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Hip Replacement Surgery
Relevant information about Hip Replacement Surgery.
The Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant. The hip is a ball and socket joint. The ball at the top of the thigh bone (femur) moves in the socket of the pelvis (hip) on a lining of cartilage. If the cartilage wears away, the joint may be painful and stiff. A new hip joint can help patient improve mobility and reduce pain. Replacing the hip joint consists of replacing both the acetabulum and the femoral head. Such joint replacement orthopedic surgery generally is conducted to relieve arthritis pain or fix severe physical joint damage as part of hip fracture treatment. Hip replacement is currently the most successful and reliable orthopedic operation. The Hip Replacement Surgery is also called total hip arthroplasty.
- When you need a Hip Replacement Surgery
The replacement of the Hip might be needed because it provokes pain, limits patient´s movement, or in order to reduce patient´s wear and tear. Hip replacement is typically used for patients with hip joint is damaged from arthritis or an injury.
Followed by rehabilitation, hip replacement can relieve pain and restore a range of motion and function of the patient´s hip joint. Surgery is usually recommended only if non-surgical treatments, such as physiotherapy, taking medicines or using physical aids such as a walking stick, no longer help to reduce pain or improve mobility. Artificial hip parts can be made of metal, ceramic or plastic.
On the other hand, there´re other options as alternative treatments for surgery. Hip resurfacing is an alternative surgical procedure. In this operation the surfaces of the ball and socket are covered with metal parts. Hip joints can be fixed in place using a special substance called "bone cement". Alternatively, they may be coated with a chemical that encourages bone to grow into the prosthetic joint fixing it in place. Occasionally the artificial joints may be fixed using bone screws.
- What does the surgery consist on
There are several different incisions, defined by their relation to the gluteus medius. The approaches are posterior, lateral, antero-lateral, anterior and greater trochanter osteotomy. The typical hip replacement procedure uses one of two approaches performed through similar incisions located on the upper thigh and buttock. One is called a posterior-lateral approach and the other is the anterior-lateral approach. On the other hand, Minimally Invasive Technique’s approaches using small incisions combined with traditional approaches, as well as, to alternate surgical approaches employing smaller incisions or sometimes two incisions. Single incision techniques for minimally invasive surgery include the Anterior Approach. Anterior means front. So this technique uses one small incision on the front of the upper thigh. The posterior-lateral approach accesses the joint through the back, taking piriformis muscle and the short external rotators off the femur. This approach gives excellent access to the acetabulum and preserves the hip abductors. Critics cite a higher dislocation rate, although repair of the capsule and the short external rotators negates this risk. Two-incision techniques use one opening nearer the front of the thigh to insert the socket part of the implant, and a separate small incision toward the back of the thigh to insert the stem of the implant. Minimally invasive hip replacement allows surgeons to implant traditional hip components through one or two small (1.5 to 4 inch) incisions rather than the traditional 10 to 12 inch incision. The goal of minimally invasive hip replacement is to minimize the amount of soft tissue damage that occurs when a surgeon reconstructs a hip. There are more than 60 different types of implant or prosthesis. In practice, however, the options are usually limited to around four or five. Patient´s surgeon can advise him/her on the type he thinks would suit best.
The surgeon performs the planned approach and will reshape the hip´s socket to fit the new cup implant that replaces the diseased socket. After the socket is reshaped, a new cup will be placed in the socket. The cup usually consists of a metal shell and a polyethylene or metal liner. The surgeon then prepares patient´s femur for the femoral stem, which will hold the new ball part of patient´s hip joint. The head of patient´s femur is removed and the bone is prepared for the new femoral stem. The surgeon will most likely use a trial implant to verify the correct fit. After the permanent hip stem is implanted, the ball that sits at the top of the patient´s femoral stem will be put into place. Once the surgeon is satisfied with the position, movement and adaptation of the new artificial hip, he finishes the procedure. After the surgery, patient must remain in the medical center for a couple of dates. Patient’s heart rate, blood pressure, and respiration will be controlled at all time. Patient will be given pain medication, by various means depending on the surgeon's plan.
- Anesthesia: Before the operation, patient will receive a general anesthetic (where patients are put to sleep) or a spinal (epidural) anesthetic plus sedation. Patient will be sleep and won´t feel paint during the procedure.
- How is the post-surgery process
Patient with a new implanted hip must avoid movement in the days after the procedure. Patient´s physical therapist will instruct him/her to begin isometric exercises a number of times per day while patient are still in bed. Also, physical therapist will advise how to move the ankle and other joints. Patient will have to learn the safest methods for getting in and out of bed or a chair, and on and off. The physical therapist will check patient´s progress daily and will keep the surgeon informed. Strong or constant movements might affect the result of the surgery. When the surgeon recommends it, patient will start a series of exercise in order to be able to walk the soon as possible. Patient can return to work a few days after the surgery, but he/she should avoid uncomfortable position.
The Hip Replacement Surgery is a safe procedure. Complications are rarely, and most of them happen due to wrong surgeon´s praxis, or patient´s specific conditions. A common complication is the infection of the wound or joint. Antibiotics are given during and after surgery to help prevent this. Joint dislocation is another facto of risk. This is most likely to happen immediately after your surgery and patient may need another operation to treat this. Also, patient´s leg may be slightly shorter or longer and he/she may need to wear a raised shoe on the shorter side to correct your balance.
Hip fracture and unstable joint might also occur after the surgery is done.
Hip replacement procedure might allow the patient:
- Feel no pain at walking, sitting, sleeping or any other time that demands a specific body position.
- The practice of favorite sport (although professional or high-demand sports might not be practiced again).
- Body appearance may be improved by the surgery.
Patient could suffer mostly temporary effects of a successful treatment, for example feeling sick as a result of the general anesthetic. Patient might feel uncomfortable for a couple of risk in the hip zone. Patient may also have some temporary pain and swelling in his/her knee and ankle.
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