Nowadays, hip replacement is so commonly performed that it is regarded as routine. The outcomes are usually excellent, and many people aren’t aware of their new hip after a few months.

Some new research just published shows that in some younger patients who have hip replacement surgery, the results aren’t always so predictable.

The study examines whether we ought to make our expectations more realistic in terms of what we tell younger patients (18 to 60 years) to expect, symptomatically and functionally, following total hip arthroplasty surgery. Traditionally, the perceived expectation is to be able to achieve the “forgotten hip”. It is a retrospective cohort study which initially identified 1336 patients undergoing either total hip arthroplasty or hip resurfacing. After patient dropout/refusal to comply, or failure to meet exclusion criteria, 886 remained in the final dataset. A computer system was then used, utilising telephone numbers randomly generated, to identify and contact a group of control patients matched for age, sex, and various other criteria. In the control group, the researchers found a surprisingly high incidence of limp (15%), stiffness (11%), pain (8%), or hip noise during the previous 30 days. Although these issues are less common than those found in the joint replacement surgery group, this does highlight the fact that even a “normal” hip is not always a symptom-free joint. Given the results of this study, it is unrealistic to suggest to patients who have both experienced significant hip pathology and then undergone a major surgical intervention that the end results of a “forgotten hip” can be in any way taken for granted.

Nam et al (2016) Residual symptoms and function in young, active hip arthroplasty patients: comparable to normative controls? J Arthroplasty 2016;31:1492-1497