* What Is a Hip Replacement?
* Who Should Have Hip Replacement Surgery?
* What Are Alternatives to Total Hip Replacement?
* What Does Hip Replacement Surgery Involve?
* Is a Cemented or Uncemented Prosthesis Better?
* What Can Be Expected Immediately After Surgery?
* How Long Are Recovery and Rehabilitation?
* What Are Possible Complications of Hip Replacement Surgery?
* When Is Revision Surgery Necessary?
* What Types of Exercise Are Most Suitable for Someone With a Total Hip Replacement?
* What Hip Replacement Research Is Being Done?
* Where Can People Find More Information About Hip Replacement Surgery?
What Is a Hip Replacement?
Hip replacement, or arthroplasty, is a surgical procedure in which the diseased parts of the hip united are removed and replaced with tentative, artificial parts. These artificial parts are called the prosthesis. The goal of hip replacement surgery are to improve mobility by relieving affliction and improve function of the hip amalgamated.
Who Should Have Hip Replacement Surgery?
The most common explanation that people hold hip replacement surgery is the wearing down of the hip joint that results from osteoarthritis. Other conditions, such as rheumatoid arthritis (a chronic inflammatory disease that cause joint anguish, stiffness, and swelling), avascular necrosis (loss of bone caused by insufficient blood supply), injury, and bone tumors also may front to breakdown of the hip joint and the inevitability for hip replacement surgery.
Before suggesting hip replacement surgery, the doctor is likely to try walking aids such as a rattan, or non-surgical therapies such as medication and physical psychiatric therapy. These therapies are not other effective within relieving pain and on an upward curve the function of the hip joint. Hip replacement may be an substitute if persistent twinge and disability interfere with day by day activities. Before a doctor recommend hip replacement, joint desecrate should be detectable on x rays.
In the past, hip replacement surgery be an option primarily for society over 60 years of age. Typically, older relatives are less live and put less strain on the artificial hip than do younger, more involved people. In recent years, however, doctors own found that hip replacement surgery can be very successful contained by younger people as in good health. New technology has enhanced the artificial parts, allowing them to withstand more stress and strain. A more important factor than age within determining the success of hip replacement is the overall form and activity stratum of the patient.
For some folks who would otherwise qualify, hip replacement may be problematic. For example, people beside chronic diseases such as those that result in severe muscle lowliness or Parkinson's disease are more likely than race without chronic diseases to vandalize or dislocate an artificial hip. Because people who are at illustrious risk for infections or in poor health are smaller quantity likely to get better successfully, doctors may not recommend hip replacement surgery for these patients.
What Are Alternatives to Total Hip Replacement?
Before considering a total hip replacement, the doctor may try other methods of treatment, such as an exercise program and medication. An exercise program can strengthen the muscles in the hip joint and sometimes raise positioning of the hip and relieve pain.
The doctor also may treat inflammation in the hip beside nonsteroidal anti-inflammatory drugs, or NSAIDs. Some common NSAIDs are aspirin and ibuprofen. NSAIDs also include Celebrex * and Vioxx, so-called COX-2 inhibitors that block an enzyme particular to cause an inflammatory response. Many of these medication are available without a prescription, although a doctor also can prescribe NSAIDs within stronger doses.
* Brand names included here booklet are provided as examples only and their inclusion does not be a sign of that these products are endorsed by the National Institutes of Health or any other Government agency. Also, if a particular brand describe is not mentioned, this does not niggardly or imply that the product is unsatisfactory.
In hardly any cases, the doctor may prescribe corticosteroids, such as prednisone or cortisone, if NSAIDs do not relieve pain. Corticosteroids mute joint inflammation and are frequently used to treat rheumatic diseases such as rheumatoid arthritis. Corticosteroids are not other a treatment option because they can cause further despoil to the bones in the integrated. Some people experience side effects from corticosteroids such as increased appetite, weightiness gain, and lower resistance to infections. A doctor must prescribe and monitor corticosteroid treatment. Because corticosteroids alter the body's natural hormone production, patients should not stop taking them suddenly and should follow the doctor's instructions for discontinuing treatment.
