A total hip replacement (THR) – also called a Hip Arthroplasty- is a surgical procedure that re-forms the hip joint. In THR, the head of the femur (the bone that extends from the hip to the knee) is removed along with the surface layer of the socket in the pelvis (the two large bones that rest on the lower limbs and support the spinal column).
Functioning Of Hip Joint:
- Head of the femur
- Acetabulum of the pelvis
- Ligaments of the hip joint
The head of the femur or “ball” of the hip joint articulates or moves within the cup-like “socket” called the acetabulum of the pelvic bone. Together, these structures are referred to as a “ball and socket” joint. The femoral head and acetabulum are covered by a specialized surface called articular cartilage. This allows smooth and painless motion of the hip joint.
Causes Of Hip Replacement:
Total hip replacement can benefit individuals suffering from a variety of hip problems resulting from either wear and tear from a lifetime of activity or from disease and injury. Some of the common hip problems leading to total hip replacement are:
- Osteoarthritis resulting from “wear and tear” is the most common reason for individuals to undergo Hip replacement surgery.
- Rheumatoid arthritis, an inflammation of the tissue surrounding the joints, can cause deterioration of cartilage and other parts of the joint and also result in the need for hip replacement.
- Post-traumatic arthritis, a type of arthritis that can arise following an injury to the joint cartilage or through damage to the ligaments leading to an unstable hip.
- Avascular necrosis results from an inadequate supply of blood to the bone end inside the joint.
- Others :- Benign and malignant bone tumors can alter the shape and congruency of the joint and also disrupt blood supply of the joint, affecting articular cartilage.
When Does One Need Hip Replacement?
- Hip/groin pain that keeps you awake, or awakens you, at night.
- Hip pain that limits activities necessary to go about your daily activities (getting up from a chair, climbing stairs, etc.).
- Hip pain that limits activities that give you pleasure (walking for exercise, traveling, shopping, etc.).
- Tried other treatments for a reasonable period of time, and still having persistent hip pain.
Hip Replacement Procedure:
During surgery, once the hip joint is exposed, the head and neck of the femur are removed. The shaft of the femur is then reamed to accept the metal component consisting of the head, neck, and stem.
The acetabulum is then reamed to accept a plastic cup. The ball and socket are then replaced into normal position. Both of these implants can be fastened into the bone with or without special cement.
- Cemented procedure: – The cemented procedure utilizes a doughy substance mixed at the time of surgery that is introduced between the artificial component and the bone.
- Non-cemented procedure: – Artificial joint covered with a material that allows bone tissue to grow into the metal. A tight bond of scar tissue if formed, which anchors the metal to the bone. This is called a cementless total hip replacement.
Post – Operative Care
Postoperative care begins with a team approach of health professionals within the hospital with special emphasis on Physiotherapy regime. The regime is focused on Circulation, Range of motion, Mild muscle strengthening exercises, Gait training, deep breathing exercises. These are all centered on getting the patient back to doing Activities of Daily Living.
Benefits Of Hip Replacement Surgery:
- The general goal of total hip replacement is designed to provide painless and unlimited standing, sitting, walking, and other normal activities of daily living. It Improves quality of life and restores mobility.
- It has very high success rates, relieves the pain and disability from degenerative arthritis, meniscus tears, osteoarthritis, cartilage defects, and ligament tears
- Technology has led to the development of materials used in the artificial hip joint allowing it to last over fifteen years.
- Artificial joint replacement for arthritis of hip is one of the most successful surgeries of the last century.
Individuals are able to begin walking the day following surgery and pain relief is achieved in greater than 95% of people.