Hip replacement. Treatment abroad
Hip replacement is a surgery used to replace patient’s own joint with an artificial one. This surgery has a very high efficiency, since it helps to recover from pain syndrome.
After surgery and rehabilitation the range of movements in the artificial joint is restored. Therefore, the patient can lead an active lifestyle and even do some sports.
Indications of Hip replacement
Hip replacement is required for patients, whose joint, for one reason or another, has lost its normal structure and cannot fulfil its functions to the full. The indications include:
- Coxarthrosis (arthrosis of the hip joint)
- Bekhterev’s disease
- Posttraumatic arthrosis
- Hip dysplasia
- Rheumatoid arthritis
- Aseptic necrosis of the hip joint structures
- Femoral neck fracture
- Tumors of the femoral bone in the proximal section
Depending on the indications and peculiarities of the disease, there can be performed full or partial hip replacement. The first case involves the replacement of all elements of the hip. The partial hip replacement intends to replace only head and neck of the femur.
Nowadays, this surgery is used less and less, since it is not as effective as full hip replacement.
What implants are used?
The doctors used the first hip implants in the early twentieth century. They were made of ivory and wood, therefore, they wore out quite quickly. Overall, the results of such operations were unsatisfactory, but current implants have high wear resistance and biocompatibility with human tissues.
The implants consist of the following components:
- Cup must match with the patient’s acetabulum in order to form a perfect articular surface for the head
- Head simulates the femoral head
- Liner provides wear resistance of the hip joint by friction
- Leg must have a high mechanical strength to ensure implant stability
- Modular neck is responsible for joint functionality and influences on the distribution of mechanical loads
Size is selected individually for each patient. Production of various elements for implants involves the use of the following materials:
- Metal (cobalt-chrome, steel)
- High-density polyethylene
All types of materials are resistant to corrosion. The joint is fixed with or without the use of cement. In this case the bone grows into the porous surface of the prosthesis.
Preparation for surgery - Hip replacement
At the stage of preparation, the patient must go through a number of examinations in order to be sure that there are no contraindications for hip replacement. Patient has to take the following blood tests:
- Blood glucose test
- Biochemical test
- Clinical test
- Coagulation test
- Blood test to detect infection (HIV and viral hepatitis)
Patient should also have urine test, ECG, and photofluorography.
It is necessary to make X-ray images of the damaged hip joint. CT and MRI are used for a more accurate imaging.
How is surgery performed?
The surgery is performed under general or spinal anesthesia. In the first case person is unconscious, while the second case involves the administration of drugs into the subarachnoid space (into the spine, below the spinal cord) to make the patient insensitive at the level of the spinal nerve roots.
Modern clinics use minimally invasive surgical procedures to perform hip replacement. A cut length is 10 cm instead of usual 20-25 cm. This ensures:
- Less blood loss and absence of necessity for blood transfusion
- Quick rehabilitation after surgery
- Less risk of complications
- More favorable postoperative period
The surgery usually lasts 30-60 minutes. The first 7-10 days after surgery the patient stays in the hospital and then he/she is discharged for the further rehabilitation at home.
What happens after surgery?
Many patients worry about an early and late postoperative periods.
Is there a severe pain after surgery?
The early postoperative period is manifested by severe pain syndrome, but it is stopped with administering drugs.
Modern medical clinics use the systems, which administer drugs at the patient’s request, by pressing a button. The next dose of the drug comes into the vein through catheter.
When is it allowed to eat?
Usually patient can eat small amounts of food, including solid foods, already the evening after the surgery.
How to take a shower in the first days after surgery?
It will be necessary to cover the postoperative wound to avoid water in that area. This should be done within the first 10-14 days. The day when sutures or staples are removed can serve as a reference, since it is allowed to take a shower without any restrictions a day later.
If there were used monofilament threads during the surgery, patient can do hygienic procedures without waiting the removal of sutures.
How to move around after surgery?
The first day you will move in the wheelchair. The first days after surgery you will move using crutches or walker, afterwards during the first weeks after surgery only with one crunch or a cane.
When will you be able to move without any restrictions?
The limb can fulfil its functions to the full 2-3 months after hip replacement.
When will you need the next prosthesis replacement?
Current implants can serve up to 30 years, so the majority of patients will not need the repeated hip replacement.