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Hip Replacement
Joint prosthesis application is a surgical method applied to restore joint function and relieve pain by replacing damaged joint surfaces with specially made prostheses. Hip replacement surgery is performed if the patient's complaints do not improve with other treatments for hip discomfort. In addition, it is also applied in the treatment of late-recognized congenital hip dislocation.
Who needs hip replacement surgery?
Hip prosthesis is applied in the treatment of hip arthrosis (coxarthrosis), untreated hip dislocation, Perthes disease, osteonecrosis, post-fracture and cancer treatments. Hip osteoarthritis is a progressive disease. Pain and limitation of movement gradually increase with age.
Is the type of prosthesis to be used in surgery important?
Depending on the characteristics of the hip joint and your disease, the prosthesis to be used by your doctor is determined and the patient is informed. It is very important for the patient to learn the brand of the prosthesis to be used. Prosthesis brands with international reliability certificates, widely used in developed countries and with successful results, are important in terms of postoperative prosthesis life.
When Is Hip Replacement Surgery Recommended?
Pain is the most important indicator for the selection of the patient who will undergo hip replacement surgery. Possible hip sparing procedures should be considered in pain-free situations. Another important issue is the limitation of movement. Damage to the cartilage tissue in the joint causes deterioration of the harmony of the hip joint. As a result, hip movements are restricted and the patient begins to feel pain.
First of all, patient complaints should be well listened and a good physical examination should be done. X-ray of the hip is the most important and first step imaging method. Other treatment methods should be tried before surgical treatment. Some of these are measures and treatment methods such as rest, medications, physiotherapy methods, use of walking sticks, and restriction of climbing stairs.
It is the patient who will decide whether the condition is serious enough to require hip replacement. If his complaints are excessive and he has not benefited from non-surgical treatments, planning for hip replacement surgery should be made.
Surgical Process
The surgery can be performed with general anesthesia or regional anesthesia. In this preference, the patient's co-morbidities are evaluated, but the patient's request is more important. Postoperative pain control is provided with preoperative epidural catheter or peripheral nerve block applications. The operation time takes an average of 2 hours. One day after the operation, the patient can stand up with the help of crutches and can do his own personal needs.
After the surgery, the rehabilitation-exercise programs that are specially programmed for the patient are explained to the patient in detail. After the prosthesis surgery, the patient reaches a level where he can fully return to his daily life in an average of 6 weeks. In order to allow the soft tissues to heal after surgery, some movements such as cross-legged, squatting, crossing the legs are not allowed.
What Are the Risks of Hip Replacement Surgery?
Some complications may occur after hip replacement surgery.
Here are some examples of possible complications:
Infection: Joint infections are one of the most serious
problems encountered after prosthetic surgeries. The risk of infection in hip
replacement surgery is 0.3-1.3%. Infection, which can occur sometimes in the
early period and sometimes years later after hip replacement surgery, can lead
to serious consequences that extend to replacement of the prosthesis.
Debridement can be performed in early infection, but in infections that occur
after many years, the implant may need to be replaced. An infection around the
prosthesis may cause your pain to start and to have surgery again.
Dislocation of the Hip Prosthesis: It can happen for many
reasons after the prosthesis procedure. It usually occurs after sudden impacts,
accidents or falls. Its incidence is 1-3%. To prevent this, you should follow
your doctor's recommendations after the surgery and avoid some extreme
movements for a certain period of time.
Deep Vein Thrombosis: One of the complications that can be
seen after hip replacement surgery is blood clots. Clots that prevent blood
flow and damage blood vessels can even cause vital functions to stop. If it
breaks off from where it is and reaches the lungs, it can cause pulmonary
embolism and cause the death of the person. This serious condition is followed
and mobility is ensured after the surgery and anticoagulant drugs are given.
Loosening of Prosthesis: One of the symptoms of unsuccessful
hip replacement surgeries is loosening of the implant and loss of stability.
Movement of the prosthesis after the surgery may cause re-abrasions in the
joint and the onset of pain again. The treatment of this condition is to fix
the prosthesis again by surgery and replace it when necessary.
Stiffness: One of the complications seen after hip
replacement surgery is stiffness. It is very important to be active in order to
avoid stiffness in the joint after the surgery. Stiffness that may occur in the
skin and joints, together with remaining inactive, will cause compression in
the soft tissue and will cause difficulty in movement. Hip joint movements such
as climbing stairs or sitting in a chair can become painful for you again. In
cases where you do not perform the recommended movements after the surgery,
surgical intervention may be required again to relieve the stiffness.
