1.What is an artificial joint replacement?
Total artificial hip arthroplasty is the surgical placement of a designed and made artificial hip joint, including: the artificial acetabulum and the artificial femoral head part. The types of artificial hip joints include.
① surface replacement of the head of the femur.
② Artificial femoral head replacement.
③Total hip artificial joint replacement.
2.What are the advantages of artificial joint replacement for femoral head necrosis? What are the disadvantages?
Femoral head necrosis damages the function of the hip joint, often causing pain and limited movement of the hip joint, affecting the patient’s learning, work and quality of life.
The advantage of artificial joint replacement is that it can restore the function of the hip joint as soon as possible, relieve the pain and improve the range of motion of the hip joint, so that the patient can return to society as soon as possible. The disadvantage is that the artificial joint has a certain service life, but the current artificial hip surgery technology and materials can make the patient use in more than 20-30 years, and not only about 10 years as previously feared.
3.Is there a lot of damage in artificial joint replacement? Can minimally invasive methods be used?
Before the last few years, total hip replacement was a very big operation for doctors and patients, and the operation took a long time. With the improvement of surgical techniques, especially the promotion of small incision or minimally invasive artificial hip replacement techniques, total hip arthroplasty is becoming less and less invasive. The surgical incision is about 10 cm small, and the damage to the soft tissues around the hip joint is also small. It can be replaced bilaterally at the same time (about 3 hours in total), and you can walk on the ground early after surgery. Minimally invasive surgical methods can also be used.
4.Which patients with femoral head necrosis are suitable for artificial joint surgery? Are there any age and physical condition restrictions?
If the diagnosed femoral head necrosis has progressed to stage 3 or above, the femoral head has collapsed, and the hip joint is painful or the movement of the hip joint is limited, which affects the daily life, total hip replacement is suitable. Patients with specific requirements can have their indications relaxed appropriately, such as: wishing to obtain a normal hip joint, or having high requirements for work and quality of life; girls requiring a normal walking gait, etc.
As long as an adult has femoral head necrosis and the physical condition allows, artificial hip replacement surgery is feasible, without any limitation of age or physical condition. Of course, the artificial joint has its own service life, so it should be postponed as much as possible; it should be especially emphasized that indefinite postponement will make the soft tissue around the hip joint worse (less compliant), which will make it difficult for the surgeon to place the prosthesis and affect the postoperative recovery and the effect of the surgery (poor range of motion of the hip joint after surgery), and will affect the long-term efficacy of the surgery.
5.What are the contraindications of artificial joint replacement for the treatment of femoral head necrosis?
Total hip replacement is not suitable for patients with active hip infection, or poor muscle strength around the hip joint (damaged gluteus medius); patients with ankylosis of the hip joint should be treated individually.
6.Artificial joint prosthesis.
(1) How many kinds of artificial joint prosthesis are there? What is the price?
According to the design concept and different manufacturers, there are many types of artificial hip joints, roughly divided into.
Classified by material.
① cobalt-chromium alloy.
② Titanium alloy. The majority of prostheses used today are titanium.
According to the method of fixation, there are
①Bone cement fixation.
②Bio-press-fit fixation.
According to the manufacturer, they are roughly divided into
① domestic artificial hip prosthesis; ② imported artificial hip prosthesis.
②imported artificial hip prosthesis.
According to the different joint wear surface of the hip prosthesis is divided into.
① metal to high cross-linked polyethylene.
②ceramic to high cross-linked polyethylene.
③ceramic to ceramic.
④metal to metal.
⑤ ceramic-to-metal.
The price of artificial hip prosthesis varies according to the bidding price in different places (Beijing as a reference, according to the set) domestic hip: about 10,000 yuan imported hip: between 25,000 yuan and 50,000 yuan (mainly according to the different prices of joint wear surface): ① metal to high cross-linked polyethylene (about 25,000 yuan)
① metal to high cross-linked polyethylene (about 25,000 yuan)
②Ceramic to high cross-linked polyethylene (around 30,000 yuan)
③ceramics to ceramics (about 36,000 yuan for 3-generation ceramics and about 50,000 yuan for 4-generation ceramics)
④Metal to metal (around 38,000 RMB).
(2) How to choose the right artificial joint prosthesis for the patient?
The choice of the artificial hip joint is mainly based on the patient’s age and the quality of the bone. The younger ones choose a hard-to-hard joint surface, and there is also the financial ability that the patient can afford, and theoretically there is a certain advantage of the artificial hip joint that will be priced high.
(3) What is the duration of use of artificial joint prosthesis?
According to the statistics, the efficiency of artificial hip prosthesis after 20 years of use is more than 80%, and 30 years is about 60%.
The influencing factor is 50% depending on the design, material and technology of the prosthesis, 35% on the fitting technique of the surgeon, and 15% on the others (including patient factors and usage methods, etc.).
7.How should I rehabilitate after artificial joint surgery? How long does it usually take to live like a normal person?
After total hip replacement, the main exercise is to exercise the muscle strength of the lower limbs and the range of motion of the hip joint, and pay attention to prevent the hip joint from dislocation. Small incision total hip arthroplasty can enable you to walk on the ground with crutches 2 to 3 days after surgery, and abandon the crutches 3 weeks after surgery. About 2 to 3 months later, you can live like a normal person.
8.What should I pay attention to in my life after the artificial joint replacement? How to do the maintenance of the prosthesis?
In the early stage after total hip arthroplasty, you should pay attention to prevent hip dislocation, and in the posterior lateral incision, pay attention to the lower limbs not to be extremely inwardly flexed and internally rotated, and to hold a pillow between the legs when turning over in bed. In the later stage, attention should be paid to avoid serious violent trauma and fracture around the prosthesis and ceramic rupture (the incidence is very low).
The main maintenance of the prosthesis is to avoid strenuous sports (such as mountain climbing, basketball, etc.) as a daily exercise, which will increase the wear and tear of the prosthesis, you can choose to swim and other sports.
9.Does it need regular review? How long is it better to review?
After total hip arthroplasty, X-rays should be taken regularly for review, so that small problems can be found in time for “minor repair”, such as polyethylene lining wear and tear replacement, and avoid “major repair”, such as wear particles that cause bone dissolution around the hip joint for a long time, which requires revision surgery. After hip joint replacement, you should go to the hospital for X-ray review at 3 months, 6 months and 12 months to understand how the prosthesis combines with the surrounding bone. In the future, X-rays should be taken at the hospital every year.
10.When does a situation arise that indicates the need for a revision or re-replacement of the artificial joint?
If there is pain or popping in the groin area after the initial artificial joint replacement, you should promptly go to the hospital for a review. If severe prosthesis wear occurs, or if osteolysis is present, revision should be performed even if there are no symptoms. This is because it can cause more serious consequences (severe osteolysis, bone defects and prosthesis loosening, etc.).