Artificial hip joint

introduction

The hip joint consists of two parts. These include the head of the thigh bone and the acetabulum, which is formed by the hip bone.
The joint or the articular cartilage can through age-related wear (arthrosis) are damaged. It comes to Cartilage loss on the articular surfaces and Deformity of the acetabulumwhat Pain and Restrictions on movement arise.

If conservative therapies with osteoarthritis of the hip no longer effective and wear and tear of the hip joint is associated with excessive pain and increasing mobility restrictions, it is advisable to have a Operation with hip replacement to improve the quality of life and maintain mobility. In the event of complete wear, the entire hip can be replaced by an artificial hip joint. If only certain parts of the joint are destroyed, only these are replaced so that natural structures can be preserved.

Must the entire hip joint be replaced by an artificial hip joint, one also speaks of a Total hip endoprosthesis (total hip replacement).

A Hip prosthesis (hip replacement) consists of a shaftwhich is anchored in the thigh bone, the head, which is fixed on the shaft and later articulated with the acetabulum, the pan, which is anchored in the natural hip socket and the so-called Insert (inlay)which is fitted into the socket and in which the new femoral head can slide easily.
This form of the artificial hip becomes mainly used, when a primary osteoarthritis (Joint wear without recognizable individual event) with complete joint destruction, in which conservative measures are no longer helpful, or a Femoral neck fracture (femoral neck fracture) With Hip osteoarthritis exist.

The so-called Dual head prosthesis describes a Thigh bone prosthesis (Femur), the Hip socket preserved remains. This variant is often used when it comes to Femoral neck fracture in older people who are not under a arthrosis (Cartilage wear) in the hip joint.

OP

Although the insertion of a artificial hip (hip prosthesis) a frequent surgery in Germany, this must individually planned become.
X-rays and special computer programs ensure the exact creation of the prosthesis and precise planning of the operation.

The prosthesis to be used can cemented or cementless be. A combination of these two variants is called a hybrid hip prosthesis designated.
The acetabulum is screwed into the pelvis while the prosthesis shaft is cemented into the thigh bone.
Will be a cemented artificial hip inserted, the advantage is that this immediately after the operation can be charged again. However, this variant is also harder to remove, if after about 15 years Parts of the artificial hip joint exchanged Need to become.

Before an artificial hip inserted will need from the patient largely no preparations to be hit.
Medication that May promote bleeding (aspirin or marcumar), must be discontinued or may no longer be taken.
In addition to a general anesthetic can also perform the operation using a Spinal anesthesia be performed.This is a local anesthetic in which only the leg and pelvis are anesthetized. One advantage over general anesthesia is that the spinal anesthesia With fewer complications connected is.

During the operation the patient lies on his back. First, access to the joint must be made possible. Therefore, the hip muscle is partially split, taking care not to injure as little soft tissue as possible.
The old The joint or the femoral head are removed first. Then the acetabulum is prepared by removing the disturbing structures.
Now the metal shell, which represents the new socket, together with the inner shell, which ensures that the femoral head glides smoothly in the joint, can be used. The implant is then prepared for the prosthesis shaft and mounted.
After the dentures are positioned in their designated place and attached were can the Hips adjusted again become.
Then it is checked that the joint is working properly and is stable enough.
Finally, the joint is rinsed and the deep layers such as muscles and connective tissue are sutured before the wound is closed.

As already mentioned, lasts an artificial hip for about 15 years. After this time it is not uncommon to change the prosthesis, as the parts of the artificial hip joint also wear out gradually. Consequently should regular follow-up examinationseven if there are no complaints, be perceived.

Complications

Like any other operation, the insertion of an artificial hip joint also involves Risks.
These can be minimized by well-trained staff, compatible material selection and a good implementation of the previously planned operation.

Furthermore, there may be a Dislocation (dislocation) of the hip come. This is very painful and usually has to be adjusted again under anesthesia.
Also a bruise can develop on the hip, which can cause swelling and mild pain in the hip and thigh.
Another important complication to mention is that possible risk of infection when inserting an artificial joint. It can be used in the event of an uncontrollable infection (antibiotics ineffective) lead to it, that this Joint must be completely removed again.
Also can through surgery Nerve damage arise.
Too big one Leg length difference is another complication of an artificial hip. Too great a difference can cause spine discomfort and back pain. A However, a difference of less than 1 cm should not cause any interference cause.

