pathologies
Hip
Hip arthritis
treatment
Hip joint replacement is called arthroplasty. It involves removing the diseased part of the joint and replacing it with an "artificial" joint. This is called a hip prosthesis.
The aim of a total hip replacement is to remove pain and improve mobility in the affected joint.
The outcome of the intervention depends on several factors:
- Degree of hip wear.
- Etiology of coxarthrosis.
- Patient's general condition.
- Type of prosthesis.
- Choice of surgical approach, etc.
If the indication for surgery is well established, the hospital stay rarely exceeds 3 days, with resumption of weight-bearing walking the day after the operation.
Before the operation
A consultation with an anesthetist will be scheduled.
The anaesthetist will also ask you for additional tests (blood tests, ECG, chest X-ray, etc.), which can sometimes be effected by family doctors.
Dental infections must be treated before any prosthetic hip replacement.
Before the operation, you should discuss with your anaesthetist the possibility of stopping certain medications.
The intervention
You will be admitted to the Trauma and Orthopedic Surgery Department the day before the operation, but if the operation is scheduled for the afternoon, you may be admitted in the morning.
Of course, if further tests are required, you will need to be hospitalized a few days before the operation.
The surgery itself will take around 60-80 minutes.
In the post-operative period, anti-thrombotic treatment must be continued for four weeks (even after you return home).
Walking is resumed the following day with full support, initially with a walker or crutches.
In most cases, you can return home as soon as you are able to use your crutches to go up and down the stairs.
If you have chosen a rehabilitation center, the length of your hospital stay will be shorter, as the centers are medicalized.
I will see you again in consultation 4 weeks after the operation. After 4 to 6 weeks, you can drive your car.
Possible complications
They are rare, occurring in around 2% to 3% of cases.
Post-operative hematoma
I recommend using ice on the hip for 15 minutes every 3 hours.
Thrombosis
They are prevented by anticoagulant injections in the abdomen (for one month), and by wearing compression stockings during the day, for four weeks.
Post-operative infection
To prevent any infection, you will receive antibiotics for 24 hours as a preventive measure.
If the wound becomes red, don't hesitate to contact the surgeon as soon as possible.
Pain that sometimes has no clear explanation
Some patients may develop inflammations around the operated hip (tendonitis, bursitis). These pains usually finish within a few weeks.
Hip prosthesis dislocation
This is a rare complication, the frequency of which depends on the approach used by the surgeon. I often use an anterior approach, where the risk of dislocation is minimal.
Unequal lengths of the lower limbs
It is corrected by a sole or heel pad.
Hip replacement surgery
Hip prosthesis replacements (prosthesis revision)
This complex procedure involves several stages:
- Removal of the prosthesis and cement.
- Possible filling with greffes of bone destruction.
- Placement of a new prosthesis.
- Reinforcement of the bone support around the prosthesis by additional synthesis.
In the acetabulum, the use of bone greffe from bone banks, is often necessary. The bone bank used is mixed with bone samples effected during preparation of the prosthesis bed. Occasionally, a metal support may be used, designed to stabilize the greffes and strengthen the bony acetabulum afin a cup is cemented to it.
Femur fracture in a patient with hip prosthesis
The technique used will depend on the type of fracture. In some cases, fixation of the prosthesis is sufficient, while in others, partial or total replacement of the prosthesis is required.
Revision of a hip prosthesis remains a complicated procedure, even in the hands of confirmed surgeons, with complications occurring more frequently than in first-line prostheses.
diagnosis
After the clinical examination, an X-ray is requested. This is often sufficient, especially when the damage is extensive. Additional examinations are required in cases of secondary coxarthrosis (CT scan, MRI, etc.).
symptoms
The hip is painful. Patients are often awakened at night by pain.
Joint mobility is limited. Difficulties are encountered in everyday activities, such as putting on stockings, walking fast or walking at a longer pace, climbing stairs, etc. The first few steps on waking up in the morning are difficult. The first few steps in the morning are painful. You get the impression that your hip is "rusty". Sometimes, patients have to use crutches.
Definition
Arthiritis of the hip
As with every joint in the human body, the bony ends that make up the joint are covered in cartilage. In the case of a hip, we're talking about the femur and acetabulum (part of the pelvic bone). As the cartilage surface wears away, the underlying bone is exposed. This is osteoarthritis. When osteoarthritis affects the hip joint, it's called coxarthrosis.
The most common cause is age-related wear and tear, but there are also cases of post-traumatic or secondary coxarthrosis (following hip disease).