CNY Orthopedic Sports Medicine, PC: Treatment: Total Hip Arthroplasty
 
Injuries and Conditions: Hip: Total Hip Arthroplasty: Treatment Options
 
Overview
  • Hip replacement surgery is generally very successful in reducing pain. Most artificial hip recipients indicate nearly complete elimination of their hip pain for as long as the replacement hip lasts.
  • The surgical procedure to replace a hip is a major operation. Surgery removes the damaged areas of the thighbone (femur) and the inside of the socket (the acetabulum). The femur is hollowed out to produce a central canal to allow the insertion of a rod capped with a metal or ceramic ball, and the socket of the hip is resurfaced with an alloy and polyethylene (plastic) implant or insert that is placed with the metal shell in the acetabulum.
  • Some patients may have degenerative conditions in both hips requiring the replacement of both hips; surgery to replace each hip during the same operation is usually not recommended under these circumstances. Patients requiring the replacement of both hips are recommended to have the 2nd hip replacement several months after the first operation, to allow for adequate rehabilitation.
  • Hip replacement is an elective surgery, and is considered an effective and long-lasting treatment for a degenerating hip.


     

  • Surgical Treatment: Total Hip Arthroplasty
    Osteoarthritis, or other degenerative joint diseases, may be treated non-surgically during the early stages of the condition. Hip replacement surgery is considered for advanced conditions, which cause severe pain and greatly reduce a patient's ability to be active. The degenerated joint cannot rebuild itself; surgery will be required to replace the working surfaces of the hip with metals and plastics. A hip replacement will last 10-15 years in 90%-95% of patients.


    Surgical Product Considerations

    NSAIDs
    NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) are a group of drugs used to control pain. This category of medications includes both prescription and common over-the-counter painkillers such as ibuprofen. NSAIDs are effective for many types of pain that can occur because of inflammation of muscles, joints and bones. The drugs work quickly and people often notice some benefit within a few hours of taking the tablet. However, the complete effectiveness of the drug may not be realized for up to four weeks. For each individual, some varieties of NSAIDs are more effective than others. Often, patients will find that one or two varieties are helpful whereas others may not be as effective in controlling symptoms. It is usually necessary to try several brands and continue with the one that is most suitable. NSAIDs can be used to treat:
  • Pain resulting from inflammation or swelling.
  • Pain after injury.
  • Joint pain and arthritis.

  • Abduction Pillow
    An abduction pillow is used to separate or hold a patient's leg apart at the thighs after total hip replacement or revision surgery. The pillow helps position the legs correctly to properly position the hip prosthesis in the hip joint; used after surgery, this device helps to reduce the likelihood of a dislocation after a hip replacement or revision procedure.

    The pillow is used immediately post-operatively, and is particularly important for maintaining an anatomically correct position while the patient rests and sleeps. As the muscles, tendons and ligaments gradually heal, the pillow will be used less frequently, until it is eventually discontinued.

    Surgical Hardware Considerations
    There are a variety of materials available for use as a substitute for an arthritic hip. Polyethylene, an extremely high grade plastic, is a common choice for the socket. The ball, which fits snugly inside the socket, is often composed of very resilient, precisely machined metal. However, there are a wide variety of components available, from numerous materials. This is an ongoing area of great interest, as medical professionals seek longer-lasting, better performing materials to enhance the patient's quality of life.

    The choice of components for each patient is influenced by a variety of factors. Some variables which can affect the type of material the surgeon may use include the patient's age, expected level of activity, and the overall condition of the surrounding musculoskeletal structures.


     
    Factors in Transplant Source
    This procedure does not normally involve the transplanting of tissue.

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