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Hip Replacement Surgery |
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Your hip consists of two components: the head of the femur (the
ball) and the acetabulum (the socket). These two components are
intricately opposed in low friction environment forming the hip
joint. When arthritis occurs there is a breakdown of the cartilage
resulting in bone wearing on bone.
A Damaged Hip
When one or more parts of the hip are damaged, movement becomes
stiff. Over time, cartilage starts to crack or wear away. When this
happens, the bones making up the joint rub together. Stiffness and
pain occur when the ball starts to grind in the socket. Any of the
problems below may lead to joint damage.
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Osteoarthritis
As time goes by, normal wear and tear can add up. Cartilage may
begin to crack (osteoarthritis)). As the bones rub together, they
become rough and pitted. This wears down the socket.
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Inflammatory Arthritis
A chronic disease, such as rheumatoid arthritis or gout, can cause
swelling and heat (inflammation) in the joint lining. As the disease
progresses, cartilage may be worn away and the joint may stiffen.
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Fracture
A bad fall or blow to the hip can break (fracture) the bone.
If the broken bone does not heal properly, the joint may slowly
wear down.
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Necrosis
A bad injury or long-term use of alcohol or steroids can reduce
blood supply to the bone. If the bone dies (necrosis), the
joint will decay.
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This causes severe pain and disability that can worsen over time.
The initial treatment of this arthritic hip pain is anti-inflammatory
medications, weight reduction, physical therapy and assistive devices
such as a cane.
As the pain progresses, however, then a total hip arthroplasty
becomes an option. The decision to undergo a hip replacement is
based on pain level, functional level and x-ray findings. This involves
replacing your hip joint with an artificial one. An artificial hip
is composed of a metal ball and a plastic socket . The metal ball
is attached to a stem, which is inserted into the femoral shaft
while the plastic socket is secured into the acetabulum with a tight
press fit and screws. This new bearing surface provides a smooth
surface that allows the hip to function in a nearly normal without
pain
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The Surgical Procedure
When the surgical team is ready, you'll be taken to the operating
room. There you'll be given anesthesia. The Anesthesia will help
you sleep through surgery, or it will make you numb from the waist
down. Then an incision is made down the side of your hip. The damaged
ball is removed, and the socket is prepared to hold the prosthesis.
After the new joint is in place, the incision is closed with staples
or stitches.
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Preparing the Bone
The ball is cut from the thighbone, and the surface of the old socket
is smoothed. Then the new socket is put into the pelvis. The socket
is usually press-fit and may be held in place with screws or cement.
A press-fit prosthesis has tiny pores on its surface that your bone
will grow into.
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Joining the New Parts
The new hip stem is inserted into the head of your thighbone. After
the stem is secure in the thighbone, the new ball and socket are
joined. The stem of the prosthesis may be held with cement or press-fit.
Your surgeon will choose the method that is best for you.
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The success rate of a total hip replacement is close to 90% at
15 years. As with any major surgery there are complications associated
with hip replacements. There is the risk of anesthesia, infection,
bleeding, blood clots, injury to nerves or arteries, leg length
discrepancy and dislocation of the ball from the socket. The artificial
hip can loosen over time necessitating revision surgery. These risks
are uncommon.
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