Appointment with a hip expert?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

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.

You can find me in:

• Lumedis - your orthopedic surgeon
  Kaiserstrasse 14
  60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert

Pain

There are different reasonwhy an artificial hip joint causes pain.
So can the prosthesis for example loosen and Pain cause. Also the Wear of the sliding surfaces can lead to pain.
If the hip joint becomes inflamed, it is usually accompanied by pain. Such inflammation is often by bacteria (Staphylococci or streptococci). If those Inflammation not caused by antibiotics can be contained, it must artificial hip joint to be removed.

Sports with an artificial hip joint

Before an artificial hip joint is used in a patient, the suffering is usually very high and there is a pronounced restriction of movement.

After a hip prosthesis operation is this Exercise is possible again. However, you should use these sports activities not to be started too early.
After surgery should no sport for three to six months operated because the structures that fix the joint, such as the joint capsule, must first grow back.
It will Joint loaded too early, is the Greater danger, that the artificial femoral head from the artificial socket pops out.

After a period of rest, the patient should be active again. This has a number of advantages: For one, the Muscles, the for a certain stability of the joint, trains and thus prevent a possible dislocation of the artificial hip joint.
On the other hand, sport becomes the Bone building promoted, which enables better anchoring of the artificial hip joint in the bone.
Exercise also helps To reduce the risk of falling, since physical activity trains the mobility of the joint and coordination skills. Recommended sports are for example that To go biking, swim - where breaststroke should be avoided because of leg movement - and Nordic walking. In these sports, the artificial hip is protected from excessive stress and still trained.

Dislocated

An artificial hip joint can also be dislocated (luxated) become. Here the Dislocation of the hip backwards or forwards.

Possible Reasons for the dislocation are for example the too early loading of the artificial hip joint after the operation, so that supporting structures did not have enough time to regenerate.
Incorrect or excessive movements can cause the artificial joint to dislocate.
Sometimes even harmless movements like crossing your legs are a possible reason that the artificial hip joint is dislocated.
To bring the femoral head back into the acetabulummust Joint can be adjustedwhat usually under anesthesia he follows.
On the x-rays care should be taken whether structures on or around the hip joint was damaged during dislocation.

To prevent a new dislocation as much as possible, the patient should note Movements conscious and not to be carried out too jerkily. In addition, avoid lifting heavy objects.

Duration of treatment

In general, it takes about 6 months from the operation to complete rehabilitation.
The operation itself, in which the artificial hip joint is inserted, varies between one and a half to four hours. How long the patient ultimately has to stay in the hospital depends on whether complications extend the hospital stay or not.

After hip replacement surgery without complications, the patient can usually leave the hospital after two weeks. The use of crutches on both sides after the operation should be carried out for four to six weeks so that the muscular system can regenerate. If the patient then feels safe enough, these can gradually be omitted.

After leaving the hospital, a rehab follows, which can be carried out on an outpatient or inpatient basis and can usually last a few weeks to 6 months.
How long it takes before patients can return to work depends on the type of occupation. Work on the telephone can sometimes be carried out again as early as three days after leaving the hospital. In the case of heavy physical work, you should wait several weeks or up to three months so that the structures can properly recover and renew.

Rehab

As a rule, movement exercises to build muscle are started on the first day after the operation. Here the patients are instructed by physiotherapists.
After about six days, most patients will be able to walk with the crutches on their own.

After discharge from the hospital, rehabilitation measures are carried out, which can be carried out on an outpatient or inpatient basis.
During rehab, the patient is shown exercises and joint-friendly movement measures that should be used over the next few months

Outpatient rehab should take place close to where you live. This is a daily four to six hour treatment of the patient by doctors and physiotherapists in special rehabilitation clinics.
In inpatient rehab, the patient temporarily moves to a clinic. The patient has a daily therapy plan with intermittent breaks or recovery phases, in which the advantage of inpatient rehabilitation lies. In-patient rehab is also better for patients who live alone or for patients who have problems dealing with the new hip joint.

After three to six months of rehabilitation measures, the hip is in most cases fully capable of bearing again. Nevertheless, when doing sporting activity, care should be taken to select sports that are gentle on the joints in order to keep the artificial hip joint as long as possible and to delay changing the prosthesis.

Read more about this at: Rehabilitation after installing a hip prosthesis