HIP REPLACEMENT
Description
Hip replacement surgery can relieve you from acute pain, deformity, or disability caused due to any of the reason, such as osteoarthritis, accident, or childhood hip disease etc. It is generally proposed when no other treatment is able to relieve you from hip joint pain and discomfort. If your orthopedic doctor has finally advised a hip replacement surgery, it is the time to know how this surgery would change your life for good.
Hip joint replacement surgery has proved to be a boon in the lives of millions of people around the world who were facing acute pain in their hip joints and were not able to do simple activities of their lives. With the development of medical science and technology, implant materials have also gone better and enhanced the longevity of hip replacement surgeries. Also, the latest advanced surgical techniques have greatly reduced the risks of such surgeries. So, if you have been advised a hip replacement, do not need to worry.
Hip replacement has the success rate of over 95%, 10 years after the surgery, and over 85%, 20 years post-operation. After the surgery, over 98% patients reported complete relief from hip pain and did not required revision surgery later.
Do I need a hip replacement?
The hip is a ball-and- socket joint, which allows a wide range of movement. Arthritis damages the cartilage-covered surfaces of the joint so the ball moves less smoothly and less freely within the socket. In a hip replacement or resurfacing operation, the surgeon replaces the damaged surfaces with artificial parts, which may be made of metal, plastic or ceramic materials.
Hip replacement is most commonly recommended for severe osteoarthritis, but it’s sometimes used for inflammatory conditions such as rheumatoid arthritisor ankylosing spondylitis or for problems with development of the hip during childhood. Hip surgery may also be needed for fractures of the hip, including those resulting from osteoporosis.
You won’t necessarily need a hip replacement if you have arthritis of the hip, but it may be worth considering if your hip is severely damaged and the pain, disability or stiffness are having serious effects on your daily activities. Your doctors will always try other measures before suggesting a hip replacement – for example,painkillers, physiotherapy and/or walking aids, or occasionally a steroid injection into your hip joint.
There are no age limits for having hip replacement surgery, although the younger you are when you have surgery, the greater the chances that your new joint will eventually wear out. However, it’s usually possible to have another hip replacement later on if you need to.
What are the possible advantages of a hip replacement?
Freedom from pain is the main possible advantage of hip replacement surgery, along with improved mobility. Both of these should improve your quality of life. You'll have some pain from the surgery to begin with but you should soon start to notice improvements soon after the operation.
What are the different types of hip replacement surgery?
There are two main types of hip replacement operation, but a number of different components and surgical techniques may be used.
• Total Hip Replacement
In a total hip replacement, part of the thigh bone (femur) including the ball (head of femur) is removed and a new, smaller artificial ball is fixed into the rest of the thigh bone. The surface of the existing socket in the pelvis (the acetabulum) is roughened to accept a new socket component that will join up (articulate) with the new ball component.
Many artificial joint components are fixed into the bone with acrylic cement. However, it's becoming more common, especially in younger, more active patients, for one part (usually the socket) or both parts to be inserted without cement. If cement isn’t used, the surfaces of the implants are roughened or specially treated to encourage bone to grow onto them. Bone is a living substance and, as long as it’s strong and healthy, it’ll continue to renew itself over time and provide a long-lasting bond. Where only one part is fixed with cement, it’s known as a hybrid hip replacement.
The replacement parts can be plastic (polyethylene), metal or ceramic and are used in different combinations:
• Metal-on- plastic (a metal ball with a plastic socket) is the most widely used combination.
• Ceramic-on- plastic (a ceramic ball with a plastic socket) or ceramic-on- ceramic (where both parts are ceramic) are often used in younger, more active patients.
• Metal-on- metal (a metal ball with a metal socket) is very occasionally used in younger, more active patients.
• Metal-on- metal hip resurfacing
Resurfacing the original socket and the ball of the thigh bone is a different form of hip replacement. Instead of removing the head of the thigh bone and replacing it with an artificial ball, a hollow metal cap is fitted over the head of the thigh bone. The socket part of the joint is also resurfaced with a metal component.
People who have this type of operation have a lower risk of dislocation and may be able to return to a higher level of physical activity compared with those having a conventional hip replacement.
This type of hip surgery is linked with a release of metal particles from the joint replacement materials, which may cause local inflammatory reactions and have unknown effects on your general health. The complication rates and early repeat surgery rates for hip resurfacing procedures in the National Joint Registry for England and Wales are much greater than for conventional hip replacements. Complication rates are particularly high in older patients and in women. Metal-on- metal resurfacing isn’t suitable for people with low bone density or osteoporosis, where the bones are weakened.
Little is known about the long-term performance of these joints as the technique hasn’t been in use for as long as total hip replacements. However, the poorer mid-term performance for these types of hip replacement means they're being used less frequently in the UK and in other countries.
Pre & Post Pictures of Hip Replacement
Pre op showing: Neck of femur left with implant failure with osteoarthritic changes
Post op total hip arthroplasty