Whether you are just beginning to choose a method of hip pain relief or you have agreed with your doctor to have a total hip replacement, the following will help you understand some of the advantages and disadvantages of total hip replacement as an orthopedic treatment. You will learn how a normal hip works; what causes hip pain; the effects of total hip replacement; and what activities and exercises can help you regain the muscle strength and flexibility you need to get back to your daily activities after surgery.
If your hip joint has been worn down by inflammation, fractures or other injuries, simple activities such as walking, sitting in a chair, etc. can be painful and difficult; even when you are at rest. If medication, reduced activity levels and the use of walking aids such as a cane do not alleviate your pain, you should consider a total hip replacement. By replacing the worn out surface of your hip joint, this procedure will not only reduce your pain, but will also allow you to resume your daily activities with ease. Normally, the parts that make up the hip joint work in harmony so that people can move around easily and painlessly.
Common causes of hip pain and dysfunction.
Arthritis is the most common cause of chronic pain and dysfunction in the hip joint. Osteoarthritis, rheumatoid arthritis and traumatic arthritis are some of the most common types of arthritis.
1, osteoarthritis: It mainly develops in people over 50 years old or people with a family history of osteoarthritis. In this disease, the hip cartilage, which plays a padding role, is worn down, which makes the bone surfaces rub directly when moving, causing pain and joint stiffness in the hip joint.
2, rheumatoid arthritis: people suffering from this disease have inflammatory congestion and edema of the synovial membrane, producing excessive synovial fluid and causing wear and tear of the articular cartilage, resulting in hip pain and joint stiffness.
3, traumatic arthritis: often occurs after a serious hip injury or fracture. Hip fracture often leads to aseptic osteonecrosis, and over time the articular cartilage is destroyed, which in turn causes pain and limited movement of the hip joint.
Whether you are a candidate for hip replacement or not is a matter of consultation between you, your family, your health care provider and your orthopedic surgeon. Your health care provider will first refer you to an orthopedic surgeon for an initial examination. Although the age of patients undergoing total hip replacement is approximately 60 to 80 years, each patient is evaluated independently by the orthopedic department and the need for total hip replacement is based on the patient’s pain, degree of dysfunction and health status, not on age alone.
If your condition is one of the following, then generally you should have a hip replacement.
1. The pain in the hip joint has limited your daily activities, such as walking, bending, etc.
2. Hip pain that is present at rest either day or night.
3.The stiffness of the hip joint prevents you from walking or lifting your leg.
4.After taking anti-inflammatory drugs to treat the hip pain, the reduction is very slight.
5.There are serious side effects or you feel very uncomfortable after taking the medication.
6.After other treatments such as physical therapy, the hip pain is not reduced.
Expected results of total hip replacement
A full understanding of what can and cannot be achieved with total hip replacement is an important factor in deciding whether or not to have a joint replacement. Approximately 90% or more of patients who have a total hip replacement experience significant improvement in their symptoms; a significant reduction in hip pain and a significant improvement in their ability to perform daily activities. However, you should never engage in more strenuous exercise after a total hip replacement than you did before surgery, and your doctor may advise you to avoid jogging, slow jumping, and other high-impact sports in the future. The plastic spacer of the hip joint will wear to some degree during normal use, and excessive weight bearing and activity will increase this wear and tear, causing loosening and pain in the replacement hip joint. Generally speaking, with proper use, an artificial hip can last for many years.
You may be admitted to the hospital a few days before the surgery to make the necessary preparations. The anesthesiologist will examine you on the day of the surgery and determine the type of anesthesia you will need based on your condition. The common types of anesthesia are general anesthesia, in which you are asleep throughout the surgery, and epidural anesthesia, in which only your lower extremities are anesthetized and you are awake at all times.
The procedure
Your orthopedic surgeon removes the diseased bone and cartilage and places a metal or plastic prosthesis to restore the strength and function of your lower extremity. There are many types of designs and materials used in today’s total hip replacements, but generally they consist of two parts, a high-smooth metal femoral head prosthesis and a wear-resistant plastic acetabular prosthesis, which may also be encased in a metal shell. There is also a special surgical cement called bone cement that fills the space between the prosthesis and the bone to hold the prosthesis in place. You will be taken back to your room after the surgery until you are fully awake from the anesthesia.
Hospitalization
You will have to stay in the hospital for a while after the operation. It is very important for your recovery that you do functional exercises of the hip as early as possible after surgery. Of course you will feel pain in the incision and your surgeon will prescribe you some medication to relieve your pain. To prevent lung infections after surgery, you should breathe deeply and cough often. Your surgeon will use measures such as placing drains, compression bandages on the lower extremities and using anticoagulants to prevent swelling and blood clots in the lower extremities.
Your surgeon will also use a CPM machine to perform functional hip exercises, which will be very beneficial to the recovery of your lower extremities and hip joint after surgery. The CPM machine will improve your blood circulation by elevating your lower extremities and exercising the muscles of your lower extremities to reduce lower extremity edema and prevent thrombosis. You should perform foot and ankle activities right after surgery, which will improve circulation by exercising the calf muscles, thereby reducing lower extremity edema and preventing thrombosis. Your surgeon usually teaches you how to exercise the muscles of the lower extremities and how to move the hip joint before or the day after surgery so that you can resume walking and performing daily activities as soon as possible.
Possible complications after total hip arthroplasty
The likelihood of complications after total hip arthroplasty is low. The incidence of some serious complications such as infection after total hip replacement is reported to be less than 2%, and other complications such as myocardial infarction or sudden cardiac death are even less frequent. Other complications such as myocardial infarction or sudden cardiac death are less common. However, patients with chronic diseases such as hypertension and diabetes have a significantly higher chance of developing complications. These complications are uncommon, but if they do occur, they can seriously prolong and hinder your recovery. Deep vein thrombosis is the most common complication after total hip arthroplasty. Your surgeon will take a set of measures to prevent this, such as short-term elevation of the affected limb, early functional exercises of the lower leg and ankle, compression bandaging of the lower limb and the use of anticoagulants. In general, it is very important to ask your surgeon carefully about postoperative complications.
Preventing falls
A fall within a few weeks after surgery may damage your new joint and may require a second surgery. Therefore, until your hip is strong and flexible and your balance is restored, walking up and down stairs can be a major obstacle and it is best to have someone to take care of you, using a stick, crutches, handrail walker, etc. if necessary. Your doctor can help you determine when you need to be cared for and when you can live alone.