Hip replacement, also called arthroplasty, is a surgical procedure to replace a damaged hip with a prosthesis (an artificial joint). This surgery may be considered following a hip fracture (breaking of the bone) or for someone who has severe arthritis. The most common condition that results in the need for hip replacement surgery is arthritis.
The following are the various forms of arthritis that can occur:
osteoarthritis, a degenerative, joint disease that affects mostly middle-aged and older adults, causes the breakdown of joint cartilage and adjacent bone in the hips
rheumatoid arthritis, which causes inflammation of the synovial membrane and results in excessive synovial fluid, can lead to pain and stiffness
traumatic arthritis, arthritis due to injury, can cause damage to the articular cartilage of the hip
Diagnostic procedures may include the following:
x-ray, MRI, CT scan
bone fracture from a fall or injury
joint soreness after inactivity or periods of overuse of a joint
joint pain which increases with activity throughout the day
muscle atrophy around joints caused by inactivity can increase pain
pain and stiffness affecting posture, coordination and ability to walk
pain in the groin, inner thigh, or buttocks and a pronounced limp
limiting painful activities
assistive devices for walking (such as a cane)
hip replacement surgery
Surgery and Prostheses: The two most common types of artificial hip prostheses used in replacement surgery are cemented prostheses or uncemented prostheses. Sometimes, a combination of the two types is used to replace a hip joint. A hip prosthesis is made up of metal and plastic. A cemented prosthesis is attached to the bone with a type of surgical cement. An uncemented prosthesis attaches to the bone with a fine mesh of holes on the surface, in order for the bone to grow into the mesh and attach naturally to the prosthesis.
The prosthesis (artificial hip) is comprised of the following two components:
metal stem component
metal or ceramic ball component
metal or plastic (backed with metal) socket component
Traditional Hip Replacement
A traditional hip replacement involves an incision (cut) about 10 to 12 inches long over the hip joint. Newer approaches are being developed that use one or two smaller incisions to perform the procedure, called minimal incision hip replacement or minimally invasive hip replacement. However, the minimally invasive procedure is not suited for all candidates for hip replacement. The physician will determine the best procedure for a person, based on that individual's situation.
Anterior Hip Replacement
DMC Sinai-Grace Hospital orthopedic surgeon Robert Ference, MD, was one of the first in Michigan to be trained in minimally invasive hip replacement and resurfacing, a procedure that brings many benefits to patient.
“Because of the new angle of the surgery, we can spread the muscles to access the hip from the front of the body. Unlike previous surgeries which cut muscles, no muscles are detached from the pelvis or femur or damaged,” explains Dr. Ference.
“As a result, recovery times are much faster, with patients leaving the hospital in one or two days. They are able to return to normal activities almost immediately, since the new hip prosthesis is stabilized by healthy, uncut muscles.”
Blood loss and pain are also significantly reduced. The anterior minimally invasive technique can be used on patients who have experienced hip fracture or previous hip surgery, as well as those who have not.
Dr. Ference trained with Joel Matta, MD, of Los Angeles who developed the anterior approach for minimally invasive hip surgery.
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