Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis. Hip replacement surgery can be performed as a total replacement or a hemi replacement
A diseased hip can make anyone’s life pathetic. Even if your doctor suggests for the replacement of the hip, you need to carefully examine whether it would be boon or bane before taking this major decision of hip replacement. Pain in hip joints or arthritis has developed as an unavoidable part of the ageing process, while some people get such problems from accidents, injuries in sports or from other disorders.
And many times doesn’t matter what precautions were taken to avoid joints damage, surgery becomes an inevitable solution.
A lot of people deal with pain, stiffness and swelling for years before considering hip replacement surgery as an option. Some people consult a doctor when symptoms like crumbling, grinding, limping or clicking get worse. Not every case of arthritis, fracture or deterioration causes the doctor to suggest a hip replacement surgery for a patient.
In many cases, physiotherapies and the use of walking aids alleviate the pain and results in good benefits. However, for some patients who are facing constant pain, total hip replacement surgery becomes unavoidable for them.
Total hip arthroplasty (THA) is considered to be one of the most successful orthopedic interventions of its generation. The earliest recorded attempts at hip replacement occurred in Germany in 1891, with results presented at the 10th International Medical Conference. Professor Themistocles Glück presented the use of ivory to replace femoral heads of patients whose hip joints had been destroyed by tuberculosis.
Later, surgeons experimented with interpositional arthroplasty in the late 19th and early 20th century, which involved placing various tissues (fascia lata, skin, pig bladders submucosa) between articulating hip surfaces of the arthritic hip.
In 1925, the American surgeon Marius Smith-Petersen created the first mold arthroplasty out of glass. This consisted of a hollow hemisphere which could fit over the femoral head and provide a new smooth surface for movement.
Despite glass being a biocompatible material, it failed to withstand the great forces going through the hip joint and shattered. Marius Smith-Petersen, along with Philip Wiles, later went on to trial the current material of choice – stainless steel – to create the first total hip replacement that was fitted to bone with bolts and screws.
The first to use a metal-on-metal prosthesis on a regular basis was English surgeon George McKee. In 1953, he began by using the modified Thompson stem (a cemented hemiarthroplasty used for neck of femur fracture treatment) with a new one-piece cobalt-chrome socket as the new acetabulum.
This prosthesis had a good survival rate, with one study recently showing a 28 year survival rate of 74%. Yet this method grew unpopular by the mid-1970’s due to local effects of metal particles seen during revision surgery for prosthetic failure.
The orthopaedic surgeon Sir John Charnley, who worked at the Manchester Royal Infirmary, is considered the father of the modern THA. His low friction arthroplasty designed in the early 1960’s is identical, in principle, to the prostheses used today.
It consisted of three parts; a metal femoral stem, a polyethylene acetabular component and acrylic bone cement – which was borrowed from dentists. It was called the low friction arthroplasty as Charnley advocated the use of a small femoral head which reduces wear due to its smaller surface area.
Currently, in the 5th decade of modern THA, over 75,000 joint replacements are performed each year within the NHS. As the number of successful operations has increased, techniques have become standardized and the average age of those receiving hip replacements has reduced. As a result, this magnified the problems of implant failure due to wear of bearings. Thus there are a variety of bearing and techniques currently used in an attempt to find the combination that yields the fewest complications and best long-term survival.
But how to know whether you really need a Total Hip Surgery or not?
The most important factor in choosing to have a hip replacement is how much it’s causing pain and affecting your life. Here are certain signals that indicate it is the time to have a Hip surgery:
1. Stiffness or swelling in the hip.
A swollen hip joint may be caused by conditions such as arthritis or gout, or by an injury. You may have other symptoms such as pain, stiffness, or trouble moving your hip.
2. You are suffering from Osteoarthritis and this disease is affecting you physically, mentally and socially.
Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage that cushions the ends of the bones wears down over time. Although osteoarthritis can damage any joint, the disorder most commonly affects joints in your hands, knees, hips and spine
3. Your hip gets badly injured or damaged.
4. Physical therapies and walking aids are not providing any relief.
Physical therapy, also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination
5. You can’t have a complete motion of the hip and can’t bend easily.
For best results, right surgeon and hospital play a very important role.