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What is total hip replacement?
It is a surgery that replaces the damaged hip joint, which can be affected for different reasons, by an artificial joint or prosthesis.
This process is carried out when the joint has severe damage due to osteoarthritis, wear and tear, arthritis, osteonecrosis and fractures in older adults that make it impossible for the patient to live normally.
Total hip replacement is the most successful surgery in orthopedics, it has a 97% rate of good results, it is a procedure that allows the patient to walk again the next day so it should not be considered a failure in the preservation process.
This procedure is effective for patients who are paralyzed by pain, who have reached the point of not being able to jump, climb stairs, walk, and even sleep well because of the pain.
Although it is an invasive surgical process, hip replacement is necessary when the patient does not find improvement in their joint through analgesics, non-invasive treatments and even hip preservation procedures.
When is a total hip replacement diagnosed?
It is likely that in the face of diseases such as rheumatoid arthritis, osteoarthritis, osteonecrosis, injuries and/or fractures in this joint, the orthopedic doctor will recommend hip replacement surgery that uses an artificial hip prosthesis to completely replace the damaged cartilage and bone of the joint.
This surgery aims to recover the patient’s quality of life by eliminating pain and recovering the mobility of the joint.
However, before deciding on this treatment, the patient must overcome certain levels of hip recovery that have to do with the patient’s age, type of injury and physical conditions.
For example, before diagnosing hip replacement surgery, your doctor may recommend drug treatments accompanied by physical therapy and joint reconstruction treatments.
In case the joint does not improve with these other options, the final solution will be hip surgery with which the damaged joint is replaced with advanced hip implants, which can be a definitive solution for problems and pain in the hip area.
This surgical procedure is currently considered a safe solution that ensures immediate relief for the patient. Dr. José Felix Castillo, with his procedure, can guarantee the patient’s mobility in a period of 48 hours after surgery, which means a fairly rapid improvement of symptoms.
Recovery from surgery
Although surgery represents an almost automatic relief of pain, it is necessary to complete a postoperative period that takes care of the integrity of the prosthesis and the patient’s health. The instructions for recovery depend on your doctor as they are adjusted to each particular case. Although the patient can walk short distances, he should consider resting and avoiding certain movements.
Some common recommendations are:
- Using crutches inside your home to get around, it may only be the first week, to regain balance and strength within the joint.
- Rest and walk as little as possible for a prudent time that will depend on the characteristics of each patient. As the doctor indicates it, the patient will be able to recover certain activities of their daily life.
- Shower sitting on a high seat, or leaning on a railing so as not to demand too much effort from the operated joint.
- Avoid actions that flex the joint such as sitting in low seats, bending over, even putting on shoes.
- It is recommended to include a bath lift to avoid sitting on the regular toilet which is quite low for the newly replaced hip.
- Sleep on your back with a pillow between your legs for at least the first few weeks after the operation.
- It is common for patients to go home the same day of surgery, however this decision will depend on the doctor who evaluates the characteristics of each patient.
It is also important to mention the other care that the patient must take to avoid any infection in the incisions of the surgery, as well as others to take care of the blood circulation after the operation in order to avoid thrombosis.
The general recommendations are:
- Keep the surgery dressing clean and dry, prevent soap and water splashes from entering that area, and wash with the doctor's instructions.
- You should be aware of the healing of the skin and when observing any possible infection, notify your doctor, the same applies to dental procedures that may generate infection. The risk must be reduced.
- Walk and mobilize the legs to promote good circulation after surgery.
- Wear compression stockings for two weeks after the operation, this recommendation can be checked with your doctor as it depends on your physical condition and family history of heart disease.
- Perform exercises to increase blood flow in the legs such as moving the ankles up and down, among others that can be defined by the specialist.
- If you have doubts about your circulatory system, it is best to talk to your doctor before surgery so that he or she can take these aspects into account, he or she may recommend taking anticoagulants after surgery, however this option is valid under the supervision of a professional.
Possible Risks of Surgery
Joint replacement surgery has advanced a lot thanks to science, the procedure is less and less risky for patients and they are more effective, you have to trust that this procedure provides immediate relief and well-being that is worthwhile.
However, like any surgical procedure, it has certain risks that must be considered before performing it in order to minimize them.
- Infection after surgery is a risk that can and should be controlled with drugs and good hygiene.
- Fractures, during the operation some fractures can be caused in the bone that if they are small they solidify on their own, if they are large they need the intervention of screws and other advanced procedures. The cases in which this happens are very rare.
- Change in hip length, meaning that one leg is longer than the other. This is anticipated before surgery, a skilled surgeon could prevent and/or fix it.
- Nerve damage, there are rare times when the nerves are touched or hit by the joint, in the event that it happens it can generate numbness in the leg, pain and weakness.
- Loosening of the prosthesis, thanks to advances in prostheses, there are fewer and fewer cases in which they do not adhere well to the bone. When this happens, the pain in the hip is reactivated and a second surgery must be performed to correct it.
What is the procedure of hip arthroplasty surgery?
Depending on the style of the orthopedic doctor, three types of approach can be used, in this case the position of the patient’s half side is used with the hip to be treated at the top.
A 10- to 12-centimeter incision is made that separates tissues that need to be repaired again at the end of surgery. This is made possible by a dose of general anesthesia to eliminate pain.
To place the prosthesis, the patient’s femoral head is removed and replaced by a metal one, a metal cup is placed in the acetabulum and the polyethylene that serves as cartilage that has been lost goes between both parts.
Now the prostheses are held in place with screws and are impacted into the patient’s bone in each of the required areas.
To finish the surgical procedure, the surgeon restores the muscles and tendons before closing the incision with sutures.
This procedure lasts approximately two hours.
What to do before surgery?
The patient must suspend taking medications and supplements that can alter blood clotting since it is an open surgery. Consult your orthopedic surgeon before self-medicating for any symptoms before and after surgery.
It’s important to record your medical history, pre-existing conditions, allergies, and current treatments with your surgeon.
You may need to have a variety of blood tests and x-rays to give your surgeon a more objective picture of your personal case.
It is also recommended to give up alcoholic beverages and cigarettes that can be counterproductive for wound healing.
Pre-op testing
Before total hip replacement surgery, several tests may be performed, including:
- Blood tests.
- Radiographs.
- Mri.
- Cardiac evaluations.
These tests help assess the patient’s overall health and hip condition for safe and successful surgery.
What to do before surgery?
The patient must suspend taking medications and supplements that can alter blood clotting since it is an open surgery. Consult your orthopedic surgeon before self-medicating for any symptoms before and after surgery.
It’s important to record your medical history, pre-existing conditions, allergies, and current treatments with your surgeon.
You may need to have a variety of blood tests and x-rays to give your surgeon a more objective picture of your personal case.
It is also recommended to give up alcoholic beverages and cigarettes that can be counterproductive for wound healing.
