Arthritis is a general term covering numerous conditions where the joint surface (cartilage) wears out. The joint surface is covered by a smooth articular surface that
allows pain free movement in the joint. This surface can wear out for a number of reasons; often the definite cause is not known. When the articular cartilage wears out, the bone ends rub on one another and cause pain.
There are numerous conditions that can cause arthritis and often the exact cause is never known. In general, but not always, it affects people as they get older and is called Osteoarthritis.
In an arthritic hip:
The combinations of these factors make the arthritic hip stiff and limit activities due to pain or fatigue.
Hip conditions should be evaluated by an Orthopaedic surgeon for proper diagnosis and treatment.
Your surgeon will perform the following:
Diagnostic Studies may include:
There is no blood test to diagnose osteoarthritis.
The surgery will be performed using general, spinal or epidural anaesthesia. A combination of techniques is often used. The surgeon makes an incision along the affected hip joint, exposing the hip joint.
The femur is separated from the hipbone socket. The socket of the hip joint is exposed. It is reamed to a hemispherical surface and prepared to take the new cup (acetabular component). The new cup is a press-fit; the back of this cup is roughened to allow bone
to grow into it. The femur is then exposed and the femoral head is either trimmed or reamed down to an accurate shape to take its new metal component. The metal component is attached to the reshaped femur. This new metal ball will act like the hip joint’s original ball. Then the new ball and the new socket components are joined together to form the new hip joint. The muscles and tendons are then repaired and the skin is closed. Drains are usually inserted to drain excessive blood.
Remember this is an artificial hip and must be treated with care. Avoid the combined movement of bending your hip and turning your foot in. This can cause dislocation. Other precautions to avoid dislocation are:
As with any major surgery, there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages. It is important that you are informed of these risks before the surgery takes place.
Complications can be medical (general) or specific to the hip
Medical complications include those of the anaesthetic and your general wellbeing. Almost any medical condition can occur so this list is not complete. Complications include
Infection can occur with any operation. In the hip this can be superficial or deep. Infection rates are approximately 1%. If it occurs, it can be treated with antibiotics but may require further surgery. Very rarely your hip may need to be removed to eradicate infection.
This means the hip comes out of its socket. Precautions need to be taken with your new hip forever. If a dislocation occurs it needs to be put back into place with an anaesthetic. Rarely this becomes a recurrent problem needing further surgery.
This is also rare but can occur during or after surgery. This may prolong your recovery or require further surgery.
Also rare but can lead to weakness and loss of sensation in part of the leg. Damage to blood vessels may require further surgery if bleeding is ongoing.
These can form in the calf muscles and can travel to the lung (pulmonary embolism). These can occasionally be serious and even life threatening. If you get calf pain or shortness of breath at any stage, you should notify your surgeon.
Your scar can be sensitive or have a surrounding area of numbness. This normally decreases over time and does not lead to any problems with your new joint.
It is very difficult to make the leg exactly the same length as the other one. Occasionally the leg is deliberately lengthened to make the hip stable during surgery. There are some occasions when it is simply not possible to match the leg lengths. All leg length inequalities can be treated by a simple shoe raise on the shorter side.
All joints eventually wear out. The more active you are, the quicker this will occur. In general 80-90% of hips survive 15 years.
Very rare but may occur especially if some pain is coming from other areas such as the spine.
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