Professor MD Thomas Gösling
Arthritis is the most common cause of pain in the hip joints, motion reducing and discomfort. When all of those problem reach highest degree and pain has become severe and persistent, replacement of the hip may be considered as a mean to improve your life quality. Hip replacement surgery ranks second on popularity among the joint replacement after knee prosthetic surgery.
Artificial hip joint (hip total endoprosthesis)
Definition: What is an artificial hip joint?
An artificial hip joint (hip total endoprosthesis, hip TEP) is an implant that is used in place of the diseased hip joint. It is usually made of ceramic, plastic or metal (titanium) and has the same components as the natural hip joint with a joint head and a joint shaft. With the partial hip prosthesis only the condyle is replaced.
Execution: How is a hip replacement surgery performed?
The artificial hip joint (hip total endoprosthesis) is used in surgery. Depending on the type of connection, three prosthesis types differ. The cementless prosthesis is clamped to the bone without any aids and grows over time with the body's own bone. In the cemented prosthesis, the surgeon uses cement to connect the artificial hip joint and bone. The hybrid prosthesis combines elements made of cemented and cementless prosthesis: it is partially clamped and partially cemented.
The hip replacement surgery is now one of the most commonly performed in Germany surgical procedures and therefore a routine operation. During the procedure, however, blood loss can occur, which is why a blood donation is advisable a few weeks before surgery. The inpatient hospital stay after surgery is about two to three weeks. During this time, rehabilitation measures for the life with the artificial hip joint are already initiated.
Applications: What are the indications of an artificial hip joint?
If the limitations of movement and / or pain can not be treated with conservative (non-surgical) procedures, it is recommended to use an artificial hip joint. The most common reason for a permanent disorder is the arthrosis (joint wear) of the hip joint (coxarthrosis). Increased wear of the articular cartilage leads to joint changes, resulting in pain and restricted mobility. Even fractures, injuries, malpositions or joint infections can damage the natural hip joint and make an artificial joint necessary.
Only a specialist can decide whether you need joint replacement but you could check some symptoms that you are probably should go on operation:
If you have most of above symptoms you may be a candidate for hip replacement surgery. But there also some contraindication that could make you illegible for prosthesis:
The surgery can be performed traditionally with open method and by arthroscopy which is minimally invasive method. In hip replacement segment a range of classical method is still quite high and arthroscopic surgery is used rarer than for knee or shoulder replacement.
During operation, first, the surgeon makes a cut about 10-15 cm long to open an access to inner joint surface. Then, he/she removes diseases bone tissue until it stays clean and healthy. Then, the doctor inserts an implant and fixes it with cement or using cementless method. The second technique involves biological mechanism stimulating the bone cells growing. For this purpose the implant surfaces are made porous that allows a bone growing into implant. Which of the methods is better still contradictory, both of them have theirs pros and contras.
The materials used for implants are metal, plastic and ceramic in combination with each others. Some recent studies indicates that metal is less safe material and many joint surgeons in Germany suggest plastic or ceramic implants.
The parts prosthesis consists of are the same non regardless to the material and type of fixation: a stem, ball, liner and socket. Normally, they are made of different material and your orthopedist suggest you the better option. Presently, combination of ceramic and polyethylene is considered as the most progressive.
The surgery is mostly performed under general anesthesia and lasts for about two hours.
Anterior hip replacement is minimally invasive alternative to traditional operative method. The incision for access to joint is made in frontal area of the hip and allow to surgeon working between muscles. The muscles are not detached from the bones, that provides lesser pain and shorter recovery. The frontal approach gives the possibility to avoid sitting on the side of incision assuring, thus, less pain. Another advantage is that anterior replacement prevents joint dislocation.
Half hip (or partial) hip replacement is a type of surgery when only the ball is replaced in diseased joint but socket stays untouched. As a rule, this operation is carried out for traumatic injuries and not so common for arthritis treatment as total hip replacement.
After operation you should stay in rest for five – six days. It is recommended to keep cushion between your legs to avoid wrong load on your joint.
You should start physiotherapy in a few days after surgery and keep on it from two weeks till several months depending on your doctor recommendations. You should avoid twisting movement and do not bend past 90 degree.
There some rules helping to protect you from undesired load:
If you consider hip replacement surgery it is reasonable option to apply to Clinic of Braunschweig. With choice of medical centers and clinical departments in different locations you can find your best solution on joint implantation in Germany. Have a consultation or apply for treatment online.