Types Of Hip Replacement Surgery
Surgeons perform hip replacements by using a posterior approach or an anterior approach. With a posterior hip replacement, the incision is made at the side or back of the hip. During anterior hip replacement, the surgeon makes the incision at the front of the hip.
The posterior approach is more common in part because it allows better visibility of the hip joint, though the anterior approach is becoming more prevalent. There is no significant difference between the procedures as far as recovery from surgery, but the anterior procedure may pose a higher risk of nerve damage that could cause numbness in the outer thigh.
Patients who are younger than 50, have a normal body mass index or who are in overall good health may be candidates for minimally-invasive surgery. During this surgery, the incision is smaller and recovery time after the surgery is shorter.
Special bone cement is commonly used to hold hip implants in place, but some surgeons use a cementless fixation technique. Devices that do not require cement have a textured surface that allows the bone to grow onto the implant and secure it. A hybrid total hip replacement involves implanting the cup without cement and setting the ball in place with cement.
Protecting Your Hip Replacement
There are many things you can do to protect your hip replacement and extend the life of your hip implant.
- Participate in a regular light exercise program to maintain proper strength and mobility of your new hip.
- Take special precautions to avoid falls and injuries. If you break a bone in your leg, you may require more surgery.
- Make sure your dentist knows that you have a hip replacement. Talk with your orthopaedic surgeon about whether you need to take antibiotics prior to dental procedures.
- See your orthopaedic surgeon periodically for routine follow-up examinations and X-rays, even if your hip replacement seems to be doing fine.
Which Type Should I Have
Your surgeon will discuss this with you. It will depend on how much of your knee is affected by arthritis it may not be possible to know this until your surgeon has started your operation.
If you have a partial knee replacement it is more likely that you will need to have it done again, than if you have a total knee replacement . Sometimes the reason for choosing to have a partial knee replacement is that it leaves the option to have a TKR at a later date. However its also more likely that you will need to have your total knee replacement re-done, if you had a partial knee replacement done before having your total knee replacement.
There are over 150 different designs of knee replacement and some of the differences between all the different types and makes of knee replacement parts arent known, particularly how they perform in the long term. In many countries, registries have been set up so that anyone who has had a knee replacement is entered into the register. The information collected is used to monitor how their replacement is performing. In the UK, patients also enter information about their health and quality of life before and after their operation.
A study of over 500 patients with osteoarthritis of the inner part of their knee has compared the effectiveness of total and partial knee replacement. The two groups were followed up five years after surgery, and asked to complete questionnaires about pain, activity and day-to-day living.
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Outlook For Knee Replacement
While some activities are off-limits after a knee replacement, you still have plenty of others to choose from. Unlimited walking, golf, light hiking, cycling, ballroom dancing, and swimming are all safe for most people with knee implants. By following your doctors guidelines, you can expect long-lasting results about 85% of knee replacements will last 20 years.
Physical Therapy For A New Hip
This will start in the hospital, probably right after the surgery. Your doctor and physical therapist will recommend rehab either at home or short-term in a rehab center. Youâll do certain movements every day to regain your strength and ability. The exercises will start out simple in order to improve your circulation and range of motion. Your physical therapist will teach you what to do and when to move on to more advanced moves.
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Meet The Surgeon Behind Titanium Hips
An internationally-recognized surgeon and researcher, Jeffrey McLaughlin, M.D., knew there had to be a way to create stronger, longer-lasting hipreplacements. In 1993, Dr. McLaughlin modified the Taperloc femoral component, which was designed in 1982 by the Kennedy Centers founder, Dr. William Kennedy.
Now the most successful titanium hip in the world and one of the best hip replacements for posterior and anterior overall, the Taperloc femoral component has allowed thousands of people to enjoy a higher quality of life, even decades after their hip replacement.
After researching and modifying the Taperloc femoral component, Dr. McLaughlin won the Orthopedic Research and Education Foundations Current Concepts in Joint Replacement Clinical Paper Award in 2010.
Dr. McLaughlin has also presented these results at the American Academy of Orthopedic Surgeons, the Japanese Hip Society, the Harvard Hip Symposium and the European Hip Society.
As one of the best posterior and anterior hip replacement surgeons, Dr. McLaughlin has performed more than 15,000 total joint replacements, nearly twice as many as any other orthopedic surgeon in Wisconsin. If youre looking for the best hip replacement surgeons near you, the Kennedy Center surgeons are the most experienced with the best results.
