Hip prosthesis: artificial hip joint
The destroyed hip joint will be substituted by an artificial joint. A mechanical problem is most often at the origin of the destruction of the joint - osteoarthritis. If the cartilage damage is only moderate, sometimes it is possible to do "conservative" surgery with the aim to avoid prosthetic hip replacement. In severe cartilage damage only hip prosthesis will resolve the pain and functional deficit.
The prosthetic hip replacement:
Surgery technique: there are different skin incision techniques and approaches to do the surgery
- anterior approach (variant: Bikini incision)
- direct lateral approach
- posterior approach
Each approach presents advantages and disadvantages. During the last years the anterior approach got more and more popular, because of the fast postoperative recovery and reduced pain. At Bozen we are practicing the anterior approach since 2003, and we have been one of the first centers in Europe.
We have improved several devices for this approach: particular levers, traction table (Arch-table).
Standard prosthesis and smaller short stem prosthesis can be used.
What means prothesis? during the surgery we must substitute the acetabulum (the hip socket) and the femoral head.
- Cup: replaces the acetabulum
- Stem: the stem is introduced inside the femoral neck, diaphysis and support the artificial femoral head.
The fixation of the cup and stem con occur with or without bone cement. Cemented prosthesis are immediately stable and give you the guarantee of immediate weigth bearing. Not cemented prosthesises are fixed to the bone by their seize: they are introduced with a certain pressure. Later the bone ingrowth will guarantee a definitive fixation. Often a non cemented prothesis will give you the possibility of immediate full weigth bearing, but sometimes partial weigth bearing for the first 3 weeks is recommended.
Stem (traditional stem with long follow up)
After the surgery you will get drugs against postoperative pain, because immediately after the surgery you should start moving and walk with crutches soon during the first days. The physiotherapists will show you how to move and walk with the crutches. Your surgeon decides if full weigth bearing is possibile.
During the first weeks you have to avoid certain movements, positions - necessary to reduce the postoperative dislocation risk of the prosthetic joint. The skin sutures will be removed after 2-3 weeks.
The most patients are happy with their new hip joint (about 98/100), but as in all surgeries there is a certain risk with the operative procedure. You can inform about the risks in the 2. part (click here).