Hip Replacement
Hip replacement is the process of changing the damaged hip joint with metal / ceramic implants which were designed to copy the movements of a healthy joint.
Hip joints are one of the main pressure points of the body, and damages on these joints can cause a lot of pain in daily life. If the case is advanced and other factors such as age, weight and general health are favorable, the surgeon might choose this surgery to treat the patient. The success rate for knee replacement surgeries is above 95% if done by an experienced surgeon. With modern designs and materials, expected life of a hip prosthesis increased up to 25 – 30 years.
Why Hip Joints Get Damaged?
Young Patients:
- Congenital Joint Problems
- Hip Joint Diseases in Childhood
- Perthes Disease
- Osteonecrosis Disease
- Rheumatic Issues
- Damaged Cartilage Due to Untreated Hip Dislocations
Older Patients:
- Due to age
- Osteoporosis
- Fractures
Step 1:
Who Needs Surgery?
There are 2 cases for hips with osteoarthritis to have a surgery.
- When patient can’t walk longer than 300 meters without pain.
- Patients who need to use painkillers everyday due to their pain since it causes serious problems in the liver and the kidneys after sometime. Surgery is a must to stop the pain and stop the consumption of painkillers in these cases.
There are also some cases that shouldn’t have knee replacement.
- If there is an active infection in the patients body, the surgery won’t be applied until the infection is gone.
- If the patient has a neurotic sickness that causes loss of balance and fallings.
Types of Hip Prosthesis’
Total Hip Replacement is the surgery where both the bone and the socket are changed with an implant.
If only the bone or the socket is changed, it is called a Partial Hip Replacement.
An orthopedic surgeon would decide which procedure is the best option after examining the case.
The procedures are also separated as with or without cement, depending on the material used. If the patient is young, generally options without cement are chosen in case the prosthesis needs revision in the future. Also the material used is likely to be ceramic with young patients since ceramic has a longer life. There are also special tumor prosthesis’ to be used after bone cancer surgeries to replace the bone.
Before the Surgery
- A physical therapy program might be given before the surgery to get the area stronger in order to decrease the duration of healing period after the surgery.
- Antibiotic or other medicines might be prescribed to the patient before the surgery to prevent some possible complications
- Some medicines (blood diluents etc.) used regularly by the patient might be rearranged
The patient gets checked with blood and urine tests to see if the patient is suitable for a surgery. If the tests results are clean, the patient is ready for a surgical procedure. If the patient is using any blood diluent medicine there would be a switch in the medicine around 10 to 5 days before the surgery. When the risk of bleeding end after a few days the patient can get back to the original medicine.
After the Surgery
The healing period varies in each case depending on factors like age, gender, weight, lifestyle and rehabilitation. Complete healing will take between 2-3 months. It is advised that the patient gets physical therapy treatments for 6-8 weeks after leaving the hospital. Patients immediately report loss of pain in the joints and increase in their quality of life. Heavy physical work is discouraged after the surgery since it might affect the prosthesis. However, light exercises are recommended to maintain and increase the muscle tissues in the area.
During the stay in hospital the patient walks short distances with the supervision of the doctor to prevent possible deep vein thrombosis. When leaving the hospital, the patient gets prescribed medicines to use for 30 days. Patients should strictly listen the doctors advices and be careful at all times until the healing process in completed.
Possible Complications During and After the Surgery
Some possible complications that may occur during a prosthesis surgery are damages on blood vessels or nerves, fractures and cracks on the bone.
After the surgery, early and late complications may occur.
Possible early complications are infection and deep vein thrombosis and loosening of prosthesis.
Possible late complications are pain, and loosening of the prosthesis.
A total hip replacement surgery will serve the patient successfully for about 30 years. The expected life of the surgery is determined by the techniques applied by the surgeon, the quality of the prosthesis, the level of activity of the patient, the quality of the bone and the weight of the patient. Choosing a surgeon with experience is very important for the prosthesis to have a long life and to prevent any possible complications.
How to Prevent Infection After Surgery
The prosthesis in the hip can be vulnerable to possible infections. To be protected, patients should use certain antibiotics before any other surgical procedures, including basic procedures like having a tooth pulled. Doctors will inform the patients about the medicines in these cases.