What Is Hip Replacement Surgery
Hip replacement is the removal and replacement of portions of the pelvis and femur that form your hip joint. It is performed primarily to relieve hip pain and stiffness caused by .
This procedure is also sometimes used to treat injuries such as a broken or improperly growing hip, and for other conditions. “” rel=”nofollow”> hip replacement specialist at HSS.)
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Whats The Procedure For A Ceramic Hip Replacement
Hip surgery is typically done in an operating room at the hospital and takes from 1 to 3 hours.
Once youre checked in at the hospital, a nurse will take you into a room to prep for surgery, where youll put on a hospital gown.
The nurse will then start an IV in your hand, wrist, or arm for you to receive fluids and medications during the surgery.
Then, an orthopedic surgeon will do the following:
What Is A Squeaking Hip
When a ceramic liner was used with a ceramic femoral head , it occasionally produced a very loud squeak, which patients found very annoying and, thus the ceramic liners also fell out of favor. When the two pieces of ceramic rubbed together very rarely one of the pieces of ceramic would shatter which would be a devastating problem. Both metal-on-metal and ceramic-on-ceramic designs tried to solve the problems caused by the older model plastic liners wearing out. Since the newer models of plastic liners have been shown to be so effective and last longer, the vast majority of hip replacements done today are with a ceramic or metal femoral head and a plastic acetabular liner.
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What Is A Metal
When a metal acetabular liner is used in combination with a metal cobalt chrome femoral head, this is called a metal-on-metal hip replacement . Initially the thought was that these MoM hips would never wear out and could replace the traditional metal liner and plastic ball joint, but it was discovered that these hips often released tiny metal particles that could cause aggressive reactions around the hip joint as well as problems throughout the body if these particles were absorbed into the blood stream. For these reasons metal on metal hips have mostly fallen out of favor.
Where Do Wear Particles From The Artificial Hip Go
All hip bearings produce microscopic wear particles that collect in the soft tissue envelope around the artificial hip. This layer of tissue, called the hip capsule, forms around the prosthetic joint after surgery. Cells in this layer act like a biological sink by absorbing and storing the wear particles.
Some wear particles migrate into the body, and are spread by the circulating blood to remote organs such as the heart, liver, spleen, and lymph nodes. No study has shown any adverse impact of such wear particles from artificial hips that spread throughout the body, although this remains an area of investigation and research.
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Do I Need A Custom Implant Or Instruments Made From Ct/mri Studies
Hip components come in many sizes, configurations, models, and geometries. Off-shelf components give a precise fit in nearly all the patients. In some cases involving congenital abnormality, special-sized components can be ordered if necessary.
Technology keeps advancing, and in the future, custom-built hips that are designed precisely for one person to ensure perfect leg lengths, tissue tension, fit, and sizing will probably become a reality. Surgery advancements will probably mean that some patients may even be able to go home the day of surgery. These innovations reflect research and product development that professionals around the country are actively engaged in at the present time, to further improve on the already very successful operation of hip replacement.
Frequently Asked Questions About Total Hip And Knee Replacement Materials
What is the chance of my body rejecting the implant?
Unlike an organ transplant, the risk of your body rejecting the artificial hip or knee parts is exceedingly rare. The materials used in the typical replacement surgery are well tolerated by the body and have a long track record of successful implantation. While in rare cases the parts may become loose or infected, this is typically related to other factors and not due to your body rejecting the parts.
How do I know if I have a recalled implant?
I have a history of nickel allergy and/or break out in a rash with certain types of jewelry. How do I know if I am allergic to the implants?
How do I know if I have developed metal poisoning from the replacement parts?
Can I have a hip or knee replacement if I am allergic to metal?
This article has been written and peer reviewed by the AAHKS Patient and Public Relations Committee and the AAHKS Evidence Based Medicine Committee. Links to these pages or content used from the articles must be given proper citation to the American Association of Hip and Knee Surgeons.
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What Are The Different Types Of Hip Replacement Surgery
The three major types of hip replacement are:
- total hip replacement
- partial hip replacement
- hip resurfacing
The most common type of hip replacement surgery is called a total hip replacement . In this surgery, worn-out or damaged sections of your hip are replaced with artificial implants. The socket is replaced with a durable plastic cup, which may or may not also include a titanium metal shell. Your femoral head will be removed and replaced with a ball made from ceramic or a metal alloy. The new ball is attached to a metal stem that is inserted into the top of your femur.
