Hip Replacement Surgery
Total Hip Joint Replacement Anatomy
Nowadays hip replacement surgery has become a common procedure. Total hip replacement (THR) is a surgical procedure that relieves pain from most kinds of hip arthritis, improving the quality of life for the large majority of patients who undergo the operation.
When other therapies fail to provide relief from the pain of a damaged hip, hip replacement may be the answer. Hip replacement — called total hip arthroplasty — can relieve pain and give you back the range of motion you need to go about your daily tasks.
Conventional Total Hip Replacement surgery is a very successful procedure for the treatment of Hip Arthritis. The purpose of the total hip replacement is to remove the two damaged and worn parts of the hip joint – the hip socket ( acetabulum and the ball (femoral head) – and replace them with smooth, artificial implants called prostheses which will help make the hip strong, stable and flexible again.
Hip replacement is usually considered once other therapies, such as pain medications, have failed. Most people undergo hip replacement as a result of osteoarthritis of the hip joint.
You might want to ask your doctor about the possibility of hip replacement if you frequently experience any of the following:
- Pain that keeps you awake at night
- Little or no relief from pain medications
- Difficulty walking up or down stairs
- Trouble standing from a seated position
- Having to quit activities you enjoy, such as walking, because you’re in too much pain
Hip replacement used to be an option primarily for adults age 60 and above. But improved technology has made strong and longer-lasting artificial joints that are feasible for more active people, including younger people. However, active people face the possibility of another surgery to replace worn-out artificial hip joints after 15 or 20 years
Total Hip Joint Replacement Operation takes two hours and you are in hospital between 5 and 7 days. Crutches are usually required for the first 6 weeks. These are provided by the hospital.
What is a Hip Joint?
A joint is a special structure in the body where the ends of two more bones meet. Hip Joint is a simple ball and socket joint. Upper end of the femur fits into a socket called the acetabulum, which is part of the pelvis. Ends of the bone are covered with a smooth, glistening material called hyaline cartilage. Hyaline cartilage cushions the underlying bone from excessive force and allows the joint to glide freely without pain.
The hip joint is held together with ligaments to keep the joint stable. The hip joint is enclosed in a capsule with a smooth inner lining called the synovium. Synovium provides the lubricant, synovial fluid, which helps to reduce friction and wear in the joint. Surrounding muscles and tendons enable the joint to move in various directions and also help to keep it stable.
Complications and Risks
Before having a total hip joint replacement there are certain things you should understand regarding the surgery. The main indication for doing a total hip joint replacement is the severity of the pain. Therefore to a large extent the decision to proceed with surgery rests with the patient. Although alternative procedures are available for management of hip pain from arthritis, including stiffening of the hip and a realignment of the thighbone, these days the most common procedure is a hip replacement.
No operation can be guaranteed 100% successful but in the main total hip joint replacements are very successful and over 95% of patients are very pleased with the result. With ANY operation there are risks to nerves, blood vessels, bone, tendons, ligaments, muscle, skin and structures which are not intentionally injured but occasionally are so. The more common complications may arise and these include:
Hip Dislocation – Dislocation of the hip, which most commonly occurs in the first few weeks following surgery. Dislocation occurs if the leg is put in an extreme position. Your physiotherapist will advise which positions to avoid. This can usually be reduced without difficulty and usually only a few will go on to give further problems.
Implant Wear – Wear of the components is slow but does occur though it is not a problem for many years following surgery.The majority will last more than 15 – 20 years.
Implant Loosening – The most major long term problem is one of loosening of the fixation of the components. With this there can be slow loss of bone around the hip. This is dependent on weight and activity as well as age. On average less than 5% of implants will require revision within 10 years.
Leg Length Discrepancy – An alteration of leg length may occur. It is important at the time of surgery that the hip is stable to prevent dislocation , and sometimes this may result in some lengthening of the leg. This is rare and if it occurs it is usually less than 1-2 cm. This would be particularly obvious if there is arthritis in the opposite hip causing shortening on that side. If your leg is already long, it is rare that I can shorten it as this makes the hip more likely to dislocate.
Infection – Infection can be a major problem which is difficult to treat and sometimes results in removal of implant. Antibiotics are given during and after the operation. Infection control parameters are in place to reduce the risk. However It is important not to have any infections at the time of surgery, including teeth problems, bladder or skin infections. We suggest that you have a dental check up within 6 months prior to surgery as it is important not to have any major dental work for 6 months after the surgery. Please let me know if you have any infections prior to surgery.
Anaesthetic Complications – Modern day anaesthetics are very efficient and safe but when dealing with older patients there is always the possibility, although small, of heart or chest complications. Blood clots can occur as a complication of any operation and these may be fatal in less than one patient per thousand. This is reduced further by taking 100mg of Aspirin (Cartia) daily for 6 weeks after surgery.
For further information or questions discuss with your doctor or you can visit: Information on the link should be discussed with your surgeon.