PAO surgery realigns the hip socket to better cover the femoral head, providing improved stability and function. It is typically recommended for patients with hip dysplasia to prevent further joint damage and reduce pain.
The surgery itself is painless due to anaesthesia, but post-operative pain and discomfort are expected. Pain management and physiotherapy are crucial for recovery.
PAO surgery is effective for patients with hip dysplasia. Most patients experience improved hip stability and function, reducing the risk of arthritis and improving quality of life.
The actual surgical time for a primary total hip replacement is surprisingly short, particularly with an experienced orthopaedic surgeon like Dr. Khoo who performs these procedures routinely. Typically, the time spent with the incision open and the actual placement of the new joint takes about 60 to 90 minutes. However, the total time you are in the operating theatre is longer. This includes the preparation time, where the anaesthetist places the necessary monitoring lines and administers the anaesthetic, and the clean-up time once the surgery is complete. Therefore, the total time a patient spends in the operating room environment from entry to exit is generally closer to one and a half to two hours. Patients often appreciate that the surgery itself is not a prolonged event, which helps in minimising blood loss and soft tissue trauma. This shorter, focused surgical time is part of the modern strategy to facilitate an enhanced recovery and a quicker hospital discharge, sometimes even allowing for day-of-surgery mobilisation.
The longevity of a total hip replacement is one of the most common and important questions Dr. Khoo addresses with his patients. Modern hip implants are highly durable, and evidence from orthopaedic registries shows that the vast majority of new hip joints can be expected to last a very long time. For most patients, it's reasonable to expect the implant to function well for 15 to 20 years or more. In fact, many patients find their hip replacement lasts even longer, with data showing a significant number of replacements are still functioning successfully after 25 years. The exact lifespan can vary between individuals and depends on several factors. A younger, more active patient who places higher stress on the joint may experience wear and tear on the plastic or polyethylene component sooner than an older, less active person. The quality of the bone fixation, the materials used in the implant (like ceramic or metal heads and different bearing surfaces), and maintaining a healthy weight all play a role. Ultimately, regular follow-up appointments allow Dr. Khoo to monitor the implant for any signs of loosening or excessive wear, helping to ensure its maximum possible lifespan.
The durability of modern total hip replacements is excellent, and it's highly likely your new hip will last a very long time. Australian registry data shows that the vast majority of implants remain functional for 15 to 20 years or more. In fact, the chance of needing a revision (a second surgery to replace components) is low, sitting at approximately 8% to 10% at the 20-year mark. This means that over 90% of patients still have their original hip in place two decades later. Dr. Khoo uses advanced materials, such as highly durable polyethylene in the socket liner, which is the component that typically wears out first. Improved materials and surgical precision, particularly when using techniques like the anterior approach, contribute to this excellent longevity. Factors like maintaining a healthy weight and sticking to low-impact exercises will help maximise the lifespan of your hip, potentially pushing its use well into the third decade. For most patients, this means the replacement is a long-term, life-changing solution to hip pain and loss of function.
While total hip replacement is one of the most successful orthopaedic procedures, Dr. Khoo ensures all patients are fully informed about the potential risks, which are carefully managed by the surgical and medical team. The most common complications, though still rare, include infection (which can affect the wound or, more seriously, the joint itself), dislocation of the new joint, and blood clots (deep vein thrombosis or pulmonary embolism). Measures are taken during and after surgery, such as antibiotics and blood thinners, to minimise these risks. Other potential issues include changes in leg length, which is corrected as accurately as possible but may still require a minor shoe raise, or nerve and blood vessel injury, which is very uncommon. Over time, there's also the risk of the components wearing out or becoming loose, which would necessitate a revision surgery, as discussed earlier. Dr. Khoo emphasises that most risks are low in percentage terms, but they are serious enough to warrant careful consideration. The decision to proceed with surgery is always based on the overwhelming likelihood that the benefit of pain relief and improved function will far outweigh these rare but manageable risks.
The recovery from a total hip replacement is a journey that begins immediately after surgery, but it is often less daunting than patients initially imagine. The first 24 to 48 hours are focused on pain management and getting you moving. Physiotherapy typically starts on the day of surgery, or the next morning, where you’ll learn to stand and take a few steps with assistance, often using crutches or a walking frame. Most patients in Australia are ready to go home in about three to five days, sometimes sooner with modern approaches.
Once you are home, the recovery process shifts into an intensive phase of regaining independence. For the first six weeks, your focus is on following hip precautions (if applicable to your surgical approach) and diligently performing your prescribed exercises. You'll likely need crutches or a cane for support during this time. By the six-to-twelve-week mark, most people can walk comfortably without assistance and can return to driving, provided they are off strong pain medication. While you’ll feel significantly better and resume many normal activities by three months, full recovery—the kind where you forget you even had surgery—can take up to a year. Dr. Khoo often reminds patients that consistency with physiotherapy is the single greatest predictor of a successful long-term result.
The prospect of needing a second surgery, often called a revision hip replacement, is something Dr. Khoo discusses openly with all patients. While the vast majority of hip replacements are successful and last for many years, a revision may eventually be required. This typically happens because the plastic liner begins to wear out after 15 or 20 years, or sometimes the metal components become loose from the surrounding bone over time. For an elderly patient receiving a hip replacement later in life, the implant may well outlast them, meaning a second surgery is very unlikely. For younger patients, however, a revision is a strong possibility, but it's important to view it as a solution for a well-functioning first operation that has simply reached its practical limit. Revision surgery is more complex, but outcomes are generally good. Other, less common reasons for a revision might include a recurrent dislocation or, very rarely, a deep infection that requires treatment. Dr. Khoo uses modern implant materials and surgical techniques, like the anterior approach, which are designed to maximise the longevity of the first replacement and push the need for any second operation as far into the future as possible.
The goal of a hip replacement is not necessarily to regain the "full" range of motion you might have had as a teenager, but rather to achieve a functional and pain-free range of motion that allows you to perform everyday activities without limitation. For most people, this means comfortably walking, sitting, climbing stairs, and getting in and out of a car. Prior to surgery, your hip joint's movement was limited and painful due to arthritis, so the new hip will undoubtedly improve your mobility significantly. It is important to remember that every individual is different. Factors like the quality of the surrounding muscle tissue, your commitment to physiotherapy, and any pre-existing spinal stiffness can influence the final outcome. Patients who have an anterior hip replacement often find they have fewer immediate restrictions on movement, which can feel like a more natural return to function. Dr. Khoo's aim is to eliminate the pain that restricted you before, allowing your muscles and soft tissues to strengthen and support a new, much wider range of movement than was previously possible. While deep squatting or extreme twisting may be cautioned against to protect the implant, you will have a hip that moves freely enough to let you get back to enjoying life.