Hip Joint Replacement Surgery Mesa AZ
Artificial Joint Replacement of the Hip
A Patient's Guide to Artificial Joint Replacement of the Hip
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
Related Document: A Patient's Guide to Osteoarthritis of the Hip
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.
Related Document: A Patient's Guide to Hip Anatomy
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.
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 noncemente...
The Past, Present, and Future of Hip Joint Replacements
The first Baby Boomers are turning 65 next year (2011). A Baby Boomer is someone born in the United States between 1946 and 1964. Some of those folks already have hip or knee joint replacements. Many more will be candidates for total hip replacement in the next 10 years. Chances are the type of hip replacement they receive will be very different from what their parents or even grandparents might have been given.
That's because we are now on the third-generation of hip replacement implants. That means the implants have changed in major ways three times since they were first introduced more than 40 years ago. Changes in implant materials, surface, and component parts (e.g., liners, sockets, femoral head and stem) are the subject of this review article.
In some ways, today's surgeons face even bigger challenges than those early surgeons. The rate of implant failure requiring another operation remains fairly high. Patients are getting implants at an earlier age and wearing them out faster in part because of greater activity levels than ever before.
Other risk factors for implant failure include patient problems such as being overweight and surgical factors (e.g., failure to balance muscles properly, improper placement of the implant, surgeon inexperience). And implant materials, bearing surfaces, toughness, and wear mechanisms can contribute to implant wear and tear and ultimate failure.
This last factor (important bearing surface) is the topic of today's article. Types of surfaces, their advantages and disadvantages, and future alternatives are all presented for your consideration in making a choice about your preferred type of hip implant.
Let's start with the metal-on-polyethylene implant. This is probably the most commonly used hip implant. The socket has a plastic liner. The round head of the femur that fits into the socket is metal with a metal stem that sets down inside the femoral shaft to hold it in place. It's the least costly of all the types available. It goes in easily and doesn't have to be set into the bone exactly-so to have a good result. But there are some problems. Most notably, it wears out faster than other types and isn't as stable. Older adults who are fairly inactive are the best candidates for the metal-on-polyethylene implant type.
Next comes the ceramic-on-polyethylene. The plastic liner is the same as the one used in the metal-on-polyethylene implant. The difference here is in the material used for the stem and femoral head: ceramic instead of metal. Ceramic is hard and scratch resistant. That's important in keeping wear debris out of the joint. There is a risk that the ceramic will crack or fracture and it doesn't hold up as good as the ceramic-on-ceramic implants.
Those ceramic-on-ceramic surfaces have the lowest friction, roughness, and biologic reactivity. The surface is resistant to wear and tear so this type is used most often for younger, more active patients. And, of course, it can be...
Thinking Small in Hip Replacement Surgery
Smaller may be better in joint replacement surgery--smaller incisions, that is. The trend in most joint replacement surgeries is to use the smallest incision possible. The thinking is that smaller cuts do less damage to the surrounding tissues. This can mean fewer complications and quicker recovery.
This study looked at the possible benefits of a type of hip replacement surgery that uses very small incisions. Researchers compared it to a more common type of hip replacement surgery. Both groups got good results from their surgeries. They had about the same rate of complications after surgery and got out of the hospital in about the same amount of time.
But the "mini-incision" group had shorter surgeries. They also had less blood loss and needed fewer blood transfusions during surgery. The mini-incision group walked sooner after surgery and needed less help with moving around. Patients in this group were also less likely to need high levels of nursing care after leaving the hospital.
Researchers tested to see if mini-incision hip replacement worked for obese patients. It seemed to have the same benefits for them. However, the incisions did need to be somewhat larger, and obese patients had more blood less than thinner patients.
The authors emphasize that surgeons need to practice the techniques of mini-incision hip surgery. But clearly, this specific type of mini-incision hip replacement surgery can maximize benefits in the operating room and right after s...