1. What is the artificial total hip joint made of?
Artificial total hip joint is generally made of non-toxic metal (made of cobalt-chromium-molybdenum alloy or titanium alloy) and ultra-high polymer polyethylene (plastic) according to the anatomical characteristics of human joints, designed and manufactured to imitate the function of the joint. It is implanted into the human body to play the role of the original hip joint.
2.What diseases require artificial total hip joint replacement?
Regardless of the cause of severe hip pain and limited movement, affecting life and work, can be considered artificial total hip replacement. Common diseases include rheumatoid arthritis, ankylosing spondylitis, advanced aseptic necrosis of the femoral head, femoral neck fracture in the elderly, congenital acetabular dysplasia and secondary hip arthritis.
3 .How to perform total hip replacement?
After the preoperative examinations, it is determined that the patient is ready for surgery. Under anesthesia, the surgeon opens the damaged joint, removes the diseased femoral head, and selects a metal stem suitable for the size of the patient’s femoral medullary 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 then 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?
A kind of fixation is to apply a non-toxic adhesive (bone cement) to stick the artificial joint prosthesis in the bone, which is suitable for the elderly and patients with osteoporosis. Advantages: After surgery, the patient can get out of bed and move around with the help of crutches. Disadvantage: After several years, some patients will have bone destruction, which will cause the prosthesis to loosen and make it difficult to operate again.
The other type of fixation is biological fixation, which is currently the preferred method. The surface of the artificial prosthesis is specially treated to contact with the bone so that the bone tissue grows together with the prosthesis to achieve a stable long-term fixation. Advantages: less bone destruction, easy to operate again. Disadvantages: late weight-bearing time, about 6 weeks later, suitable for young patients.
5. Precautions after artificial total hip replacement.
After surgery, the patient should generally follow the doctor’s requirements for rehabilitation activities. The ankle pump and ankle rotation can be done 6 hours after waking up from anesthesia. The ankle pump: i.e., the foot moves up and down significantly, several times a day, and can be continued until full recovery. Ankle rotation: the ankle is rotated back and forth for 5 weeks at a time, several times a day, and can be continued until full recovery. On the first day after surgery, the patient can get out of bed and move around with the help of crutches. 6 weeks, care should be taken to avoid internal and external rotation of the hip joint on the side of surgery (leg coiling), soft pillows should be held between the legs when lying on the healthy side, bending the hip over 90 degrees is prohibited, straight leg elevation is prohibited, and complete weight bearing of the affected limb should be avoided for those who are not cemented when going down to prevent hip dislocation or loosening. 2-3 months, the patient can go to crutches and resume normal walking.
Post-operative patients advocate activities: cycling, swimming, walking, etc.; not advocate activities: heavy physical labor, strenuous activities, etc.
6. Exercise of muscles after hip replacement.
(1) quadriceps training: the patient is lying down, tense the thigh muscle, hold for 10 seconds, 10 times in a row.
(2) training of gluteus maximus: the patient is lying down, clench the hip and tense the hip muscles, hold for 10 seconds, 10 times in a row.
(3) Training of the adductor muscles: the affected limb is held close to the bed, and the straight leg is tucked in. Back and forth 10 times, at least 2 times a day.
(4) Adductor training: the affected limb is pressed firmly against the bed, and the straight leg is abducted. Back and forth 10 times, at least 2 times a day.
(5) Stirrup training: heel against the bed, thigh towards the abdomen (the angle between thigh and abdominal wall is less than 90 degrees). Back and forth 10 times, 2 times a day.
7, Post-operative complications of artificial total hip joint
(1) Nerve injury The sciatic nerve and common peroneal nerve are the most easily damaged nerves in artificial hip arthroplasty, mostly occurring 1-3 days after surgery. Cause: caused by improper placement of the lower limb, lengthening of the lower limb, and subgluteal hematoma after surgery.
Treatment: Remove all dressings, flex the knee 20-30 degrees, position the ankle joint neutrally, perform passive dorsiflexion exercises of the ankle joint to avoid foot drop.
(2) Hematoma Most often occurs in the elderly and in patients with more joint activity 48-72 hours after surgery.
Treatment: If the hematoma continues to increase, skin tension increases and local pain is severe, brake should be applied promptly to relieve the symptoms, and if necessary, incision and drainage or vascular ligation should be performed.
(3) Pain is the most common postoperative symptom, early with pain pump, after removing the pain pump, oral painkillers can be taken.
(4) lower limb unequal length postoperative double lower limb unequal length phenomenon is more common, mainly performance of the operation side lengthening, allow the error of 1cm. no special treatment, time can let the patient adapt, necessary is to adjust the heel height.
8. Factors affecting the post-operative life of the prosthesis?
The age of the prosthesis depends on three factors: the first is the surgical technique, through a professional and skilled doctor to fit the patient’s bone marrow cavity size artificial prosthesis accurately into the body, the second is to choose a suitable artificial prosthesis that is acceptable and suitable for the patient’s bone quality. The third is that the patient should learn to use and protect the joint after the operation.
9.What about the infection after total hip replacement?
Infection in the late postoperative period is the most serious complication of artificial joint replacement, and even requires removal of the prosthesis, resulting in the complete failure of the artificial joint replacement. Presentation: Redness, swelling, hard nodules or pus around the affected joint. Treatment: Immediately administer antibiotics and come to our center for consultation with a professional physician. Prevention: In case of pneumonia or infection in other parts of the body, treat with antibiotics as early as possible; in case of tooth extraction or surgery in other parts of the body, use antibiotics routinely before surgery.
10. Post-operative review
Starting from the first day after surgery, review at 6 weeks, 3 months, 6 months, 1 year, and annually thereafter.