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Arthroplasty – Hip replacement surgery

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Hip replacement surgery involves removal of the diseased or non-functional hip joint and replacing it with an artificial joint. The following paragraphs will answer some of your questions regarding arthroplasty – hip replacement surgery.

What is Arthroplasty?

Arthroplasty means surgical repair of the joint. It is an orthopedic surgery where the musculoskeletal joint is replaced, remodeled and realigned.

The different forms of arthroplasty include:

  • Interpositional arthroplasty
  • Resectional athroplasty
  • Resurfacing arthroplasty
  • Mold arthroplasty
  • Cup arthroplasty
  • Silicone replacement arthroplasty
  • Osteotomy

What is Hip Replacement?

The surgical procedure to replace the hip joint by a prosthetic implant is called as hip replacement. It is one of the most common orthopedic operations. Hip replacement includes total replacement of joint or ‘hemi’ (half) replacement of the joint.

In case of total replacement, both the acetabulum and femoral head are replaced. In case of hemiarthroplasty, only the femoral head is replaced. The diseased joint is replaced with a prosthesis. It is made of metal or ceramic ball component and the insert or liner is made of plastic, ceramic or metal. The prostheses are made up of biocompatible material. This makes it easy for the body to accept the prostheses.

Who Are Eligible for Hip Replacement?

Hip replacement is a joint replacement orthopedic surgery. It is conducted after all conventional treatments like pain medications and physical therapies have failed. The reasons for this surgery usually include:

  • Relieving severe arthritis pain
  • Fixing severe physical joint damage due to hip fracture
  • Treatment of joint failure due to osteoarthritis
  • Rheumatoid arthritis treatment
  • Treating avascular necrosis, benign and malignant bone tumors
  • To cure the conditions associated with juvenile rheumatoid arthritis, ankylosing spondylitis and Paget’s disease

Are There Any Risks Associated with Arthroplasty?

Joint replacement surgeries including hip replacement surgery, carry certain risks.

These risks include:

  • Deep vein thrombosis
  • Pulmonary embolism
  • Dislocation of the hip joint during the healing period after the surgery
  • Osteolysis due to the body’s reaction to the polyethylene wear debris
  • Sensitivity to the metal in the prostheses leading to skin hives, eczema, redness, itching, etc.
  • Nerve palsy due to injury to the nerve
  • Chronic pain in the groin after the surgery
  • Leg length inequality

What Happens Before the Procedure?

The orthopedic surgeon will take your medical history and ask about the medications you take. A brief physical examination will be conducted to make sure you are healthy enough to undergo the procedure. The hip and the motion of the joint will be examined. A few blood tests will be conducted and maybe an MRI.

This is the right time to ask your surgeon regarding any doubts, questions, fear, etc. you may have regarding your surgery.

How is The Procedure Performed?

Hip replacement surgery is performed under general anesthesia. One will be asked to lie on the side on the operating table. A special brace will be placed around you, to hold you on the side and stabilize the pelvis.

The surgeon will make an incision in the hip joint and split the muscles carefully. This will help expose the worn out hip joint. The femoral head will be removed to allow the surgeon the acetabulum properly. Any debris present will be removed and a reamer is used to design the socket in such  way that it accepts the artificial acetabular component.

After this the artificial socket is inserted into the joint. There are two types of sockets, cemented and uncemented. The cemented is socket is cemented into the bone. In case of uncemented, the bone grows into the socket. The doctor will advise you which socket is appropriate for you, after assessing your bone health.

Once the socket is prepared, the femoral bone is made ready to accept a cemented or uncemented socket. A trial femoral head is placed on the stem with reduction in hip. This helps the surgeon tension the hip properly and measure its range of motion. The leg lents and stability is also checked.

Once the trail is complete, the femoral head is placed in the socket and the hip is reduced. In some cases, the leg lengths will not be equal. This is done to help prevent dislocation and maintain equal tension in the hip joint. The wound is then sutured with absorbable sutures and a drain is inserted.

What Happens After the Surgery?

After the surgery, you will be wheeled into the recovery room. Your blood pressure, pulse, blood oxygen meter, etc. will be monitored continuously. After you are stable, you will be taken to your room. The surgery requires one to stay in the hospital for several days.

A physical therapist will help plan an exercise program for you to make sure your joints start moving. After a few days, you will be discharged and given an exercise regime to follow.

Once home, make sure you have a friend or relative to assist you at home. Do not bend to pick things up. Try to keep things at waist level. If possible, raise the level of the toilet seat. After about 6 to 8 weeks you may have to visit the doctor for follow-up. Most people with successful surgeries resume most of their daily activities in a limited fashion by this time.

Prognosis

The percentage of patient satisfaction immediately after the surgery and in the long run varies. However, in 90% of the cases, the surgery is a success. Most people can walk, jog, swim, play golf or ride a bicycle after the surgery. Also, the amount of pain is reduced greatly after the surgery.

This was all about arthroplasty, hip replacement. If you have trouble with your hip joint and non of the traditional treatments help, speak to your orthopedic regarding the chances of a hip replacement surgery in your case.

Written by: healthplus24.com team

Date last updated: December 11, 2014