Bone and joint disease is one of the major causes of human health. Severe joint disease can even result in loss of joint function. Artificial joint replacement is one of the most important breakthroughs in orthopedic surgery in the 20th century. It involves removing the worn and damaged joint surfaces and replacing them with artificial materials, thus effectively relieving pain, improving joint function and enhancing the patient’s quality of life. At present, millions of artificial joint replacement surgeries are performed worldwide every year. With the development of the national economy and the improvement of people’s demand for quality of life, the number of artificial joint replacement surgeries in China is increasing at a rate of 15%-20% per year. What is an artificial hip joint replacement? The hip joint is a mobile joint consisting of the acetabulum and the femoral head. The procedure to replace the acetabular surface and femoral head of a diseased hip with an artificial one is called an artificial hip replacement. Surgery that replaces both the acetabular surface and the femoral head is called total hip arthroplasty, while surgery that replaces only the femoral head is called artificial femoral head arthroplasty, also called artificial hemiarthroplasty. What kind of patients need to receive artificial hip arthroplasty? Hip arthroplasty is indicated for patients with any of the following diseases that cause pain and dysfunction of the hip joint and significantly affect the quality of life: ① advanced primary or secondary osteoarthritis from various causes; ② more serious ischemic necrosis of the femoral head; ③ acetabular dysplasia with osteoarthritis; ④ advanced ankylosing spondylitis or rheumatoid arthritis. ⑤ elderly femoral neck fracture or femoral neck fracture with significant displacement; ⑥ bone nonunion between femoral neck and femoral rotor fracture; ⑦ proximal femoral tumor or acetabular tumor; ⑧ septic or tuberculous hip osteoarthritis in stationary stage, etc. Contraindications include absolute contraindications and relative contraindications. Absolute contraindications include active infection in the hip joint or other parts of the body, and insufficient muscle strength or loss of hip abductor muscles. Relative contraindications: (1) poor general condition or severe co-morbidities that make it difficult to tolerate larger surgery; (2) severe systemic or local osteoporosis or progressive bone loss; (3) neurotrophic arthropathy (Charcot arthropathy); (4) history of septic infection or tuberculosis of the hip joint without sufficient follow-up to confirm that the lesion has been quiescent for more than one year; (5) inability to cooperate with postoperative functional rehabilitation, such as Parkinson’s disease, cerebral palsy, mental retardation, etc. What kind of artificial hip joint is suitable for you There are many ways to classify artificial hip joints, and they can be divided into different types according to the friction material of the joint surface, the fixation method of the artificial joint and the form of the artificial joint. Different people are suitable for different artificial joints. The artificial joints can be classified into metal-polyethylene, metal-metal, ceramic-ceramic and ceramic-polyethylene according to the friction material of the joint surface. Metal-polyethylene is slightly less wear-resistant than metal-metal or ceramic-ceramic and has a slightly shorter service life, but is less expensive and is usually used in older patients. Metal-metal or ceramic-ceramic are more wear-resistant, have a longer service life, and are usually used in younger patients. The artificial joints are divided into cemented and biologic fixation. Bone cement is like concrete for building a house, which is filled with bone cement to achieve a firm fixation of the prosthesis. Biological fixation is achieved by treating the surface of the prosthesis so that the bone tissue grows into (ingrowth) or onto (ongrowth) the surface of the prosthesis, thus achieving firm fixation. In elderly people with osteoporosis, the choice of cemented prosthesis can provide good stability at an early stage and can be out of bed within a few days after surgery. Younger patients with good bone quality are more likely to use a biologic fixation prosthesis. What issues should be noted in the daily life of patients who have received artificial hip arthroplasty? Patients who have received artificial hip arthroplasty should pay attention to the following issues within 6 weeks after surgery: they should not sit for a long time to avoid poor blood return and swelling of the lower limbs; they should not sit on chairs or sofas that are too low; they should not cross their legs or bend over 90°; when using the toilet, it is better to use a raised toilet seat or lean back and extend the affected limb forward as much as possible; when sleeping on their sides If the hip joint on the operated side is facing upward, a pillow should be placed between the legs to avoid excessive hip inversion; when riding in a car, sit with the hips as far forward as possible, lean back and extend the leg forward; try to wear loose shoes without laces, and choose to carry the shoes on the inside of the leg or on the outside of the leg according to the doctor’s instructions; to reduce the risk of slipping when bathing, sit on a high stool and scrub the lower limbs and feet with a bath sponge with a long handle. Three months to six months after surgery, patients can perform normal daily activities, such as walking, sitting in a chair, using a commode for toileting, and lying on their sides normally, with the permission of the doctor. Jogging and appropriate physical exercise are recommended to start six months after surgery. What are the most common problems after artificial hip arthroplasty? The most common problems after artificial hip arthroplasty include dislocation of the artificial joint, loosening of the prosthesis, joint infection, significant unequal length of bilateral lower limbs and periprosthetic fracture. However, the probability of these complications is very low, and currently more than 90% of patients do not have significant problems with the prosthesis for more than 10-20 years. It can be said that artificial hip arthroplasty is one of the most successful surgical treatments in the 20th century.