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Hip Replacement Surgery – Arthroplasty and Alternatives: All You Need to Know
If you have a hip joint injury or injury that causes pain and interferes with 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 called prostheses. The hip joint is a ball joint that can rotate in many positions. This procedure replaces both the natural depression and the round ball at the top of the femur with dual parts. A hip prosthesis is made to improve the functioning of the hip joint and to improve its mobility. More than 50,000 hip replacements are performed in the United States each year, and most of them are performed on adults age 65 and older. Most people who have hip replacements are women who want a better quality of life.
Hip replacement is typically reserved for those with pain and mobility limitations that interfere with daily life. One of the most common causes of hip joint damage is osteoarthritis, which causes pain and stiffness in the joint. Rheumatoid arthritis is another cause. This disease causes joint pain, stiffness and swelling.
Osteonecrosis can also cause hip damage. It is accompanied by avascular necrosis, which is the death of bone due to insufficient blood flow. Septic arthritis, another source of hip destruction, is caused by a joint becoming infected. Other reasons for a hip replacement include a fracture, bone tumors, or an injury that leads to hip joint collapse.
Not long ago, doctors only performed joint surgeries on people over 60 years old. This was because older people were less active and put less stress on the replaced artificial hip than their younger counterparts. Now doctors have discovered that these operations can also be successful in younger people. New medical technology has improved artificial parts, allowing them to withstand more stress and strain. A person’s general health and activity are valued more than a person’s age.
What are the alternatives to hip replacement surgery?
Your doctor may try many other treatment methods before introducing a hip replacement. These options include exercise, physical therapy, walking aids, an exercise program, and medication. If inflammation is the cause of the problem, your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), such as Naproxen or Motrin. It is not unheard of for people with severe hip pain to use strong narcotics. Additionally, there are numerous supplement programs that combine glucosamine and chondroitin for pain relief.
A 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. Doctors may also inject joint lubricants, such as hyaluronan, which allow for greater range of motion. If exercise and medication don’t work for you, your doctor may suggest a less complicated procedure before hip replacement. A common substitute is an osteotomy. This treatment involves realigning the bone to shift weight from the damaged, painful bone surface to one healthy, strong area.
What is involved in hip replacement surgery?
The area where the femur (thigh bone) and the hip bone meet is known as the hip joint. The head of the femur (the ball of the head of the femur) fits into the acetabulum (socket) allowing for a wide range of motion. The surgeon simply makes a 6- to 8-inch incision in the side of the hip and removes the diseased bone tissue and cartilage from the joint area. After this, the surgeon replaces the head of the femur and the etabulum with prosthetic parts. These new artificial materials allow the joint to slide naturally.
A new surgery that has hit the most remote areas is a surgery called minimally invasive replacement surgery or mini-incision arthroplasty. Over the past decade, this procedure has been used because it allows for smaller incisions and a shorter recovery afterwards. The candidate must be under 50 years old and of normal weight. Overall health is measured for this measure. Parts for both styles of surgery, traditional or minimally invasive, are available in two standard varieties. One type involves cemented parts that are attached to existing healthy bone with surgical glue.
This procedure is called a “cemented” hip replacement. Another option involves non-cemented parts and requires biological fixation to hold these parts in place. The “Uncemented” technique involves the use of components with a porous surface that allows the patient’s bone to grow into the pores, holding the artificial components in place. Uncemented abutments are often chosen for older, less active individuals and those with weak, brittle bones from osteoporosis or Paget’s disease.
The cemented method has an advantage. Research results show that recovery time is shorter with this type of technique compared to Uncemented surgery. Experts say that with uncemented hip replacements, it takes longer for the natural bone to grow and attach to the replacement.
What are the complications of hip replacement surgery?
The American Academy of Orthopedic Surgeons states that more than 231,000 hip surgeries are performed annually in the United States alone. At least 90 percent of these do not require any kind of revision due to new technology and surgical innovations. However, some complications and difficulties arise. The most common and most dangerous initial complication is hip dislocation. In this case, the ball comes off the socket.
The most common later complication is an inflammatory reaction to the synovial particles of the prosthesis, which can wear away from the joint surface and wedge into the adjacent tissues. This inflammatory reaction triggers the action of cells that wear down the bone and cause the implant to loosen. Less common problems are infections, blood clots and joint stiffness.
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