Healthy hip
Arthritic hip
Replaced hip
Two other types of hip replacement surgeries are each generally appropriate for patients of specific age groups and activity levels:
- Partial hip replacement involves replacing only one side of the hip joint the femoral head instead of both sides as in total hip replacement. This procedure is most commonly done in older patients who have .
- of the femoral head and socket is most commonly done in younger, active patients.
X-ray of a total hip replacement showing the ball, socket and stem implants
Hip replacement surgical methods
There are two major surgical approach methods for performing a total hip replacement:
- the posterior approach
Total hip replacement animation: Posterior approach
How Long Does It Take To Recover From A Hip Replacement
Your rehabilitation will begin within 24 hours after surgery. Most hip replacement patients progress to walking with a cane, walker or crutches within day or two after surgery. As the days progress, you will increase the distance and frequency of walking. Full recovery generally takes anywhere from two to eight weeks, depending on the patient’s general health and other factors.
If you have total hip replacement surgery at HSS:
- Your recovery will begin directly following surgery in the Post-Anesthesia Care Unit , where your medical team will manage your pain and monitor your vital signs.
- Once the anesthesiologist is satisfied with your condition, you will be moved to an inpatient recovery room to monitor your progress. Appropriate candidates for outpatient surgery will be discharged when medically appropriate.
- You will most likely have a dressing and tube on your hip for drainage, which should be removed the day after surgery.
- The pain management team will assess your medication and use a multifaceted approach to ensure comfort and mobility during the rehabilitation process.
- You will begin rehabilitation with a physical therapist within 24 hours. Your therapist will help you sit up, get in and out of bed, and practice walking and climbing stairs using a walker, cane or sometimes crutches.
- You will then continue physical therapy outside the hospital for six to eight weeks. After that period, most patients are able to do everyday activities and return to playing sports.
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What Materials Are The Pieces Made Of
Both the femoral stem and the acetabular cup are usually made from titanium and covered in a roughened surface that allows bone to grow into it, so that it eventually becomes incorporated into a patients body. Titanium is inert, which means that the body does not reject it. The femoral head has traditionally been made from a metal cobalt-chromium alloy, but more recently surgeons have been using ceramic heads to try to make hip replacements last longer. The liners have are made from a plastic called polyethylene, but metal and ceramic liners have both been tried and are occasionally still used. Older versions of this plastic had been known to wear out after 10-15 years, but the newer versions have been shown to last significantly longer, and in most cases last for the patients entire life.
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Titanium And Titanium Cobalt
Pure titanium is not used nearly as commonly as titanium cobalt. Titanium joint replacement is used as frequently as cobalt-chromium alloys. Titanium alloys are biocompatible, will not corrode, nor change inside the body. Titanium cobalt is more elastic and favorable to the natural bone surrounding the implant. Since this metal is softer, it tends to make up the tibial part of the replacement where the plastic inserts lock-in. In the tibial component, the metal choice is less important since there is little traction or rubbing during movement.
Whats The Difference Between Ceramic And Metal
Surgeons began using ceramics for hip replacement surgery due to the problems of friction and wear often reported with metal or metal and plastic.
Artificial hips were once typically made of a metal ball and a polyethylene socket. Over time, hard metal can wear away soft plastic. But ceramic is very hard and provides more longevity for an artificial hip.
Ceramic may be used for both the ball and the lining of the socket or just the ball. Other parts may be made of either metal or plastic, ceramic on metal, or ceramic on plastic .
Research shows that ceramic-on-ceramic bearings decrease wear, bone, and muscle loss, and lower the risk of dislocation. The human body also tolerates ceramic well, with low reactivity and no toxicity. Research shows that ceramic hip replacements may be preferable to metal or plastics, as ceramic is more durable and may last longer.
There are some limitations for ceramic materials, including a risk of fracture during implant. Improvements in modern materials have made fractures less of a concern today. But it is still difficult to revise a fractured ceramic implant, as there may be many tiny fragments.
A small percent of people who get a ceramic-on-ceramic hip replacement report squeaking sounds similar in sound to the creaking of a door hinge coming from their hip.
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Hip Replacement Surgery At Benenden Hospital
If you have a question about hip replacement surgery, or would like to discuss any of our other treatments and procedures, were ready to help. As one of the leading centres in the South East for hip and knee surgery, we have the experience to answer any questions you may have, whether youre only recently experiencing hip discomfort or youre awaiting surgery.
Contact us using our online form or by calling our Private Patient Team on 01580 363158 to find out how a hip replacement could change your life for the better.