When non-surgical treatment fails to control the discomfort and stiffness of hip arthritis, the surgeon may recommend Total Hip Arthroplasty. Arthroplasty implants are commonly used to replace the joint, which are usually made of metal alloy and polyethylene (plastic). Newer metallic implants are currently used in certain surgical patients. Total hip replacement replaces the upper end of the femur and the acetabular surface (pelvic socket). Implants are designed to restore functionality and minimize discomfort as much as possible, while allowing the patient to return to a more active lifestyle.
Total hip arthroplasty is a surgery that is designed to replace a damaged, usually arthritic, hip joint. The hip joint is a spherical-receptor joint. The head of the femur forms the spherical element, which fits exactly into the pelvic socket (acetabulum).
The surfaces of these bones are covered by a smooth substance called articular cartilage. Arthritis causes damage to the articular cartilage, leaving the underlying bone exposed. This result is presented in the photo on the right. Arthritis can cause pain, deformity and loss of mobility.
In a total hip replacement surgery, the surgeon replaces the damaged femoral head with a metallic or ceramic spherical implant mounted on a rod, while a polyethylene or metal cup is fitted in the pelvic socket (plastic). The prosthesis can be fixed with cement similar to dental cement or fixed in the proper position by applying pressure without cement. The parts of a total hip arthroplasty are usually called prostheses, elements or implants.
Hip Surface Arthroplasty
Hip Surface Arthroplasty involves the replacement of the affected or damaged surfaces in the hip joint (that is, the top of the femur and the inner surface of the acetabulum) with metallic surfaces.
This surgery is recommended for people under the age of 65 with advanced sciatica who would anyway undergo conventional hip arthroplasty. In hip arthroplasty, a smaller segment of bone is removed, making it easier to repeat the operation or to perform a further total hip replacement in the future. A hip arthroplasty surgery can help improve quality of life, but is not recommended for all patients.
The surgical operation
It usually requires up to two hours
The surgeon performs a single incision (20 to 30 cm) above the hip and thigh. Depending on the technique used by the surgeon, the incision may be smaller.
The upper end of the femur is removed and a spherical implant attached to a rod is placed inside the femur.
The pelvic socket is shaped so that a shallow cup is formed and an artificial socket (acetabulum) can be placed on it. The artificial part of the femur can then be applied to this socket
The surgeon sutures the surgical incision with stitches or clips.
Recovery after surgery
Physiotherapy exercises are important after a total hip arthroplasty and usually a smooth recovery depends on whether the patient follows the prescribed postoperative exercise program. In general, patients recover fairly quickly, but in some cases, the patient first needs crutches or a walker and then a cane for a few months.
Hip replacement surgery significantly helped arthritis patients to return to their normal activities and relieve the discomfort they felt.
The length of hospitalization varies, but can range from 3 to 10 days. After discharge, daily physiotherapy and exercises are required.
During the post-operative period the patient is trained on techniques to walk, climb and descend stairs, to sit and stand up from a chair, car seat and toilet seat.
Preoperative and postoperative treatments vary and depend on many factors. Talk to your surgeon about the treatment options and exercise plan that is right for you.
Back to work
Usually this is achieved within 2-3 months, but many patients, especially those who perform sedentary work, return earlier. Every person is different and your doctor will advise you on when you will be ready to return to work.