Hip Replacement Surgery
Hip replacement is also known for Arthroplasty.Arthroplasty is a reconstructive surgery to restore the joint motion and function and to relieve pain. It generally involves the replacement of bony joint structure by a prosthesis. It is the most common orthopaedic surgery.
Hip Replacement Surgery can be performed:
- Total replacement:- it consist of replacing both the acetabulum and the femoral head.
- Half(hemi) replacement:- It consist of replacing of only femoral head in general.
Principles and Considerations
- The prosthetic implant must be durable.
- They must peremit extraordinary low friction movement at the joint.
- They must be firmly fixed to the skeletal.
- They must be inert and not provoke any unwanted reaction in the tissue.
- Selection of the prosthesis and fixation technique depends pn patients bone structure, joint stability , and other individual characteristics , including age, weight ,and activity level.
IndicationFor patients with unremitting pain and irreversibly damaged joints.
- Severe osteoarthritis
- Rheumatoid arthritis
- Selected fracture(femoral head fracture)
- Failure of previous reconstructive surgery( osteotomy, cup arthroplasty, femoral neck fracture complication- nonunion, avascular necrosis)
- Congenital hip diseases.
- Pathological fractures from metastatic cancer.
- Joint stability
- When the infection is recent or remote.
- When the person is under 60 years of age , especially when alternative surgery is available.
- When pain is not severe.
- When manual labovers are gainfully employed.
- The prosthetic implant used in hip replacement consist of different part
- The acetabular cup
- The femoral component
- The articular interface
- Options exist for different patients and indications
- Correct selection of the prosthesis is important.
Types of Implants
- Metal-on –metal
- Cemented, cementless, or hybrid fixation of prosthesis.
Pre operative management :- we are making patient suitable for surgery and explain the post operative regimens.
Post operative:- the patient must not adduct or flex the operated hip- may lead to subluxation or dislocation of hip
Sign of hip dislocation
- Shortened extremity
- Increasing discomfort
- Inability to move
Patient don’t attempt excessive hip adduction, flexion and rotation for 6 weeks after hip arthroplasty.Avoid sitting low chair or toilet seat to avoid flexing hip>90 deg. Keep knees apart do not cross leg. Follow weight bearing restriction from surgeon.
- Hip replacement surgery results are often excellent. Most or all of your pain and stiffness should go away.
- Some people mayhave problems with infection, loosening or even dislocation of the new hip joint.
- Over time the artificial hip joint will loosen. This can happen after as long as 15-20 years. You may need second replacement.