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

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.

Indication

For 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

Contraindication

  • 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.

Implants

  • 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

  • Ceramic
  • 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

Health Education

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.

Prognosis

  • 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.