Hip prosthesis operation

What exactly is it?

A hip prosthesis operation is a surgical procedure where the structures that form the hip joint are replaced with an artificial joint (prosthesis). The asetabulum (lair) and the femoral head (top) are the two structures that make up the hip joint.The surgical procedure where only the femoral head is replaced with an artificial joint is called “hemi” (semi) arthroplasty, while all of the dual structure is replaced with a prosthesis, which is called “total hip prosthesis.”

Why or when do we need it?

This surgery is often performed due to osteoarthritis (calcification) that develops with advancing age. It is needed if the person cannot perform daily activities and the pain cannot be controlled. In addition, hip replacement surgery may become necessary at younger ages in cases of femoral head osteonecrosis (spontaneous bone death), developmental hip dysplasia (congenital hip dislocation), and hip joint involvement from inflammatory joint rheumatism and some hip fractures.

Preperation Phase…

In cases where your orthopedic surgeon deems hip replacement surgery necessary, the consultation or opinion of the anesthesiologist and other physicians about other accompanying disorders, if any, is obtained. Your surgery plan is created by adding criteria such as patient expectations, age, height, weight, and living conditions to these views. Pre-operative preparation with correct information is important during the post-operative recovery period. The most important parameter here is that you strictly follow the plan.

What is performed during the surgery?

This surgery, which is an open surgical procedure, begins with anesthesia appropriate to your medical history. A sterile area is created in the surgical area. It is accessed via a 15-20 cm skin incision made on the lateral (side) of the hip. The fascia and muscles are lifted in accordance with the surgical technique, and the joint capsule is exposed. Then the joint capsule is opened, and the femoral head is removed from the acetabulum. A bone incision is made in the femoral neck in accordance with the shape of the prosthesis to be used. The inner surface of the acetabulum is made suitable for the placement of the prosthesis with a special slot reamer. First, the acetebular cup is placed without cement or with the help of bone cement. It is then placed in a liner acetabular cup compatible with the head made of metal, ceramic, and/or hard plastic components to be used. The femoral medulla is prepared with the reamers of the prosthesis to be used, and the appropriate-sized femoral piece is placed without cement or with the help of bone cement. The head is placed on the neck of the prosthesis, and the joint is reattached. After the leg length and movement control are determined, a drain that evacuates the blood that may accumulate is placed, and the reverse processes are closed with an incision. Hip replacement surgery without acetabulum replacement is called partial (half) hip replacement surgery.

Post-operative period…

In general, hospitals require 2-5 days of observation.The drain placed in accordance with your medical condition is removed one day after the operation, and you will be walked out with assistance.This movement is usually in the form of walking with a full load in the room and in the corridor. During the surveillance period, combined pain relief treatments are applied to ensure a comfortable post-operative period.

The recovery of wounds may take around 2–3 weeks, depending on the patient. You will be recommended to have walking support for about 4–6 weeks after being discharged. Most of the patients are able to walk on their own after 6 weeks. Doing the exercises recommended by your doctor or physiotherapist during this time will affect your recovery time.

Complications…

As with all surgeries, this one also carries risks as well as benefits.
Although rare, the most common complication, as in all major joint surgeries, is deep vein thrombosis, commonly known as venous coagulation. You will need to use blood thinners for a while to avoid this negativity.

Although uncommon, prosthetic joint infection is the most serious complication.Infection may develop due to both patient and surgical factors. In case of signs of infection (fever above 38 oC, chills, swelling at the wound site, pain, abnormal discharge, and increased redness) in the postoperative period, consult your doctor immediately. An infected hip replacement may require a second surgery to clear the infection.

In addition to periprosthetic fractures, prostheses being loose, joint stiffness, artificial joint relaxion, leg height inequality, and nerve damage are among the complications that can be seen.

Conclusion! 

Things are going well! You fulfill your duties and implement your exercise program as required! 

Although it varies from person to person, full recovery usually takes four to eight weeks.