In human life, various joint diseases are caused by various reasons: joint pain and dysfunction. The hip joint is one of the more commonly affected joints. It causes joint pain, difficulty in walking, and even loss of ability to live. Total hip replacement is a boon for these patients. After total hip arthroplasty, the pain disappears and the function of the joint is restored. Currently, nearly 500,000 people worldwide, mainly in developed countries, undergo total hip replacement surgery each year for various causes of hip disease.
What is an artificial total hip joint made of? Who needs a total hip replacement? What should be taken care of after a total hip replacement?
By reading the following content, you can solve some of your doubts, so that you can have some more understanding of the artificial total hip joint, so that you can restore the health of the joint as soon as possible.
1.What is the artificial total hip joint made of
Artificial total hip joint is generally made of non-toxic metal (cobalt-chromium-molybdenum alloy or titanium alloy) and ultra-high polymer polyethylene-based (plastic) according to the anatomical characteristics of the human joint, imitating the functional design of the joint only manufacturing. Implanted into the human body, play the role of the original hip joint.
2.What diseases require artificial total hip joint replacement
Due to various reasons caused by the hip joint serious pain and activity restrictions. Patients whose lives and work are affected should be considered for total hip replacement. Common diseases include rheumatoid arthritis, ankylosing spondylitis, advanced aseptic necrosis of the femoral head and femoral neck fracture in the elderly, congenital acetabular dysplasia, secondary hip arthritis, etc.
3.How to perform artificial total hip replacement surgery
After the preoperative examinations, it is determined that the patient is ready for surgery. When the patient is under anesthesia, the doctor opens the damaged joint, removes the diseased femoral head, and selects a metal stem suitable for the size of the patient’s femoral marrow cavity to be embedded in the femur. At the same time, the damaged socket is trimmed and polished, and the socket is reconstructed with a special tool and embedded in an artificial socket. Then choose a suitable artificial head to be embedded in the neck, and reset the head to get a painless and movable artificial total hip joint.
4.How is the artificial total hip joint fixed in the body
At present, there are two types of fixation.
One is a non-toxic adhesive that sticks the prosthesis of the artificial joint in the bone. It is only suitable for high age patients (>70 years old) and patients with osteoporosis. The advantage is that the patient can immediately move around with the aid of a crutch after surgery. The disadvantage is that after several years, some patients develop bone destruction, which causes loosening of the prosthesis and makes reoperation difficult.
Biological fixation is currently the preferred method. The surface of the artificial prosthesis is specially treated to make contact with the bone so that the bone tissue can grow with the prosthesis and achieve a stable fixation. The advantage is less bone destruction and easy to operate again. The disadvantage is that the weight-bearing time is late, after about 6 weeks. This method is suitable for young patients.
5.How to rehabilitate after artificial total hip arthroplasty
After the surgery, the patient should generally carry out rehabilitation activities according to the doctor’s requirements. After 6 hours of awakening from anesthesia, the patient can sit halfway, and after 2 days, the patient can get out of bed and move around with the help of crutches. However, care should be taken to avoid internal and external rotation of the hip joint on the operated side within 6 weeks (i.e., a soft pillow should be added between the legs when lying on the healthy side), and bending the hip over 90 degrees and straight leg raising are prohibited. In 2-3 months, the patient can gradually return to normal walking by removing the abutment. Because each patient’s condition is different, a rehabilitation program will be developed for each individual.
Post-operative patients can do things that people can do in general, but heavy physical work and strenuous exercise are not suitable. Cycling, swimming, walking and other exercises are advocated.
6.Muscle exercise
Quadriceps exercise, the patient supine affected limb flexion hip flexion knee position, put an appropriate pillow cushion under the knee fixed, dorsal extension of the ankle joint to do straight knee and practice to maintain 6-10 seconds, and then put down the calf for a complete action, 10 groups per day, 10 times per group. Note that the thigh should not leave the pillow cushion when doing this exercise.
For the gluteus medius exercise, the patient should take the lateral recumbent position on the healthy side, clip a soft pillow on the inner side of both lower limbs to keep the affected limbs out of the booth, and do the exercise of raising and lowering the affected limbs to exercise the gluteus medius.
7.Complications after artificial total hip arthroplasty
Nerve injury
The sciatic nerve and common peroneal nerve are the most easily damaged peripheral nerves in artificial hip arthroplasty, mostly occurring 1-3 days after surgery. They are mainly caused by improper placement of the lower extremity, lengthening of the lower extremity and subgluteal hematoma, resulting in motor impairment and skin sensory changes. If it occurs, all dressings should be removed, the knee should be flexed 20-30 degrees, the ankle joint should be in neutral position, and passive dorsiflexion exercises of the ankle joint should be performed to avoid secondary foot drop deformity.
Hematoma
Hematoma can cause impaired bone healing and increase the chance of infection, and is most often seen in older patients and those with more joint movement 48-72 hours postoperatively. If the hematoma continues to increase in size, skin tension increases, and local pain is severe, braking should be applied promptly to relieve symptoms, and if necessary, incision and drainage or vascular ligation should be performed.
Pain
Pain is the most common symptom after surgery, and in serious cases, it can affect the normal recovery of hip function. For severe pain within 1-2 days after surgery, the dose of analgesic drugs can be increased or analgesic pump (intravenous analgesic pump or epidural analgesic pump) can be used.
Inequality of lower limbs
The phenomenon of unequal length of both lower limbs after surgery is very common, mainly manifested by the lengthening of the limb on the operated side. The error is usually allowed to be around 1 cm, and it will not affect postoperative walking. In exceptional cases, a 1.5-2 cm difference may occur, which may cause claudication, secondary lumbosacral pain and sciatic nerve palsy. The vast majority of patients with unequal length of both lower limbs do not need special treatment. With the extension of time, many patients will gradually adapt to the sensation and adjust the heel height if necessary.
8.How many years can the joint prosthesis be used after artificial total hip arthroplasty?
How long the prosthesis can be used in the body after the artificial total hip replacement depends on 3 important factors.
The surgical technique is the key first step. The first step is the surgical technique, which requires a skilled surgeon to accurately fit the patient’s bone marrow cavity into the body.
The second is to choose a prosthesis that is acceptable and appropriate for the patient’s bone quality.
The third is that the patient should learn to use and protect the prosthesis after surgery.
The above 3 factors if you can grasp the current clinical follow-up more than 20 years is no problem. Therefore, for the elderly over 60 years old, it can be said that no further surgery is needed, while for young patients there is a possibility of receiving a second chance of surgery.