San Diego patients who undergo hip replacement (hip arthroplasty) due to arthritis receive an amazing level of hip pain relief. Uniformly, orthopedists tend to view the hip replacement as one of the best surgeries in the field. However, it is associated with several complications: dislocation, infection, and need for revision.
An infected hip replacement can be one of the most challenging clinical scenarios in orthopedic surgery to manage. A recent study found that infections were controlled in nearly all patients who underwent the two-stage approach for total hip replacement (hip arthroplasty). Once an infection in a hip that has been replaced is identified, the first stage is to explant (remove the metal implants) and provide antibiotics. The second stage, which occurs 6-8 weeks later, is to re-implant the metal devices (redo the hip replacement).
The Bone & Joint Journal published the results of the research in its October issue. The study involved 125 patients who underwent a total hip replacement. The study participants were monitored for five years, during which 96% had no infections.
The doctors wrote that they observed “excellent control of infection in a series of complex patients and infections using a two-stage revision protocol supported by a multidisciplinary approach.
The research confirmed the prevailing view that two-stage revision, the most common approach to management of an infected hip-replacement, is more effective than the single-stage method to eradicate infection in the replaced joint.
Because two hospital admissions and an additional surgery are required to complete the two-stage technique, it can cost 70% more than the simpler single stage procedure. Patients must cope without a hip joint for two to 12 months between the two stages, which entails hip pain and disability. However, when critically evaluated, the single stage method has a higher failure rate, which warrants a second and possible third surgery nonetheless.
Factors that affect whether an orthopedist would recommend hip replacement for a patient with pain due to hip arthritis might include a person’s health, degree of hip pain, amount of arthritis, activity level, and other individual factors. Orthopedists make the determination after examining and consulting with patients, most of whom are between the ages of 50 and 80.
The primary symptom indicating the possible need for hip arthroplasty is pain in the hip or groin that restricts the ability to walk, climb stairs or perform other activities. Patients may experience stiffness that makes it difficult to move a leg, as well as hip pain that occurs without even moving the joint.
Hip-replacement surgery or arthroplasty is not recommended until conservative treatments have failed. Patients usually first try medication, physical therapy, injections and walking supports to relieve their hip pain and regain function.
A newly performed hip replacement for hip arthritis is nearly always successful. An orthopedist extracts damaged bone and cartilage, and implants prosthetic devices. THA infection offers effective infection control. The head of the femur (thigh bone) is replaced with a metal stem that is wedged into place in the thigh bone, sometimes with the use of surgical cement. A metal or ceramic ball takes the place of the femoral head at the top of the stem.
The next step is to implant a metal socket to replace damaged cartilage in the cup of the pelvis that makes up the hip joint. In some cases, a surgeon uses screws or cement to stabilize the prosthetic. A plastic, ceramic or metal device called a liner is inserted between the new ball and socket to protect the components from wear and tear.
Patients usually receive general anesthesia before the operation. Some are administered spinal, epidural or regional nerve blocks that numb their lower bodies.
After they return home from the surgery, patients must give tissues surrounding the prosthetics time to heal by avoiding activities that put stress on the joint. Excessive strain can result in hip pain and loosened prosthetic devices.
Most hip replacements, if treated gently, last for many years. Orthopedists often advise postoperative patients to install handrails on stairways and in bathrooms, and sit with straightened backs while keeping their knees lower than their hips. Recommended devices include grabbers, raised toilet seats, shower chairs, long-handled bathing sponges or hoses, and sticks for pulling on socks.
If you have been told that you are in need of a hip replacement or suffer from hip pain, contact Orthopedic Surgery San Diego to be seen by our renowned specialists today.