If physical psychotherapy and medication do not relieve pain and add to joint function, the doctor may suggest corrective surgery i.e. less complex than a hip replacement, such as an osteotomy. Osteotomy is surgical repositioning of the shared. The surgeon cuts away damaged bone and tissue and restores the combined to its proper position. The goal of this surgery is to restore the cohesive to its correct position, which helps to distribute cargo evenly in the amalgamated. For some people, an osteotomy relieves torment. Recovery from an osteotomy takes 6 to 12 months. After an osteotomy, the function of the hip united may continue to worsen and the lenient may need superfluous treatment. The length of time before another surgery is needed vary greatly and depends on the condition of the joint past the procedure.
What Does Hip Replacement Surgery Involve?
The hip joint is located where on earth the upper end of the femur meet the acetabulum. The femur, or thigh bone, looks like a long stem beside a ball on the lapse. The acetabulum is a socket or cup-like structure in the pelvis, or hip bone. This "bubble and socket" arrangement allows a wide collection of motion, including sitting, standing, walking, and other daily undertakings.
During hip replacement, the surgeon removes the diseased bone tissue and cartilage from the hip joint. The hearty parts of the hip are left intact. Then the surgeon replaces the commander of the femur (the ball) and the acetabulum (the socket) with investigational, artificial parts. The new hip is made of materials that allow a inbred, gliding motion of the joint. Hip replacement surgery usually last 2 to 3 hours.
Sometimes the surgeon will use a special glue, or cement, to bond the hot parts of the hip joint to the existing, respectable bone. This is referred to as a "cemented" procedure. In an uncemented procedure, the artificial parts are made of porous stuff that allows the patient's own bone to grow into the pores and hold the up to date parts in place. Doctors sometimes use a "hybrid" replacement, which consists of a covered femur part and an uncemented acetabular slice.
Is a Cemented or Uncemented Prosthesis Better?
Cemented prostheses were developed 40 years ago. Uncemented prostheses be developed about 20 years ago to try to avoid the possibility of loosening parts and the breaking stale of cement particles, which sometimes arise in the lined replacement. Because each personality's condition is unique, the doctor and forgiving must weigh the advantages and disadvantages to decide which type of prosthesis is better.
For some ethnic group, an uncemented prosthesis may last longer than covered replacements because there is no cement that can break away. And, if the forgiving needs an auxiliary hip replacement (which is likely contained by younger people), also known as a revision, the surgery sometimes is easier if the party has an uncemented prosthesis.
The primary disadvantage of an uncemented prosthesis is the extended taking back period. Because it take a long time for the natural bone to grow and attach to the prosthesis, family with uncemented replacements must confine activities for up to 3 months to protect the hip pooled. The process of natural bone growth also can motivation thigh pain for several months after the surgery.
Research have proven the effectiveness of smooth prostheses to reduce aching and increase joint mobility. These results usually are striking immediately after surgery. Cemented replacements are more frequently used than cementless ones for elder, less influential people and race with colourless bones, such as those who have osteoporosis.
What Can Be Expected Immediately After Surgery?
Patients are allowed merely limited movement rapidly after hip replacement surgery. When the patient is surrounded by bed, the hip usually is braced with pillows or a special device that holds the hip within the correct position. The patient may receive fluids through an intravenous tube to replace fluids lost during surgery. There also may be a tube located essential the incision to drain fluid and a tube (catheter) may be used to drain urine until the patient is competent to use the bathroom. The doctor will prescribe medicine for affliction or discomfort.
How Long Are Recovery and Rehabilitation?
On the day after surgery or sometimes on the time of surgery, therapists will drill the patient exercises that will augment recovery. A respiratory psychoanalyst may ask the patient to breathe intensely, cough, or blow into a simple device that measures lung capacity. These exercises downsize the collection of fluid in the lungs after surgery.
A physical shrink may teach the long-suffering exercises, such as contracting and relaxing certain muscles, that can strengthen the hip. Because the unsullied, artificial hip has a more predetermined range of movement than an undiseased hip, the physical shrink also will teach the forgiving proper techniques for simple undertakings of daily living, such as bending and sitting, to prevent injury to the tentative hip. As early as 1 to 2 days after surgery, a tolerant may be able to sit on the end of the bed, stand, and even walk beside assistance.
