Total hip arthroplasty, a medical term that means hip replacement, is a surgical procedure in which a prosthetic hip is inserted in place of a patient's damaged hip joint. Common reasons for this operation include relieving extreme arthritic pain and joint damage repair as a step in hip-fracture treatment.
History
The first recorded total hip arthroplasty attempt was in Germany in 1891, when surgeons removed the damaged head section of the femur and replaced it with an ivory device. In 1940, an American surgeon, Dr. Austin T. Moore, successfully performed the first metallic hip replacement procedure. This early procedure utilized a prosthetic femoral replacement that had a cobalt-chrome alloy, vitalium fixed head. This procedure differed from modern hip replacement operations, in which prosthetic devices are inserted into the medullary canal of the femur. The ivory hip replacement made its reappearance in 1960, when Dr. San Baw, a Burmese orthopedic surgeon, successfully replaced the fractured hip bone of Daw Punya, an 83-year-old Buddhist nun. Dr. Baw eventually wrote a paper entitled "Ivory Hip Replacements for United Fractures of the Neck of Femur," which detailed his 300 plus ivory hip replacement operations from the 1960s through the 1980s. His paper claimed an 88 percent success rate, It also claimed that only a few weeks after their operations his patients were able to perform most, if not all, physical movements, including being able to ride a bike and play football.
Procedure
Two weeks before a total hip arthroplasty operation, a patient may be asked to stop taking drugs that decrease blood clotting, including ibuprofen and aspirin. He also will be asked to stop smoking, if applicable. With the patient under anesthesia, the surgeon will make an incision near the hip joint, normally over the buttocks. The head of the thigh bone is then removed and the hip socket is cleaned of remaining cartilage. Next, the replacement hip is inserted and a metal stem is inserted into the thigh bone to insure stability. Finally, a cement is applied to seal all the new parts in place and all the muscles and tendons surrounding the new joint are repaired. This procedure can last from 1 to 3 hours.
Reasons for Surgery
Severe arthritis pain is the leading cause for total hip arthroplasty and is normally the last resort for a patient suffering from severe pain. This is why most people who have the procedure are over age 60. Other reasons for the surgery include a fractured thigh bone or tumors found in the hip joint. In rare cases, the operation is recommended to treat morbid obesity, extremely weak quadriceps, damaged skin surrounding the hip or severe mental dysfunction.
Risks
Aside from the anesthesia risks of breathing problems and allergic reactions, the risks of any surgery can include blood clots near the legs that can travel to the lungs, urinary and chest infections, bleeding, heart attack or even stroke. Specifically related to total hip arthroplasty are risks of dislocation of the artificial joint, infection, pneumonia, allergic reaction to a prosthetic joint, nerve or blood vessel damage and loosening of the artificial joint over time. In rare cases, mental confusion or dementia can result. It is always recommended you carry a medical identification card when you have a prosthesis and that you take antibiotics before undergoing dental surgery or any other invasive procedure.
After Procedure
After surgery, a patient will be asked to stay in the hospital for 3 to 5 days, but full recovery can take from 2 months to a year. An IV (catheter or tube) is placed in the patient's arm to deliver fluids and a large bandage is wrapped around the point of incision. Sometimes, a Foley catheter will be used to drain urine for the first 2 to 3 days. Special compression stockings will be placed on your legs to improve blood flow. Blood-thinning medicine will be prescribed to prevent blood clots. To prevent pneumonia, you will use a spirometer and practice deep breathing and coughing exercises. Often, pain killers and/or antibiotics are prescribed. Normally, on the first day after the procedure, your doctor will ask you to begin walking and do mild stretching to further prevent blood clots. If more rehabilitation is required, you may have to stay in a rehab center for a few days to learn perform everyday tasks with your legs.
Tags: blood clots, thigh bone, total arthroplasty, artificial joint, asked stop, inserted into