Many patients with hip lesions feel fearful when they go to the hospital and are told they need artificial hip replacement surgery, and they have many doubts, such as: Do I really need joint replacement surgery? Is there no other better treatment? Is hip replacement surgery safe? How long will the artificial joint last? How long can I walk after surgery? Is there any pain during or after the surgery? How long will I need to stay in the hospital? Where is the best place to have this surgery? What type of hip prosthesis is appropriate? And so on. In fact, these questions really need to be understood before you undergo surgery.
Do I really need joint replacement surgery? Is there no other better treatment?
This is the question of indications for surgery. Generally speaking, artificial hip replacement surgery should be chosen only when there is no other better treatment for hip lesions, or when various surgeries to preserve the femoral head are already difficult to solve the hip lesions. Due to the complexity of the lesion and the specific situation of each individual, as well as the different skills and experience of doctors, different doctors may choose different treatments for the same individual and the same lesion. Therefore, in practice, if you are indecisive about your treatment choice, you may want to consult an experienced joint surgery specialist, especially if you go to a high level and strong hospital for joint surgery.
Second, is hip joint replacement surgery effective? What problems can be solved?
For patients who have lost the function of the hip joint, cause persistent and obvious pain, and are confirmed through imaging examination to be in need of hip joint replacement surgery, the standardized hip joint replacement can make the pain disappear or relieve the pain and restore the function of standing and walking after the surgery. The final functional recovery depends on the surgeon’s surgical skills and experience, the patient’s degree of lesion and the patient’s own condition, etc. If the surgery meets the requirements, the expected results can generally be obtained.
Third, is hip replacement surgery safe?
Hip replacement surgery is a mature surgery, and generally speaking, it is safe and reliable. However, since many patients who undergo hip replacement are elderly or have some hypertension, diabetes, coronary heart disease, respiratory disease and other problems at the same time, the preoperative evaluation, consultation and treatment by relevant departments are very important to improve the safety of the surgery. Therefore, in addition to having a joint surgery department with a high level of technology, the hospital where it is located needs to be strong in general strength and requires the cooperation of a strong internal medicine system, anesthesiology, intensive care unit, rehabilitation department and other disciplines. In case of problems, there can be support from related disciplines to effectively improve safety.
Fourth, how long can the artificial joint be used?
According to foreign literature, the functional retention of total hip prosthesis is generally between 85-95% for 15 years and between 80-90% for 20 years, with some reports higher and some lower. How long an artificial joint lasts depends on many factors, the main influencing factors are.
(1) The surgeon’s surgical technique. If the prosthesis placement meets the requirements, including good prosthesis position, good anteversion and abduction angles, and good bony accommodation, it will facilitate the long-term survival of the prosthesis.
(2) The use of the artificial joint.
(3) The physical condition of the patient.
(4) the type of artificial joint, interface material, etc.
(5) the presence of associated complications. The surgeon’s surgical technique plays an important role in the long-term function and survival of the prosthesis. Therefore, choosing a surgeon or team with strong technical strength is a guarantee for the long-term survival of the artificial joint.
V. How long can I walk after artificial hip replacement surgery?
After conventional total hip replacement surgery, you can generally stand on the ground 3~5 days after the surgery and gradually walk with a walker. In case of complex surgery, such as high dislocation hip dysplasia, ankylosing stiff hip, total hip replacement with severe bone defect, etc., it may be necessary to delay walking, depending on the specific situation of the patient. However, most conventional total hip replacements allow for early postoperative debridement and practice walking.
VI. Is it painful during and after surgery?
Artificial hip replacement surgery is usually performed under epidural or general anesthesia, and there is no pain during the surgery. At present, the joint surgery department of Zhongshan First Hospital has started pain-free ward as early as 3 years ago, and adopts multi-modal analgesic methods to deal with pain after joint surgery, therefore, the post-operative pain is well controlled.
VII. How long do I need to stay in hospital?
Generally about 1~2 days of physical examination before surgery, 2 weeks after surgery to remove the stitches, the hospital stay is usually about 2 weeks, if the post-operative process is smooth, you can be discharged in a week after surgery, and you can remove the stitches at the local hospital or back to the hospital.
