Total Hip Replacement
Total Hip Replacement -- What is it?
Total hip replacement (THR) surgery is a common orthopaedic procedure in the United States, with over 200,000 performed annually. Hip replacements are done to alleviate pain and disability caused by conditions such as osteoarthritis, rheumatoid arthritis, avascular necrosis, fractures, dislocations, congenital deformities, and other hip related problems.
The immediate benefits of total hip replacement include pain relief and improved function. In most cases a patient can expect to be relatively pain-free, have full mobility of his or her hip, and walk with minimal or no limp following recovery. With improved surgical techniques, better pain control and anesthesia at surgery, and implants that allow for a more rapid return of function, the time to full recovery has become faster in recent years. The doctors at the Anderson Clinic are on the cutting edge in developing and utilizing these protocols.
How THA Can Help
Total Hip Arthroplasty involves replacing the damaged surfaces of the hip with artificial surfaces. The surgeon removes the head and the neck of the femur (the thigh bone) and replaces them with a metal ball and stem.
The damaged socket is shaped into a hemisphere and a metal cup is press-fit into the bone. A liner is then inserted into the cup, which can be made of polyethylene, metal, or ceramic. The thigh bone (femur), is then shaped and an implant is press-fit inside the bone. A ball is then fit on top of the stem, creating a new, movable joint.
The operation usually takes about one hour. The hospitalization time is also relatively short, usually about two or three days. Full recovery usually takes 2 to 6 months.
Uncemented Hip Replacements
Before 1983, most hip replacements in the United States were done using acrylic cement to attach the prosthetic parts to the femur and pelvis. The area between the metal implant and the surrounding bone was filled with acrylic cement. At that time, deterioration of the cement in some cases resulted in prosthetic loosening and recurrence of pain. In many cases a revision operation, particularly with young, active patients, was required. Unfortunately, when the revision operation was done using acrylic cement, the success rate was lower than with the initial surgery.
In response to these failures, as will as the needs of active patients, the Anderson Clinic physicians began using porous-coated implants in 1977. The porous-coated method involves the use of implants with sintered metal porous surfaces, allowing the bone to "grow into" the metal, creating a very strong biologic fixation. Cement is not required. In 1983, the FDA approved the method for use by all physicians. Our experience at the Anderson Orthopaedic Clinic using this method now spans 30 years. The Anderson Orthopaedic Research Institute (AORI) has evaluated the long-term outcomes of various types of porous-coated stems.
Although initially developed for young, more active patients, our experience in nearly ten thousand cases has indicated that the porous-coated method works equally well in patients of all ages and lifestyles.
The physicians at the Anderson Clinic emphasize patient education prior to surgery, and have developed a patient education booklet. To view a PDF file of this booklet, click here.
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Physicians with special interest in Total Hip and Knee Replacement