Isn’t it amazing how medical advancements have taken us to new heights in terms of healthcare? One example is the hip replacement surgical procedure. It enables patients to have a second chance at living a normal life by replacing a damaged hip joint with a new and fully functional one. Ever wondered how surgeons do it?
Hip Arthroplasty Surgery, or simply hip replacement, is a procedure that involves surgically removing a painful hip joint and subsequently replacing it with an artificial joint which is often made of metal and plastic parts. Painful hip joints are not the only indications for this procedure though. Fractures caused by osteoarthritis, neoplasms, malignant tumors, and some disorders of the spice can be reasons for undergoing the procedure. Hip replacement surgery is the most common orthopaedic surgery procedure performed today.
Your hip joint is made up of two major parts. One or both of these may be replaced during surgery: The hip socket, also known as the acetabulum, and the upper end of the thighbone called the femoral head. Another important element of the procedure is the prosthesis, or the artificial replacement hip, which has a mobile surface composed of high molecular weight polyethylene cement. This portion of the prosthesis is what makes attachment to the native bone possible. Today however, there are now procedures that involve the use of non-cemented prosthesis which have also proven to be effective compared to its cemented counterparts. There are a lot of techniques used by surgeons as well, including the Moore or Southern, the Hardinge or Liverpool, the Watson-Jones, and the Smith-Petersen approach. The Moore or Southern technique is the most commonly used as it provides excellent access to the acetabulum and femur and preserves muscle function, minimizing the risk of some complications post operatively.
Now we describe the details of the procedure. To start, the anesthesiologist will be administering general anesthesia to relax your muscles and put you into a temporary deep sleep. This will prevent you from feeling any pain during the surgery, and will reduce your awareness of the procedure as well. A spinal anesthetic may be given pre-operatively, as well as other pain medications to help manage the pain after the procedure.
During surgery, the aim is to expose the hip joints for better visual and each surgeon may use any of the aforementioned techniques in doing so. The damaged joint is then removed by first cutting the joint using a power saw and subsequently dislocating it. Surgeons place specifically shaped reamers and rasps into the empty cavity afterwards to create an appropriate space for the prosthesis to fit. The acetabular portion of the prosthesis (the socket) that contains the high molecular weight polyethylene cement is then attached to a metal cup and subsequently impacted into place. The joint is relocated, the wound is closed, and the surgery is done.
Although it sort of sounds like the surgeon is playing with Lego blocks, great care should be taken during this procedure so that a functional anatomic position for both the femoral and acetabular components will come about. Look for an orthopedic surgeon who sub-specializes in hip arthroplasty and has years, if not decades of experience in that area. More importantly, look for a surgeon who you can really talk to and who will provide you with all the necessary info you want regarding not just the procedure but also the outlook and prognosis of the underlying reason for undergoing the procedure in the first place.