VIII. Surgery cost.
The hospitalization cost of total hip (imported products) joint replacement is strictly in accordance with the relevant national regulations. Guangzhou medical insurance patients pay according to the medical insurance regulations and public medical expenses, while medical insurance in other areas is implemented according to the relevant regulations.
9. What type of hip joint prosthesis is suitable?
At present, there are metal head to polyethylene lined joint, ceramic head to polyethylene lining, ceramic head to ceramic lining, metal head to metal lining and ceramic head to metal lining in the choice of joint interface for domestic artificial hip joints. In terms of femoral head size options there are conventional 28mm femoral heads, 32mm femoral heads and 36mm femoral heads, and even larger diameter femoral heads. There are also conventional total hip replacements and surface hip replacements. There are biological and cemented prostheses for fixation. There are grouped prostheses and one-piece prostheses. Different prostheses have different prices, different characteristics and different clinical reports. There is no one type is the best prosthesis, in the specific selection, should be based on the specific circumstances of the patient, including age, lesions, whether there is bone loss, whether there is high dislocation, whether osteoporosis, whether dysplasia, whether there is pelvic deformity, etc. Select the appropriate type of joint prosthesis, but also need to combine the doctor’s experience and technology, not the more expensive joint prosthesis is better, but to choose reasonably, suitable is the best . How to make a reasonable choice and choose only the right one, we need to consult a comprehensive and experienced joint surgery expert.
X. What are the complications of artificial hip surgery? How to prevent them? What if complications occur?
Generally speaking, as long as the indications are strictly grasped, adequate evaluation and preparation are made before surgery, good surgical techniques are available, and close observation and appropriate treatment are carried out after surgery, the complication rate is still very low. Complications include intraoperative complications and postoperative complications, and also include local complications and complications in other organs.
The most important thing to prevent the occurrence of complications is to do the relevant examination carefully before surgery, and to promptly manage and control the existing or potential diseases, including hypertension, coronary heart disease, diabetes, and potential infection lesions. Excellent surgical techniques and comprehensive anesthesia techniques can minimize intraoperative complications. Close postoperative observation and effective preventive measures, including infection prevention, prevention of venous embolism, pain control, close observation of vital signs, and timely detection and treatment of the first signs of complications will lead to a smooth recovery.
Once complications occur, timely treatment must be given according to the nature and type of complications, which often requires close cooperation of related departments such as anesthesiology, monitoring room, cardiovascular department, respiratory department, gastroenterology department, etc. to control the complications in the bud in time. Therefore, a strong group of disciplines is a guarantee for maximum safety in artificial joint replacement surgery.
Therefore, total hip replacement surgery is not just a matter of putting the joint prosthesis on, but involves scientific handling of all aspects of the entire perioperative period, prevention and treatment of various complications, various surgical techniques, and also includes the joint cooperation and collaboration of related disciplines to obtain a good functional and safe and secure outcome.
XI. Where is the best place for hip joint replacement surgery?
At present, many hospitals can carry out artificial hip joint replacement surgery. Choosing a suitable hospital for hip joint replacement surgery is an issue for every patient and family to consider. Due to the high technical requirements of joint replacement surgery, the high number of elderly patients and the risk of some potential complications, the following factors need to be considered.
(1) The presence of joint surgery in orthopedic departments with strong specialization, a fixed joint surgery ward and beds, and a team of physicians specializing in joint surgery.
(2) There should be a high number of artificial joint surgeries each year, especially the more complex and difficult surgical cases, including complex revision surgeries, total hip replacement such as hip dysplasia and ankylosing stiff hips, without complications.
(3) Complete technical team in joint surgery, with 3~5 joint surgery specialists above associate high level and 4~6 attending physicians.
(4) Good reputation of the hospital and joint surgery, good reputation, strictly in accordance with the national fees, strong comprehensive strength of the hospital, strong anesthesiology, cardiovascular department and other internal medicine systems.