joint. The hip joint movements are initiated and controlled by the muscles in the buttock, groin and thigh.

HIP JOINT REPLACEMENT

Approximately 20,000 primary total hip replacements are performed in Australia. Each hip prosthesis is made up of several components. The acetabular component replaces the acetabulum (socket). The acetabular component is typically made of a metal alloy outer shell with a fitted plastic (polyethylene) or ceramic liner or it can be made completely of one polyethylene component.

The femoral component replaces the femoral head. The femoral component is typically a two piece design. This comprises the femoral stem made of a metal alloy and the femoral head that attaches to the stem. The femoral head can be made of either ceramic or metal alloy.

Frequently Asked Questions About Hip Replacement?

Generally this varies between patients and whether they went to go home directly or to a rehabilitation centre after their hip replacement.  It is important to check your insurance covers your for rehabilitation prior to your surgery.  On average patient’s will be asked to walk the same day as their surgery or the following day under the supervision of the physiotherapist.  Patients are typically discharged from hospital on average 3-5 days after their surgery.  No patient will be discharged from hospital if they are not confident to manage at home.  Patients should be given information about telephone numbers or other methods of contacting the hospital or the orthopaedic service, should problems occur.

Mr Parminder Singh will usually see you in his rooms approximately 10-14 days after your surgery to inspect your wound and remove the skin stiches or staples.
The time will vary between patients and Mr Parminder Singh will advise you if it is safe to fully weight bear with your crutches or partially weight bear. This varies particularly if bone graft was used during your hip replacements. Generally, however, patients will use crutches for approximately 2-6 weeks after their surgery. Patients tend to progress from a walking frame to two crutches, one crutch and finally independent walking.
During your inpatient stay in hospital, the physiotherapist will go through any particular hip precautions which will vary depending on if you surgery in undertaken using the anterior muscle sparing approach or mini-posterior approach. Generally the extreme range of motion should be avoided initially, sitting on low seats and reaching for objects on the floor to reduce the risk of hip dislocation.

Most patient can drive approximately 6 weeks after your surgery. If you are not sure, please check with Dr Singh at your post operative appointment.

Put the passenger seat as far back as possible. Stand with your back to the car with knees touching the seat. Gently lower yourself down onto the seat with your bottom as far onto the seat as possible, sliding your operated leg out in from of you. Swing your legs round into the car. Getting out of the car is the same procedure in reverse.

Generally, you will require to medication for pain control and reducing the risk of developing clots in your leg. Generally pain control will diminish significantly over the first 2-3 months after your surgery.

Although deep vein thrombosis (DVT) can be demonstrated in 50-60% of patients after primary total hip replacement (THR), it is symptomatic in approximately 2%. The most severe consequence of DVT is fatal pulmonary embolism (PE). Thromboprophylaxis (taking blood thinners) reduces fatal PE by 70% and DVT by 50%.

Prophylactic (preventive) measures are pharmacological and mechanical. Mr Singh recommends a pharmacological agents that has anticoagulant properties to be administered once per day for six weeks. Mr Singh also recommends mechanical measures comprising foot pumps until discharge from hospital and graduated compression stockings for six week.

Yes you will benefit from ongoing physiotherapy following your hip replacement particular during the first 2-3 months after your surgery. Mr Parminder Singh can help you organise this should you need assistance with this. With the less invasive techniques, some patients will require even shorter duration of time with physiotherapy.

Approximately 1-2 % of patients sustain a hip dislocation after total hip replacement. Some sexual positions can increase the likelihood of hip dislocation.  In particular during extreme flexion and rotation of the hip. The following article provides some useful information to help guide the patient during sexual activity after their surgery : Sex after hip replacement surgery

The overall cost of a hip replacement surgery is inclusive of the surgeon’s fees, hospital fees, anaesthetist and surgical assistant’s fees.

  • Surgeon’s fees: Dr. Parminder J Singh follows the Australian Medical Association ( AMA ) fees guidelines for all of his surgeries.
  • Hospital fees: This cost is covered entirely by your private health insurance. If you are uninsured, our staff will assist you with providing an estimated quote for your surgery
  • Anaesthetist and Surgical Assistant Fees: Dr. Singh has his own team of assistants and anaesthetists who also follow the AMA guidelines.

Following your consultation with Dr. Singh, our staff will go through the exact cost of your surgery in detail.

What Is The Process Moving Forward?

Step 1: Book A Consultation

If you do require surgery, we will schedule and walk you through the process of your operation.

Step 2 Schedule Surgery

During your appointment, Dr Parminder Singh will take a history, examine you and review the relevant radiology. If any further scans are required Dr Singh will request those. Once the diagnosis has been confirmed Dr Singh will discuss the non-surgical option and surgical options of surgery. If no surgery is required Dr Singh may refer you to a physiotherapist for non-surgical management. If surgery is required Dr Singh will consent you for the surgery explained the risk and benefits of the procedure and the expected outcome.

Step 3 Surgery

Dr Parminder Singh will see you before the surgery in the waiting bay and ensure all your questions have been answered prior to surgery.

Dr Parminder Singh will examine your hip, thigh and leg making sure there are no open wounds or signs of skin infection.

If there are any signs of infection, you surgery will be cancelled and rescheduled for another day.  Once this has been check Dr Parminder Singh will draw an arrow on the side of your thigh confirming with you the side of surgery. Dr Parminder Singh will check your consent form to again confirm the operation being performed and side of surgery.

Step 4 Recovery

Following your surgery, you will recover on the ward. Most individual stay three to four nights in the hospital and will be seen by the physiotherapist on the ward to facilitate mobilisation using crutches for the first 1-2 weeks.

Some individuals will use the crutches for longer depending on the type of injury and treatment required.  Dr Parminder Singh will see you in his rooms approximately 10-14 days after the hip replacement surgery and inspect the hip wound.

The stitches will be removed during this appointment.  Dr Parminder Singh will also explain the operative findings and recommended precautions and rehabilitation required. Another appointment will typically be organised for you around 6-8 week after this date to assess your progress.  In the meantime, rehabilitation is usually recommended with a physiotherapist who has experience with hip replacement patients.

It is important to follow the hip precautions Dr Parminder Singh recommends to allow for the best possible outcome.

Further appointments will be made at approximately 6 and 12months post operatively and check x-rays will be requested.   Dr Parminder Singh recommends to allow approximately 3 months for the soft tissue healing from the surgery and hip precautions during this period. The bone healing will continue for up to 12 months after surgery and Dr Singh will check this for you during the following up appointments.  In terms of longer term, Dr Singh will review you in 5, 10, 15, 20 years after your hip replacement with regular x-rays.

Book a Consultation

Committed to improving the quality of patient advice, treatment and care in the field of orthopaedics, book a one-on-one consultation with Dr Parminder J Singh today.

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Consulting Locations

21 Erin St,
Richmond VIC 3121

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(03) 9428 4128
85 Wilson St,
Brighton VIC 3186

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Suite 1G, 116-118 Thames St,
Boxhill VIC 3128

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(03) 9428 4128
Waverly Private Hospital,
343-357 Blackburn Rd,
Mount Waverley VIC 3149

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(03) 9428 4128