A Primary Total Hip Replacement
While the idea of getting an artificial joint may be frightening to some, it is one of the safest and most effective medical procedures.
What is arthritis?
Arthritis is inflammation of a joint, which can cause pain, swelling, stiffness, instability and deformity.
What are the common causes of arthritis?
Osteoarthritis (degenerative joint disease) is the most common type of arthritis. When cartilage wears away, bone rubs on bone causing severe pain and disability. The most frequent reason for osteoarthritis is genetic, since the durability of each individual’s cartilage is based on genetics. If your parents have arthritis, you may also get it.
Inflammatory arthritis comes from swelling and inflammation of the joint lining which causes a release of enzymes that soften and eventually destroy the cartilage. Rheumatoid arthritis, Lupus and psoriatic arthritis are inflammatory in nature.
What is “conservative” treatment?
Conservative non-surgical treatment is usually effective in the early stages of arthritis. Pain can be relieved with anti-inflammatory drugs, cortisone shots or physical therapy. These can ease pain temporarily and sometimes permanently.
What is a total hip replacement?
When the cartilage has worn away, an artificial hip (called a prosthesis) made of metal and plastic can take its place. The surgery to implant the prosthesis is termed a total hip replacement. Only the surface of the joint is removed: the arthritic ends of the bones are shaved off and replaced with new metal and plastic surfaces. The replacement hip recreates the normal function of the hip.
What are the benefits of total joint replacement?
The most apparent benefit is pain relief. In general, most patients take six weeks to three months to recover and experience pain relief and improvement in function. However, improvement can be realized for over a year after surgery.
When will I be out of bed?
Most patients can stand the morning after surgery and begin exercise that day. With support of a walker or crutches, patients can walk, climb stairs and ride in a car by the time they leave the hospital. Physical therapy and motion exercises are the key to a good result and these should continue for months. Swelling, aching and numbing are normal during this time. Most patients are up and about within six weeks after surgery.
What are the potential problems and complications?
The most common complications of total joint surgery can now largely be avoided. Before surgery each patient receives a complete medical examination and testing by a doctor. Donation of one’s blood prior to surgery eliminates the problem of HIV and Hepatitis. While inflammation of the leg veins (phlebitis) is not rare, the occurrence of death from this has been almost eliminated with the use of support stockings and blood thinning medications (such as Coumadin). Other rare complications, which can be encountered with any surgery, include cardiac, digestive and lung problems. Nerve injury may also occur which may lead to weakness, numbness or tingling in your lower extremities.
Infection is the most serious problem and every step is taken to avoid it. Surgery is performed in special "laminar flow" operating rooms designed to keep out dust, germs and unclean air with the doctors wearing “space suits”. These full body suits, worn over normal scrubs, let the surgeons move and breathe without spreading germs.
Other long term complications (wear or loosening of the parts and stiffness of the joint) relate as much to patient behavior as to surgical success.
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