Thursday, November 14, 2013


The Hip Bone's Connected to the Knee Bone ...
   According to the U.S. Centers for Disease Control, over three hundred thousand hip arthroplasty surgeries are performed yearly in the U.S.

    Hip replacement surgery, or arthroplasty, involves removal of portions of bone tissue, then replacement with synthetic parts. Its benefits include decreased hip pain, better mobility, and improved quality of life

     In this procedure, the head of the femur is removed and cemented to synthetic parts using bone glue. A similar surgery, biologic fixation, allows fixation of parts without glue.People with limited mobility due to hip fracture, bone tumor, or arthritis benefit from hip replacement surgery. However, those with debilitating health conditions might not have a successful outcome. Alternatives to hip replacement include home weightbearing exercises and use of a cain or push-walker. These activities strengthen hip and pelvic muscles, enhance mobility, and improve balance. 

    Cemented parts are used more often for older, less active people and those with weak bones, such as osteoporosis. Un-cemented replacements are used more often in younger, active people. However, it may take longer time for bone to grow and attach to the prosthesis. Three months of activity restriction is recommended to heal and protect the joint. 

   After surgery, physical therapy is started in the hospital to move the hip and prevent blood clots. Tenderness, redness, and swelling of the calf, thigh, ankle, or foot could signal a blood clot. Fever, chills, swelling, and wound drainage suggest infection. However, most patients are discharged after three to five days. Full recovery takes three to six months. 

   Complications following surgery could include infection, leg-length inequality, damage to blood vessels or nerves, blood clots, and delayed wound healing. The most common postoperative complication is hip dislocation. This could occur if the knee bent and pulled up to the chest.
Sometimes synthetic microscopic particles wear off the artificial joint and cause an inflammatory reaction of surrounding tissues. This can be treated with anti-inflammatory medicines. In rare cases, there may be a need for repeat (revision) surgery. 

   Crucial home exercises after surgery include walking, stationary bicycling, swimming, and cross-country skiing. These activities increase muscle strength, improved balance, and provide heart conditioning without injuring the operated hip. 

   When is revision (repeat surgery) needed? Hip replacement is one of the most successful orthopedic surgeries performed. However, more people are having hip replacements at a younger age. Wearing of the operated joint surface can occur over fifteen to twenty years. This can lead to revision replacement of the artificial joint.Revision surgery is more difficult than first-time hip replacement, and the outcome isn’t as successful. It’s important to explore all available options before deciding on repeat surgery. 

Source:  National Institute of Arthritis, Muscle, and Skin Disease

 Questions or comments? Contact Dr.Clem at clementhanson