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Total Hip Replacement
Hip replacement, also called total hip arthroplasty, is a surgical procedure to replace a worn out or damaged hip with a prosthesis (an artificial joint). This surgery may be considered in patients who has any condition affecting the surface of the articulation such as in osteoarthritis, osteonecrosis or even in hip fractures among others. Severe pain is due to joint wear causing lack of cushion. Various types of arthritis may affect the hip joint. Osteoarthritis, a degenerative joint disease that affects mostly middle-aged and older adults, may cause the breakdown of joint cartilage and adjacent bone in the hips. Rheumatoid arthritis, which causes inflammation of the synovial lining of the joint and results in excessive synovial fluid, may lead to severe pain and stiffness. Traumatic arthritis, arthritis due to injury, may also cause damage to the articular cartilage of the hip. The goal of hip replacement surgery is to replace the parts of the hip joint that have been damaged and to relieve hip pain that cannot be controlled by other treatments. A traditional hip replacement involves an incision several inches long over the hip joint. An alternate approach that uses 1 or 2 smaller incisions to perform the procedure is called minimally invasive hip replacement. However, the minimally invasive procedure is not suited for all candidates for hip replacement and final outcome is the same. The doctor will determine the best procedure for a person, based on that individual’s situation.
Revision Total Hip Replacement
Surgical intervention with joint replacement surgery can be a complex and challenging procedure. Several potentially difficult portions of the surgery must be considered. Common to all joint revisions is an assessment of existing bone quality, removal of the failed components, reconstruction of remaining bone and soft-tissue structures, and successfully fixing the new components to the bone. Consideration of each of these challenges is essential to produce successful revision joint surgery. In hip revision surgery, both the femoral (stem and ball) components as well as the acetabular (socket) portion must be addressed.
- The hip bones may have deficiencies due to lysis and loosening, fracture, or shielding of the bone from normal stress. These deficiencies are graded according to several classification methods.
- Once this assessment is performed, a method to remove the existing components is selected. If some parts of the implant are still functioning, efforts may be made to retain them. Specialized removal techniques have been developed, including surgically splitting the femur bone to remove the cement and implants, as well as power and hand instruments, which accurately cut around the prosthesis.
- When the failed components are removed, the remaining bone may require a complex reconstruction, involving larger or longer implants, bone grafting using ground-up bone or large segments of bone, and possibly cement and metal cages.
- Finally, the selected revision hip implant must be firmly fixed to the bone, either through bone growing into small pores in the outer layer of the implant or by cementing the construct into place.
Hip fractures are very common, specially in elderly patients. Fractures close to the hip or the knee will often require a surgical intervention that will facilitate a fast and complete recovery. These interventions may require plate and screws, rods, or even prosthetic implants.
In our center we are committed to help you with this common condition that affects over 500,000 patients in the nation yearly.