TOTAL HIP REPLACEMENT (THR)

DEGENERATED HIP

Dislocation of the hip is a common injury to the hip joint. Dislocation occurs when the ball–shaped head of the femur comes out of the cup–shaped acetabulum set in the pelvis. This may happen to a varying degree. A dislocated hip, much more common in females than in males, is a condition that can either be congenital or acquired

ARTHRITIS OF THE HIP

Arthritis is one of the most common causes of pain in the hip. Arthritis is a progressive disorder, which means that it typically starts gradually and gets worse with time. The term arthritis literally means “inflammation of the joint.”

There are different types of arthritis that can affect the hip. The type of arthritis you have may affect your treatment options.

TYPES OF ARTHRITIS

There are five main types of arthritis that can affect the hip joint. They are:

Osteoarthritis
Rheumatoid arthritis
Ankylosing spondylitis
Systemic lupus erythematosus
Psoriatic arthritis

There is no cure for any type of arthritis, but there are ways to treat the pain and other associated symptoms.

SYMPTOMS

Pain in the hip joint that may include pain in the groin, outer thigh, or buttocks
Pain that is typically worse in the morning and lessens with activity
Difficulty walking or walking with a limp
Pain that worsens with vigorous or extended activity
Stiffness in the hip or limited range of motion

TREATMENT OF HIP ARTHRITIS

Treatment should begin with the most basic steps and progress to the more invasive, possibly including surgery. Not all treatments are appropriate for every patient, and you should have a discussion with your doctor to determine which treatments are appropriate for your particular situation. Following are the range of options.

Conservative:

Medication
Physiotherapy

Surgical:

Joint Preserving
Total Hip Replacement

TOTAL HIP REPLACEMENT (PROCEDURE)

Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant. Hip replacement surgery can be performed as a total replacement or a hemi (half) replacement. Such joint replacement orthopaedic surgery is generally conducted to relieve arthritis pain or in some hip fractures. A total hip replacement (total hip arthroplasty) consists of replacing both the acetabulum and the femoral head while hemiarthroplasty generally only replaces the femoral head. Hip replacement is currently the most common orthopaedic operation, though patient satisfaction short- and long-term varies widely.

PROCEDURE

In a total hip replacement (also called total hip arthroplasty), the damaged bone and cartilage is removed and replaced with prosthetic components.

The damaged femoral head is removed and replaced with a metal stem that is placed into the hollow center of the femur. The femoral stem may be either cemented or “press fit” into the bone.
A metal or ceramic ball is placed on the upper part of the stem. This ball replaces the damaged femoral head that was removed.
The damaged cartilage surface of the socket (acetabulum) is removed and replaced with a metal socket. Screws or cement are sometimes used to hold the socket in place.
A plastic, ceramic, or metal spacer is inserted between the new ball and the socket to allow for a smooth gliding surface.

BENEFITS

Prior to surgery you will usually have tried some simple treatments such as simple analgesics, weight loss, anti-inflammatory medications, modification of your activities, walking sticks, physiotherapy.

The decision to proceed with THR surgery is a cooperative one between you, your surgeon, family and your local doctor. Benefits of surgery include:

Reduced hip pain
Increased mobility and movement
Correction of deformity
Equalization of leg length (not guaranteed)
Increased leg strength
Improved quality of life, ability to return to normal activities
Enables you to sleep without pain

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