:: total hip replacement arthroplasty surgical procedure osteoarthritis arthritic artificial joint India UK

M.S. ORTH (Pune),M.Sc., ORTH. (London) Dipl. LAMP (CARDIFF)
Consultant Joint Replacement Surgeon

www.jointreplacementexpert.com

total hip replacement arthroplasty surgical procedure osteoarthritis arthritic artificial joint India

Total Hip Replacement

Overview

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.

Patients commonly undergo THR after non-operative treatments (such as activity modifications, medications for pain or inflammation, or use of a cane) have failed to provide relief from arthritis symptoms. Most scientific studies that have followed patients for more than 10 years have found "success rates" of 90 percent or more following traditional THR.

Distilled to its essentials, THR involves surgically removing the arthritic parts of the joint (cartilage and bone), replacing the "ball and socket" part of the joint with artificial components made from metal alloys, and placing high-performance bearing surface between the metal parts. Most commonly, the bearing surface is made from a very durable polyethylene plastic, but other materials (including ceramics, newer plastics, or metals) have been used. Patients typically spend a few days in the hospital after the procedure (5 to 10 days is most typical), and some patients benefit from a short inpatient stay in a rehabilitation facility after that to help transition back to living independently at home. Most patients will walk with a walker or crutches for 4 to 6 weeks, most will use a cane for another 4 to 6 weeks after that; after that, the large majority of patients are able to walk freely.

A bewildering number of different implant designs, bearing surface materials, and surgical approaches have been tried to achieve one seemingly straightforward goal: improving the quality of life for patients who have hip arthritis. As with any important life decision, it makes good sense to get educated on those issues as they pertain to your hip.

Introduction

A hip that is painful as a result of osteoarthritis (OA) can severely affect your ability to lead a full, active life. Over the last 25 years, major advancements in hip replacement have improved the outcome of the surgery greatly. Hip replacement surgery (also called hip arthroplasty ) is becoming more and more common as the population of the world begins to age.

This guide will help you understand

»	what your surgeon hopes to achieve
»	what happens during the procedure
»	what to expect after your operation

Anatomy

How does the hip normally work?

The hip joint is one of the true ball-and-socket joints of the body. The hip socket is called the acetabulum and forms a deep cup that surrounds the ball of the upper thigh bone, known as the femoral head. The thick muscles of the buttock at the back and the thick muscles of the thigh in the front surround the hip.

The surface of the femoral head and the inside of the acetabulum are covered with articular cartilage. This material is about one-quarter of an inch thick in most large joints. Articular cartilage is a tough, slick material that allows the surfaces to slide against one another without damage.

Rationale

What does the surgeon hope to achieve?

The main reason for replacing any arthritic joint with an artificial joint is to stop the bones from rubbing against each other. This rubbing causes pain. Replacing the painful and arthritic joint with an artificial joint gives the joint a new surface, which moves smoothly without causing pain. The goal is to help people return to many of their activities with less pain and greater freedom of movement.

Preparation

How should I prepare for surgery?

The decision to proceed with surgery should be made jointly by you and your surgeon only after you feel that you understand as much about the procedure as possible.

Once the decision to proceed with surgery is made, several things may need to be done. Your orthopedic surgeon may suggest a complete physical examination by your medical or family doctor. This is to ensure that you are in the best possible condition to undergo the operation. You may also need to spend time with the physical therapist who will be managing your rehabilitation after the surgery.

One purpose of the preoperative physical therapy visit is to record a baseline of information. This includes measurements of your current pain levels, functional abilities, and the movement and strength of each hip.

A second purpose of the preoperative therapy visit is to prepare you for your upcoming surgery. You will begin to practice some of the exercises you will use just after surgery. You will also be trained in the use of either a walker or crutches. Whether the surgeon uses a cemented or noncemented approach may determine how much weight you will be able to apply through your foot while walking.

This procedure requires the surgeon to open up the hip joint during surgery. This puts the hip at some risk for dislocation after surgery. To prevent dislocation, patients follow strict guidelines about which hip positions to avoid (called hip precautions ). Your therapist will review these precautions with you during the preoperative visit and will drill you often to make sure you practice them at all times for at least six weeks. Some surgeons give the OK to discontinue the precautions after six to 12 weeks because they feel the soft tissues have gained enough strength by this time to keep the joint from dislocating.

You may be asked to donate some of your own blood before the operation. This blood can be donated three to five weeks before the operation, and your body will make new blood cells to replace the loss. At the time of the operation, if you need to have a blood transfusion you will receive your own blood back from the blood bank. Ruby Hall Blood Bank is situated in the basement of the hospital and all enquiries can be made for further clarification.

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