About Hip Replacement
Hip replacement is the process of changing the damaged areas of the hip joint with metal / ceramic implants which were specially designed to copy the regular movements of a healthy joint. It is commonly used to treat osteoarthritis of the hip joints.
Hip joints are one of the main pressure points of the body, and damages on these joints can cause intense pain and difficulties in daily life. If the case is advanced and other factors such as age, weight and general health are favorable, the surgeon might choose surgery to treat the patient. The success rate for knee replacement surgeries is above 95% if done by an experienced surgeon the right way. With modern designs and materials, expected life of a hip prosthesis increased to 25 – 30 years.
Why Hip Joints Get Damaged?
- Congenital Joint Problems
- Hip joint illnesses during the childhood
- Perthes sickness
- Osteonecrosis sickness
- Rheumatic problems
- Damaged cartilage due to untreated hip dislocations
- Due to age
- Hip joint deformations due to osteoporosis caused fractures on the bone
- Pathological fractures due to weakening of the bone by a bone tumor or cancer metastasis.
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.
Treatment Options Other Than Surgery
One option for patients with jobs require heavy physical work (construction workers, miners etc.) would be freezing the joint with a surgery. However if the patient has problem at both hip joints this procedure is not recommended. Since it reduces the joint movement significantly, the procedure is not being chosen as much as it used to be in the past.
Types of Hip Prosthesis’
If both the bone and the socket are changed with a prothesis the process is called Total Hip Replacement. If only the bone is changed, it is called a Partial Hip Replacement. An orthopedic surgeon should 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
Like every other surgery, first the patient gets checked with blood and urine tests to see if the patient can have a surgery. If the tests results are clean, the patient is suitable for a possible 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 the blood vessels and the 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
There is a slim possibility that bacteria in the blood might infect the prosthesis. Patients who had a hip replacement surgery should always let doctors know about the operation prior to another medical treatment. It is important to get protected with antibiotics before another operation, including the simple ones like having a tooth pulled out etc. Doctors will decide on the type and the dosage of the antibiotics.