In human life, various joint diseases are caused by various reasons: joint pain and dysfunction. The hip joint is one of the more commonly affected joints. It causes joint pain, difficulty in walking, and even loss of ability to live.
Total hip replacement is a boon for these patients. After total hip arthroplasty, the pain disappears and the function of the joint is restored. At present, nearly 500,000 people worldwide, mainly in developed countries, undergo total hip replacement surgery every year due to various causes of hip joint diseases. He Baofeng, Department of Extremity Orthopedics, Tongliang County Hospital of Traditional Chinese Medicine, Chongqing
What is the artificial total hip joint made of? Who needs total hip replacement? And what should you pay attention to after the artificial total hip replacement?
By reading the following contents, you can solve some doubts for you, so that you can have some more understanding about the artificial total hip joint and restore the health of your joint as soon as possible.
1. What is the artificial total hip joint made of?
The artificial total hip joint is generally made of non-toxic metal (cobalt-chromium-molybdenum alloy or titanium alloy) and ultra-high polymer polyethylenes (plastic), which are designed and manufactured according to the anatomical characteristics of human joints and imitate the function of joints. It is implanted into the human body to play the role of the original hip joint.
2. What are the diseases that require total hip replacement?
Severe pain and limited movement of the hip joint due to various reasons. Patients whose life and work are affected should consider 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, secondary hip arthritis, etc.
3. How to perform artificial total hip replacement surgery?
After the preoperative examinations, it is determined that the patient is ready for surgery. The patient is put under anesthesia, the surgeon opens the damaged joint, removes the diseased femoral head, and selects a metal stem that fits 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 mobile artificial total hip joint.
4. How is the artificial total hip joint fixed in the body?
There are currently two types of fixation.
One is a non-toxic adhesive that adheres the prosthesis of the artificial joint to the bone. It is only suitable for patients of advanced age (>70 years) and for patients with osteoporosis. It has the advantage that the patient can be weight-bearing immediately after surgery with the aid of a crutch. The disadvantage is that after a few years, some patients develop bone destruction, causing loosening of the prosthesis and making reoperation difficult.
Biological fixation is currently the preferred method. The surface of the artificial prosthesis is specially treated to make contact with the bone so that the bone tissue can grow with the prosthesis and achieve a stable fixation. The advantage is less bone destruction and easy to operate again. The disadvantage is that the weight-bearing time is late, after about 6 weeks. This method is suitable for young patients.
5. How should I recover after total hip arthroplasty?
After surgery, the patient should generally follow the rehabilitation activities as requested by the surgeon. After 6 hours of awakening from anesthesia, the patient can be semi-sitting, and after 2 days, he/she can get out of bed and move around with the help of crutches. However, care should be taken within 6 weeks to avoid internal and external rotation of the hip joint on the operated side (i.e., a soft pillow should be added between the legs during the planking movement or lying on the healthy side), and hip flexion exceeding 90 degrees and straight leg raising are prohibited. In 2-3 months, the patient can gradually return to normal walking with the removal of the abutment. Because each patient’s condition is different, a rehabilitation program is developed for each individual.
Post-operative patients can do things that people can do in general, but heavy physical work and strenuous exercise are not suitable. Exercises such as cycling, swimming and walking are advocated.
6. muscle exercises
l Quadriceps exercise
The patient lies supine with the affected limb in a flexed hip and knee position, put an appropriate pillow cushion under the knee to fix, dorsal extension of the ankle joint to do straighten the knee joint and practice to keep 6-10 seconds, then put down the lower leg for a complete action, 10 groups per day, 10 times per group. When doing this exercise, note that the thigh should not leave the pillow cushion.
l Gluteus medius exercise
The patient should lie on the healthy side and hold a soft pillow on the inner side of both lower limbs to keep the affected limbs out of the booth, and do the exercises to raise and lower the affected limbs to exercise the gluteus medius.
7. Complications after total artificial hip arthroplasty
l Nerve injury
The sciatic nerve and common peroneal nerve are the most easily damaged peripheral nerves during artificial hip arthroplasty, which mostly appear 1-3 days after surgery. They are mainly caused by improper placement of the lower limb, lengthening of the lower limb and subgluteal hematoma, resulting in movement disorders and skin sensory changes. If it occurs, all dressings should be removed, the knee should be flexed 20-30 degrees, the ankle joint should be in neutral position, and passive dorsiflexion exercises of the ankle joint should be performed to avoid secondary foot drop deformity.
l Hematoma
Hematoma can cause impaired bone healing and increase the chance of infection, and is most often seen in elderly patients and patients with more joint movement 48-72 hours postoperatively. If the hematoma continues to increase in size, skin tension increases, and local pain is severe, braking should be applied promptly to relieve symptoms, and if necessary, incision and drainage or vascular ligation should be performed.
l Pain
Pain is the most common symptom after surgery, and in serious cases, it may affect the normal recovery of hip function. For severe pain within 1-2 days after surgery, the dose of analgesic drugs can be increased or analgesic pump (intravenous analgesic pump or epidural analgesic pump) can be used.
l Lower limb inequality
The phenomenon of unequal length of both lower limbs after surgery is very common, mainly manifested by the lengthening of the limb on the operated side. The error is usually allowed to be around 1 cm, which will not affect postoperative walking. In exceptional cases, a 1.5-2 cm difference may occur, which may cause claudication, secondary lumbosacral pain and sciatic nerve palsy. The vast majority of patients with unequal length of both lower limbs do not need special treatment. With the extension of time, many patients will gradually adapt to the sensation, and the heel height can be adjusted if necessary.
8. How many years can the joint prosthesis last after total hip arthroplasty?
How long a prosthesis can last in the body after total hip replacement depends on 3 important factors.
The surgical technique is the critical first step. A skilled surgeon must be able to accurately fit the patient’s bone marrow cavity into the body.
The second is to choose a prosthesis that is acceptable and appropriate for the patient’s bone quality.
The third is that the patient should learn to use and protect the prosthesis after surgery.
The above 3 factors if you can grasp the current clinical follow-up more than 20 years is no problem. Therefore, for the elderly over 60 years old, it can be said that no further surgery is needed, while for young patients there is a possibility of receiving a second chance of surgery.