Loosening of the hip prosthesis
introduction
The prosthetic restoration of the Hip joint is one of the most promising and frequently performed procedures in orthopedics. It is applied to arthrosis, inflammatory changes, Necrosis, Fractures, Misalignments or malformations of the hipto alleviate the pain for the patient and restore mobility.
Unfortunately the used ones hold up Joints not for eternity and after a few years without pain and complications, discomfort in the operated joint can occur. One possible complication is the loosening of the Hip prosthesis. Most of the prostheses used do not loosen, but in individual cases the hip prosthesis can loosen.
causes
The loosening of the hip prosthesis results from changes in the Connection of prosthesis and bone with cementless hip prostheses or from Bone cement and the bone with cemented hip prostheses. The changes can be caused by aseptic or septic processes.
The main causes aseptic prosthesis loosening are Drift particles (for example made of polyethylene, cement, ceramics, metal), which are released by wear and tear between the artificial femoral head and the joint socket as part of the daily stress on the joint. Over the years, they can cause tissue reactions between the bone and the prosthesis.
The detached particles of the prosthesis can also Foci of inflammation cause the bone and the prosthesis to diverge. These processes damage the bones and affect the adjacent soft tissue.
But it is also possible that a prosthesis already during the implantation has insufficient stability and the prosthesis will therefore loosen even more over time.
Septic processesthat contribute to the loosening of the prosthesis can through minimal Infections during surgery arise.
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
Symptoms
The cardinal symptom that leads to the examination in addition to the regular routine controls is the pain. In combination with other signs that are typical of a loosening of the hip prosthesis, the suspicion of loosening will strengthen.
Easing sign
The pain is not the only parameter, because the pain intensity varies depending on the location of the loosening of the hip prosthesis. While Pan loosening are often painful Loosening of the shaft is very painful. The pain leads, among other things, to the possible Walking distance fast shortened and when walking a feeling of Uncertainty or instability occurs. In addition, the patient may feel that they have lost control of the affected leg.
Another sign of easing is a new one Leg length difference. However, the shortening of the legs is a sign of that at an advanced stage occurs.
As part of a radiological examination With imaging procedures further signs of relaxation can be made out. Part of the bone dies. But at the same time it also happens New bone formation.
By loosening the hip prosthesis, the prosthesis also changes its position, the shaft position changes and the socket moves in the joint. These changes can be recognized just as easily as damage to the implant or the anchoring materials.
Pain in the thigh
The loosening of the hip prosthesis causes pain in the Thigh. In contrast to the Pan looseningthat rather rarely pain causes, above all, triggers one Severe pain in the shaft loosening in the thigh.
The pain in the thigh when the hip prosthesis is loosened is common Pain on starting or under pressure when standing or walking. The pain from the thigh can also affect the strip, the buttocks or that Knee joint radiate from the affected side.
However, not all thigh pain is due to loosening of the hip prosthesis and the doctor will rule out other possible differential diagnoses through discussions and examinations. The pain in the thigh could also be triggered by nerve irritation, for example.
therapy
In case of loosening of the hip prosthesis is one renewed operation usually unavoidable and should be done promptly after the diagnosis of loosening so as not to further damage the bones and surrounding soft tissue structures.
Further operative therapy depends on the place where the loosening of the prosthesis occurs. Possible are two areas: Of the shaftwhich is anchored in the thighbone and which panthat forms the joint.
A Loosening in the shaft the prosthesis is treated by a new prosthesis is implanted with a longer shaft. Several different systems are available. Which is most suitable is decided in the doctor-patient conversation for the respective individual case.
If the pan is affected Support rings inserted or a larger implant used.
The replacement surgery usually takes longer than a first-time procedure and is also more demanding. The loosened components and the scar tissue are removed. The bone is then freshened before the new prosthesis can be inserted. The prosthesis is adapted to the age and the load on the prosthesis of the patient either cemented or cementless brought in.
The operations are with one greater blood loss connected. After the procedure, the rapid restoration of joint function is the top priority. Exercises for this purpose are carried out in the hospital. After the inpatient stay in the hospital, the patient is given follow-up treatment ("Cure“) And the joint function, muscle strength and walking ability trained and built up. Further treatment after the hospital stay can vary individually depending on the extent of the respective intervention.
prophylaxis
The loosening of the hip prosthesis, if it should actually occur, is difficult to avoid. However, patients with an artificial hip joint are advised to regular check-ups to perceive at an orthopedic surgeon, as part of which too X-ray examinations can be carried out. The examination and imaging can detect changes such as loosening at an early stage.
