Description

Hip Replacement

Hip Replacement

Overview

The hip joint is among our most mobile joints of our
body. The components that form the hip joint may be damaged over time, or a
trauma may result in loss of stability in the hip joint.

Total hip replacement or total hip arthroplasty is
indicated for pain and joint instability that do not respond to medication
treatments and physiotherapy and rehabilitation and are severe enough to
affects daily life activities.

The most common causes of pain and instability are osteoarthritis,
rheumatoid arthritis and traumatic injuries. Moreover, blood supply to the hip
joint may reduce due to traumatic and inflammatory events, resulting in
necrosis in the ball-like head of the femur (aseptic necrosis).

Why is hip replacement procedure done?

Total hip replacement is performed to cure joint
disorders that hinder daily life activities (climbing stairs, walking, and
getting out of the bed) and do not respond to medication treatment and
physiotherapy.

There is no absolute age or weight limitation for
total hip replacement. The operation decision is based on the severity of pain
and the degree of disability rather than patient’s age. Therefore, personalized
assessment of each patient or selection of good candidates is extremely important.

Risks

As the case for all surgeries, total hip replacement
involves some risks.

Although all possible measures that modern medicine
allows are taken to prevent occurrence of risks, it is no means possible to
warrant that the risks will be completely eliminated.

These risks may be related to surgery and anesthesia,
but there are also some risks that may be faced after the surgery.

Those risks are as follows:

• Infection
• Clot formation and migration of the clot to other
  body parts
• Laxity of hip prosthesis over time
• Revision surgery
• Failure to obtain desired range of motion

When these complications occur, albeit rare, recovery
time may prolong, complete recovery might fail or revision surgery might be
required. You should inform your orthopedic surgeon about your concerns before
the surgery.

Your surgeon will explain in detail whether those
risks apply to you or if so, the rate of occurrence.

Preparation

The first phase of preoperative preparation is same in
all Medicana Hospitals. Decision of total hip replacement is made by your
orthopedic surgeon based on a series of tests and examinations. Your doctor
will make a comprehensive assessment to determine whether this surgery helps
your complaints or not. All other treatment options, including but not limited
to medications, injections, physiotherapy and other surgical procedures, are
taken into consideration.

• Review of health history
• A detailed physical examination
• Necessary laboratory tests and radiology studies
• Assessment by anesthesiologist and other laboratory
  tests and radiology studies to minimize anesthesia-related complications

After it is verified that the surgery does not pose
risk, you will be asked to quit smoking, if you are a smoker, and to stop
taking certain medications that increase risk of bleeding. All other prescribed
and over-the-counter medications, herbal products and supplements will also be
questioned and you will be informed to continue or stop taking them.

A preoperative discussion with your orthopedic surgeon
about total hip replacement is very important. All details of the procedure,
potential risks and healing period are explained.  

You will also be instructed to stop eating and
drinking at a particular time before the surgery and you should strictly follow
this instruction in order to undergo the surgery at the scheduled date.

Moreover, it is reasonable to plan discharge,
post-discharge accommodation and travel at this phase in order to manage
postoperative period better.

Surgery and early postoperative period

After you are hospitalized, preparations are completed
and your anesthesiologist will assess you to determine the best anesthesia
technique. Orthopedist will first cut the damaged cartilage and bone and
prepare them for joint replacement. Artificial (prosthesis) hip joint, which is
made of metal alloy or other suitable materials, is then placed so as to take
over the function of the hip joint. Artificial joints are attached to existing
bones and surrounding tissues using screws, plates and other fixation
materials. The range of motion of the hip joint is checked once more before the
surgery is completed.

Our physiotherapist will help you to learn how to use
your new hip joint, but moving your legs after the surgery will not only
facilitate wound healing, but it will also contribute to the success of the
surgery.

You will be given pain killer(s) after the surgery in
order to manage the postoperative pain.

Treatments will be started and measures will be taken
to eliminate risks arising out of clot formation.

You may also need to use antibiotics to prevent a
possible infection.

It is very important that you follow all instructions
of your doctor after the surgery to protect and support the outcome of the
surgery.

You should see your surgeon for follow-up visits that
are scheduled before you are discharged.

If you experience warmth and redness in your incision
line, or if you have a fever or any symptoms that you think are due to surgery
after you are discharged, contact your surgeon immediately.

Results

You will need inpatient care for several days after
the surgery. At this time interval, both your overall health will be stabilized
and your joint will be adapted to post-discharge period by physiotherapy
procedures.

Always remind that postoperative pain is a natural
component of the recovery. Your doctor and nurse will take necessary measures
to manage your pain.

Being able to use your new hip joint requires both
patience and strict compliance to the instructions.

Physical therapy, which is a part of post-operative
care, will be initiated before you are discharged. However, in order to speed
up the healing process, you will need to keep doing the exercises at home.

You may need to use a wheelchair for a few days before
full recovery. In addition, in order not to strain your hip joint, you have to
comply to some basic rules at your home (standing up carefully from sitting
position, not crossing your legs, avoiding abnormal rotational motions in your
operated leg, removing objects that can lead to stumbling, use of seat
extensions).

If you strictly follow all instructions, you will
probably start doing all routine daily life activities, with no restriction,
within several weeks. However, sufficient strengthening and elasticity of
muscles might require several months or sometimes up to one year.