Usually, people do not spend more than 10 days contained by the hospital after hip replacement surgery. Full recovery from the surgery take about 3 to 6 months, depending on the type of surgery, the overall strength of the patient, and the nouns of rehabilitation.
How to Prepare for Surgery and Recovery
People can do many things formerly and after they have surgery to clear everyday tasks easier and help speed their rescue.
Before Surgery
* Learn what to expect before, during, and after surgery. Request information written for patients from the doctor or contact one of the organization listed implicit the end of this document.
* Arrange for someone to abet you around the house for a week or two after coming home from the hospital.
* Arrange for transportation to and from the hospital.
* Set up a "recovery station" at home. Place the TV remote control, radio, telephone, prescription, tissues, waste picnic basket, and pitcher and glass subsequent to the spot where you will spend the most time while you restore your health.
* Place items you use every day at arm rank to avoid reaching up or bending down.
* Stock up on kitchen staples and prepare food in advance, such as frozen casseroles or soups that can be reheated and served confidently.
After Surgery
* Follow the doctor's instructions.
* Work with a physical psychotherapist or other health thinking professional to rehabilitate your hip.
* Wear an apron for carrying things around the house. This leaves hands and arms free for set off or to use crutches.
* Use a long-handled "reacher" to turn on lights or grab things that are beyond arm's length. Hospital personnel may provide one of these or suggest where on earth to buy one.
What Are Possible Complications of Hip Replacement Surgery?
According to the American Academy of Orthopaedic Surgeons, approximately 120,000 hip replacement operations are perform each year surrounded by the United States and less than 10 percent require further surgery. New technology and advance in surgical technique have greatly reduced the risks involved next to hip replacements.
The most common problem that may take place soon after hip replacement surgery is hip dislocation. Because the artificial ball and socket are smaller than the ordinary ones, the ball can become dislodged from the socket if the hip is placed surrounded by certain positions. The most harmful position usually is pulling the knees up to the chest.
The most common latter complication of hip replacement surgery is an inflammatory reaction to tiny particle that gradually wear rotten of the artificial joint surfaces and are rapt by the surrounding tissues. The inflammation may trigger the action of special cell that eat away some of the bone, cause the implant to loosen. To treat this complication, the doctor may use anti-inflammatory medication or recommend revision surgery (replacement of an artificial joint). Medical scientists are experimenting with unsullied materials that last longer and mete out less inflammation.
Less adjectives complications of hip replacement surgery include infection, blood clots, and heterotopic bone formation (bone growth beyond the normal edges of bone).
When Is Revision Surgery Necessary?
Hip replacement is one of the most successful orthopaedic surgeries performed--more than 90 percent of general public who have hip replacement surgery will never want revision surgery. However, because more younger people are have hip replacements, and wearing away of the collective surface becomes a problem after 15 to 20 years, revision surgery is becoming more adjectives. Revision surgery is more difficult than first-time hip replacement surgery, and the outcome is generally not as dutiful, so it is important to explore adjectives available options beforehand having further surgery.
Doctors consider revision surgery for two reasons: if medication and lifestyle change do not relieve pain and disability, or if x rays of the hip show that violate has occur to the artificial hip that must be corrected before it is too overdue for a successful revision. This surgery is usually considered only when bone loss, wearing of the unified surfaces, or joint loosening shows up on an x sunbeam. Other possible reasons for revision surgery include fracture, dislocation of the artificial parts, and infection.
What Types of Exercise Are Most Suitable for Someone With a Total Hip Replacement?
Proper exercise can shrink joint aching and stiffness and increase flexibility and muscle strength. People who have an artificial hip should communicate to their doctor or physical therapist something like developing an appropriate exercise program. Most exercise programs begin beside safe range-of-motion deeds and muscle strengthening exercises. The doctor or therapist will settle on when the patient can verbs to more demanding activities. Many doctors recommend avoiding high-impact events, such as basketball, jogging, and tennis. These comings and goings can damage the modern hip or cause loosening of its parts. Some recommended exercises are cross-country skiing, swimming, walking, and stationary bicycling. These exercises can increase muscle strength and cardiovascular fitness short injuring the new hip.
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