If you have hip joint injury or impairment that causes pain and inhibits your daily activities, you may be a candidate for hip replacement surgery.
Hip replacement surgery, also known as arthroplasty, is a surgical procedure in which the damaged and diseased parts of the hip joint are removed and replaced with artificial parts, known as a prosthesis. The hip joint is a ball-and-socket type joint that can rotate in many positions. This procedure replaces both the natural socket and the rounded ball at the top of the thigh bone with duplicate parts. Hip replacement is done to increase function of the hip joint and in turn improve mobility. In the U.S., over 50,000 hip replacements are carried out each year, and most are done on adults age 65 and older. Most people who have hip replacement are women who want a better quality of life.
Hip replacement is typically reserved for those who have pain and limited mobility that interferes with the activities of daily living. One of the most common causes of hip joint damage is osteoarthritis, a condition that consequences in pain and stiffness of a joint. Rheumatoid arthritis is another cause. This disease results in joint pain, stiffness, and swelling.
Osteonecrosis can cause hip damage, too. It involves avascular necrosis which is the death of bone due to insufficient blood supply. Septic arthritis, another source of hip destruction, results from a joint that becomes infected. Other reasons for a hip replacement are fracture, bone tumors, or injury that leads to collapse of the hip joint.
Not long ago, doctors would only perform arthroplasty on those people over 60 years of age. This was because older people were less active and put less stress on the replaced artificial hip than their younger counterparts. Now, doctors have found that these surgeries can be successful in younger people too. The new medical technology has improved the artificial parts and allows them to withstand more stress and strain. The overall health and activity level of the person is valued more than the person's age.
What are the Alternatives to Hip Arthroplasty?
Your doctor may try many other methods of treatment before bringing up a hip replacement. These alternatives include exercise, physical therapy, walking aids, an exercise program, and medication. If inflammation is the root of the problem, the doctor may prescribe a nonsteroidal anti-inflammatory drug (NSAID) such as Naproxen or Motrin. It is not unheard of for people with severe hip pain to be on strong narcotic pain medication. Also, numerous nutritional supplement programs exist that combine glucosamine and chondroitin for relief of pain.
Joint injection is a common office procedure that works for some people with hip problems. This is a procedure where corticosteroids are injected directly into the hip joint. Also, doctors can inject joint lubricants such as hyaluronan that allow for increased range-of-motion. If exercise and medication do not work for you, the doctor may suggest a less complicated procedure before hip replacement. A common substitute is osteotomy. This treatment involves realigning the bone to transfer weight from the damaged, painful bone surface to one more healthy and strong area.
What all is Involved with Hip Replacement Surgery?
The area where the end of the femur (thigh bone) and the pelvis bone meet is known as the hip joint. The femoral head (a ball from the end of the femur) fits into the acetabulum (a socket) to allow a broad range-of-motion. The surgeon simply will make a six to eight inch incision over the side of the hip and remove the diseased bone tissue and cartilage from the joint region. After that, the surgeon replaces the head of the femur and acetabulum with prosthetic parts. These new artificial materials allow for a natural sliding motion of the joint.
Alternative Procedures
A new surgery that has hit the O.R.s is a surgery called minimally invasive replacement or mini-incision arthroplasty. During the last decade, this procedure has been used because it allows for smaller incisions and shorter recovery afterwards. To be a candidate, you must be less than 50 years old and have a normal body weight. Overall health is measured for this procedure. The parts for both styles of surgery, traditional or minimally invasive, come in two customary varieties. One type involves cemented parts which are fastened to existing, healthy bone with surgical glue.
This procedure is referred to as a "Cemented" hip replacement. Another option involves uncemented parts and it requires biologic fixation to hold these parts in place. The "Uncemented" technique encompasses the use of parts made with a porous surface that lets the patient's bone grow into the pores to hold the artificial parts in place. Uncemented replacements are chosen often for the older, less active person and for individuals who have weak, fragile bones from osteoporosis or Paget's disease.
There is an advantage to the Cemented procedure. Research findings indicate that recovery time is less with this type of technique when compare to the Uncemented surgery. Experts say that it takes longer for the natural bone to grow and attach to the prosthesis with uncemented hip replacements.
What are the Complications of Hip Arthroplasty?
The American Academy of Orthopedic Surgeons conveys that there are more than 231,000 hip replacements performed each year in the United States alone. At least ninety percent of these do not require any type of revision due to new technology and innovations in surgery. However, some complications and difficulties do arise. The most common and dangerous initial complication is hip dislocation. This is when the ball becomes dislodged from the socket.
The most usual later complication is inflammatory reaction to the prosthetic joint particles that may wear off the joint surface and be wedged into the neighboring tissues. This inflammatory response triggers the action of cells that wear away the bone and cause the implant to loosen. Less common problems are infection, blood clots, and joint stiffening.
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