Artificial joint replacement surgery is the most mature procedure in human organ transplantation, and is currently the ultimate and only effective treatment for severe lesions in advanced joints, widely used at home and abroad, and is regarded as one of the important milestones in the history of orthopedic surgery in the 20th century. The earliest history of artificial joint replacement dates back to the ancient Egyptian civilization, but the first real artificial joint replacement surgery in the world was performed by the British. It was only in the late 1970s and early 1980s that some hospitals and specialists in China began to experiment with artificial joint replacement for patients with advanced femoral head necrosis. Among them, Lu Shibi of 301 Hospital was one of the pioneers. At present, orthopedic hospitals in Sichuan Province have widely carried out this kind of surgery. The boom in domestic artificial joint replacement surgery began in the 1990s, and after 1990, artificial joints were imported from abroad to China, and doctors doing artificial joint replacement sprang up everywhere. Now, the annual volume of artificial joint replacement surgery has reached more than 100,000 units. The best “treatment” for many diseases in medicine is prevention, followed by early detection and early treatment, but it seems that femoral head necrosis does not eat this set. To prevent, the cause cannot be found; to detect and treat early, the effect of early conservative treatment is not sure. Many people are over-treated due to conservative treatment, but it adds difficulty to the later surgical treatment. To address this, the referral suggests: total hip replacement surgery from the second stage. ”For young people, people may feel a little reluctant if they start from the second stage. After all, hip replacement surgery is an irreversible and ultimate treatment. Most of them still want to try something else before that, but the results are generally not good.” Experts emphasize that there is nothing wrong with conservative treatment, but there is no need to utilize surgical approaches that are too large, such as vascular implants – which are traumatic and costly to separate blood vessels and muscles during surgery. And judging from the large number of cases, the results of vascular implantation are rather mediocre. If you want to try, you can do a borehole decompression, which does not fundamentally change the pathological structure, but the pain relief is quite definite. Rejection reaction? Almost negligible When a foreign substance is implanted into the body, one of the inevitable problems is rejection. But when it comes to joint replacements, this is not a problem. According to experts, although some people in Western countries have metal allergies, there have been no cases in China where rejection of artificial joints with autologous bone has caused the surgery to be redone. The biocompatibility of bone cement and non-bone cement, pure titanium or titanium alloy is very good, and the reaction with bone is very small and almost negligible. The service life of 25 years is over 90%. Young patients with femoral head necrosis who have total hip replacement are most concerned about the service life of the artificial joint after surgery. In fact, after 20 years of development, not only the artificial joint technology has made great progress, but also the surgical skills of joint surgery experts can match or even surpass the famous foreign orthopedic experts. Prof. Shi Zhanjun pointed out that by choosing a suitable artificial joint and a main surgeon with a relatively stable skill level, the service life of a 25-year artificial joint is generally more than 90 percent. ”In other words, that means out of 100 people, there may be less than 10 people who need to do a revision. If it is lower than this standard, the main knife expert is an incompetent expert.” The specialist said he has been in practice for more than 20 years, and has handled at least 3,000 artificial joint replacement surgeries from 1990 to the present. One of them was an infection, and only two could be related to improper handling. It is understood that this number and low percentage of failure cases is leading in China and even internationally. Artificial joints, the material determines the wear factor In order to choose the right artificial joint for you, you should understand its material. There are four main combinations of artificial joints: metal and metal, ceramic and ceramic, metal and ceramic, and metal and plastic. The material varies and so does the wear factor. Experts say, “The combination of metal and plastic wears out the fastest, with an average of 5 years to wear out 1mm of plastic; followed by ceramic and plastic, with an average of 10 years to wear out 1mm; and the wear coefficient of the two combinations of metal and metal, ceramic and ceramic is very tiny.” Although the wear coefficient is small, but people for the combination of metal and metal apparently there is another hidden worry – the movement caused by the wear down of metal particles. “Although the wear down heavy metal particles can be excreted through the blood circulation, and worldwide reports have not found its toxic side effects. But the absence of reports is not the same as absence. Moreover, no effects have been found in the adult period, no one can guarantee that no effects will occur in the embryonic or fertilized egg period, and if there are effects, it will directly lead to very serious consequences.” Therefore, experts recommend that for those who have the financial means, especially infertile women who have the desire to have children, it is strongly discouraged to do metal-to-metal wear. Rather spend a little more to do ceramic-to-ceramic, a combination that will have a somewhat less toxic reaction as well as a dissolving effect on the bone. A total hip replacement costs about 5W In addition to the surgical results, the cost of the surgery is the biggest problem for families with a relatively low level of economic income. In comparison, the cost of hip replacement surgery is not cheap and may cost $4-5W on average. For an artificial joint, it takes more than $3W to get it back from the manufacturer, plus hospital fees, surgery, blood transfusion, and treatment, the total cost basically reaches about $5W. “This figure may not be enough if it is ceramic to ceramic wear. Especially with 4th generation ceramics, the cost for one joint is $6 to $7W due to better wear and crack resistance. but not everyone needs the best materials.” Doctors should provide sound, individualized advice to their patients. For young people under 40, ceramic-to-ceramic should be highly recommended, especially for patients in their 30s – 40s, where a single procedure can last a lifetime. If metal to high hinge polyethylene is done for patients under 40 years of age, a second surgery is definitely required. Conversely, if the patient is 70 years old or older, it is strongly discouraged to do ceramic to ceramic and choosing ceramic prosthesis is a waste of social resources.