Hip prosthesis causes pain
introduction
The use of a artificial hip prosthesis is a frequently performed operation in Germany, in most cases a significant improvement in quality of life brings with it. However, in some cases there are complications such that a hip replacement causes pain.
The pain may affect the hip, on the Thigh to the knee spread and often occur in connection with a hip prosthesis loosening. Pain after a hip prosthesis can also occur immediately after surgery, e.g. if the implant was not inserted optimally. In the following, the causes and severity of the symptoms are discussed in more detail, as well as a brief report on diagnosis, therapeutic options, prognosis and prophylaxis.
causes
There are a number of different causes that can arise after using a Hip prosthesis Cause pain. So it can become too over time Hip prosthesis loosening come, because a tight hip prosthesis is not always guaranteed even after surgery.
Hip prosthesis loosening
At a Hip prosthesis loosening the inserted implant no longer sits firmly in a given place, which leads to severe pain and instability. One distinguishes one aseptic, without the involvement of bacteria loosening of the hip prosthesis caused by a septic.
In septic hip prosthesis loosening, a infection the hip prosthesis pain inflammation.
Often are smallest amounts of pathogens, that got into the operating area during the operation is sufficient to continue to grow inside after the wound has been closed and to damage the tissue around the hip prosthesis.
A major cause of aseptic hip prosthesis loosening, in which pain occurs after the hip prosthesis, is Signs of wear. One is a hip prosthesis after 20-30 years at the end When it comes to durability, there are also external patient-related factors. Extreme sports or frequent excessive exertion are a risk factor for premature hip prosthesis loosening.
As a patient, you should also try to control your own weight because Obesity a big Load on the prosthesis and can cause pain. A Reactions of the bone around the foreign material can cause pain after the operation.
Pain after the operation
Does it come relative early after surgery To pain in the hip prosthesis, causes such as wear and tear and permanent overloading are eliminated, as these only become noticeable after a certain period of time.
Causes the Hip prosthesis pain after surgery, must first go to a Infection of the prosthesis be thought. These are more likely Rare, but due to the difficult accessibility, it is more complicated to treat than an infection elsewhere. Working in a sterile manner minimizes the risk of infections - the incidence on the hip is given as around 1% - but they can never be completely avoided.
Furthermore, after surgery it can happen that a hip prosthesis is painful as part of a allergic reaction evokes. The body comes into contact with the immediately after the operation prosthetic foreign material. In most cases, allergic reactions are not observed against the plastic parts of the hip prosthesis, but against metallic components that are made of chrome, nickel or cobalt consist. Other reasons why a hip prosthesis causes pain that can occur immediately after surgery bony reactions be on the foreign material. It can be both a excessive new bone formation to come to the hip prosthesis as well as to one Bone loss. Both can become one Hip prosthesis loosening and cause pain.
Basically, an operation is independent of the procedure massive injury of muscles, connective tissue and bones, so that pain after using a hip prosthesis directly after the operation are the rule. However, provided no further complications occur, these can be included Painkillers master well.
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The hip joint is one of the joints that are exposed to the greatest stress.
The treatment of the hip (e.g. hip arthrosis, hip impingement, etc.) therefore requires a lot of experience.
I treat all hip diseases with a focus on conservative methods.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
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Character of pain
It is important to distinguish whether the pain is after a hip prosthesis creeping over weeks and months develop or occur suddenly. In the case of slow hip prosthesis loosening, e.g. Due to wear and tear, pain initially only occurs when the joint is under great strain. Infections can quickly trigger pain in the hip prosthesis, then other symptoms such as Redness and swelling on. Of course, acute trauma hurts immediately after the event. Depending on the cause, the pain can be as stabbing, throbbing or dull, sometimes also appear electrifying. If a hip prosthesis causes pain, it not only occurs on the affected hip, but often radiates into certain areas such as the thigh.
Thigh pain
In most cases, hip replacement pain will spread down the thigh on the same side. These pains are mostly Outside and front observed on the thigh. Sometimes a hip prosthesis loosening is initially carried out dull pain in the thigh perceived before pain occurs in the hip itself. The thigh is particularly affected when walking or standing for long periods of time. In many cases where a hip prosthesis is painful, the pain also radiates through the thighs Knee joint which should therefore always be examined for symptoms such as pain in patients with hip prostheses. In the case of pain in the thigh, one should therefore bear in mind that a hip prosthesis can also be responsible for the pain.
diagnosis
To diagnose pain on a hip prosthesis, a detailed questioning (anamnese).
Since when has the pain started, how severe is it, are there triggering factors or are they radiating?
The mobility of the hip prosthesis should also be physically examined. A definitive diagnosis of why the hip prosthesis is causing pain includes X-ray image and possibly one Computed tomography and, if the genesis is infectious, some Blood tests and a Pathogen detection.
therapy
The therapy depends on the cause of the pain, symptomatically a suitable one must initially Pain therapy be initiated. Substances like Diclofenac or Paracetamol, but also stronger means like Oxycodone or Tramadol for use. In the case of a hip prosthesis loosening, you cannot get one Revision, that means one second operation around. If possible, the Hip prosthesis changed, infectious foci can be cleared out.
Better stability for the second hip prosthesis can be ensured through additional anchoring or artificial bone augmentation. A possibly causative factor for the pain of the hip prosthesis infection must be given with high doses, also directly into the tissue Antibiotics be treated. Must also Risk factors how Obesity, extreme stress, diabetes or Smoking and alcohol be well controlled to extend the life of a hip replacement without pain.
forecast
If a hip prosthesis causes pain, the prognosis depends on many factors. If the cause can be eliminated, nothing stands in the way of a continued good quality of life. Often is a Change of prosthesis necessary. It must be said that the The prognosis after revision surgery is worse on average than after the first operation, since healthy material is injured and removed again. Also Infections can be complicated, which worsens the prognosis, especially if it spreads to the bone (Osteomyelitis). The risk of infection is significantly increased. However, there is still a chance of a complication-free course after revision 85-90% specified.
prophylaxis
The patient can influence many things before a hip prosthesis causes pain, and some less. The Stress on the joint should be minimized, no excessive Movements like extreme bending or Rotate of the leg.
The patient is dependent on any existing Reduce excess weight and on that Refrain from smoking. All of this can significantly extend the complication-free life of a hip prosthesis. Likewise increased Muscle training as part of a guided physical therapy the stability of the joint. Prophylaxis is difficult against allergic reactions or an abnormal bone reaction after surgery, only inquiring about known allergies can be helpful when choosing the material.
Infection must be avoided through sterile work and antibiotic prophylaxis initiated during the operation, which is in the hands of the treating doctors. Despite all these measures, a hip prosthesis can sooner or later cause pain. Then should possible quick medical advice be sought in order to be able to intervene early and thus prevent further serious complications.
