Hip arthritis is the fraying in the cartilages in the hip that causes loss of function with time. Hip arthritis causes pain and restriction of movement it often occurs due to old age and excessive weight though genetic factors might also play a role in its development. The common symptom of hip arthritis is pain while having long walks, standing for extended periods of time, and climbing the stairs. In advanced stages of arthritis, pain can break out even during short walks or while resting. The main purpose of hip arthritis treatment is to detect the situation while the disease is still mild and to prevent its progression. At this stage, non-surgical methods such as losing weight, resting, physiotherapy and medication therapy are used. However, if the arthritis has reached advanced stages with progressive and severe complaints, total hip arthroplasty (replacement) surgery may become necessary.
In addition to arthritis, total hip arthroplasty is also performed for the treatment of hip fractures and avascular necrosis. It is not possible for a certain part of the fractured neck of femur (thighbone) to united once fractured. In hip fractures, therefore, surgeons extract and replace the fractured section with a prosthetic supplement that carries out the function of the hip joint. In avascular necrosis, on the other hand, the vascular structure that feeds the head of the hip joint loses its function and causes the death and collapse of the living part of the bone head. This is why advanced stages of avascular necrosis may require prosthetic treatment.
Total Hip Arthroplasty: Surgical Procedure
Total hip arthroplasty is an open surgical procedure and takes about 2 hours in average. As the operation requires attention, expertise, and precision, it can only bear successful results under the command of expert surgeons and use of advanced technologies. The operation is mostly performed under general anaesthesia. Prosthetics type to be used is determined in accordance with the requirements of the patient’s case, age, hip structure, and the stage of disease arthritis. The operation starts with a 10cm incision and the extraction of the spherical section called the femoral head. Next the surgeon carves the acetabular socket, a concave surface of the pelvis and inserts the acetabular prosthetic into the carved area. This is followed by rasping the inner side of the femur and placing the femoral prosthetic.
There is no age limit for hip replacement surgery. The ideal patient profile is over the age of 50 and below 100 kilograms in weight although age and weight may be ignored if surgical intervention is unavoidable. Losing weight is beneficial in prolonging the prosthetic joint’s longevity and decreasing the load on the joints. Currently, the average durability of a hip prosthetic has gone up to 25 years albeit this is much to do with the patient’s weight, age, sex, and daily routine.
After Total Hip Arthroplasty: Post-operative Period
Patients regain consciousness within 2 hours after they leave the operation room and can eat 3-4 hours after regaining consciousness. Post-operative pain is controlled with analgesic medications while drain, elastic bandages, and special socks are used to drain the blood that accumulates in the body. Patients stay in the hospital for 3-4 days in average. On the second post-operative day, patients can stand with the help of a walker. The drain is removed and the wound is dressed on the following day. With the fourth day, patients start mild exercises. Once discharged, patients can sit with feet on the ground and see to their daily needs and activities within the house. Patients are expected to visit the hospital 15 days after the operation for a wound check under the supervision of the physician and the stitches are removed if progress is observed on the operated area. This is also the start of physiotherapy exercises which take 3 months. Physiotherapy period is important for a quick recovery. Patients can switch the walker with a cane 3 weeks into the physiotherapy and at the end of 8 weeks they will be ready for a more active life. We ask our patients to beware of two very crucial points during the course of recovery: first, patients should never lift their leg above the hip and second, they should never sit with legs crossed.