Hip replacement surgery also known as hip arthroplasty, is a surgery involving the removal of diseased or damaged parts of hip joints , and then replacing them with an artifical one. These artifical parts called the prosthesis, are made of metals or high density plastics. Hip replacement surgery is recommended for patients suffering from pain due to damaged hip joint.Depending upon the condition of the hips, the surgery can be performed in two ways, as a total hip replacement or a hemi hip replacement surgery.
A total hip replacement otherwise total hip arthroplasty involves the replacement of the entire hip structure ( the acetabulum and the femoral head). An artificial cup is utilized in this procedure to replace the socket. the hip implants are generally cemented in place, but some surgeons prefer the use cementless method. Implants are either cemented or cementless which are applied on the basis of bone quality and patient physciological age. Cementless implants are preffered in younger patients with good bone quality. Longevity implant is more in cementless implants but it also depends on bearings. Bearings may be of poly, metal, or ceramic.Now- a-days gold standarded for hip total replacement is cementless fixation with ceramic-on-poly bearings which help longevity of approximately 30 -40 years.
Hemi hip replacement or hemiarthroplasty involves the replacement of only femoral head.The procedure involves the removal of the head of the femur and replacing it with prosthesis.With the passage of time, the implants used in hemiarthroplasty either tend to erode to the acetabulum or loosen up . Therefore , hemiarthroplasty is usually recommended only for elderly and infirm or weak patients, as they are expected to have lower life expectancy .
The average life of the artificial hip joints ranges from 10-20 years or longer, depending on lifestyle of the patient, stress put on the joints and weight of the patient.
The most common reason for considering a hip replacement surgery is severe pain in the hipjoint and osteoarthritis.Rheumatoid and traumatic arthritis are the other factors to be considered. Patients who had hip fractures, ankylosing spondylitis or osteonecrosis are also the recommended group for the replacement. However, replacement options are only considered for patients who had tried and failed alternative methods of pain reliefs.
The need for a hip replacement surgery is diagonised after the physical examination of the hips by the surgeon .The surgeon assessess the mobility and stability of the hip joints. The surgeon confirms the need for the surgery after the visualization of the X-ray reports which determines the severity of the patient’s condition.Early stages of the damage can be detected using MRI.
One of the major risks associated with hip replacement surgery is the dislocation of the prosthesis, leading to surgery for repairment, known as revision surgery. Other risks associated with the surgery are infection at the site of surgery, fracture and injuries to the nerves or blood vessels. In some cases, there occurs differences in the length of legs. The wearing of metal-on-metal implants before the estimated time interval has led to metallosis. Loss of bones around the hip – Osteolysis – is another concern. However the instances of serious complications are known to be low.
After the surgery, with the implanted prosthesis and physical therapy ,one can expect a relief from chronic pain. Most people experience an improvement in their mobility with respect to hips. One can carry out their routine activities like walking with much ease.