| Hip Arthritis and Hip Replacement |
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| General Introduction |
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Arthritis of the hip is a very common disease with millions of Americans affected. It is primarily a disease of the cartilage covering the hip joint. The hip is a ball and socket joint and both surfaces are normally covered with a smooth, white, glistening layer of cartilage. In arthritis this cartilage begins to wear out and break down – similar to what happens to automobile tires after 50,000 miles. The early signs are morning stiffness and aching after weight bearing activities such as walking or playing sports. As the cartilage is worn off further the body makes bone spurs and the joint loses mobility and becomes stiff and painful.
Patients often have difficulty rotating their hips such as is required for a golf swing or putting on shoes and socks. In severe cases, nearly all of the cartilage is gone and the bone ends rub together. Patients often have constant pain that limits even daily activities such as getting up from a chair and walking around the house. They often become weak from not exercising their hip muscles and need a cane or walker to get around. Once the arthritis symptoms interfere with a patient's lifestyle and limit daily activities even with medications, hip replacement surgery is often recommended. Patients with hip replacement surgery routinely have significant improvements in pain and function.
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| Mini Incision Hip Replacement |
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Traditionally, hip replacement surgery involved large incisions, significant blood loss requiring transfusions, and extended hospitalization stays and extensive rehabilitation. Patients did well with surgery; however, they experienced significant pain and limitation of activity for the first 3 months after surgery. With the advent of mini-incision or minimally-invasive hip surgery combined with new techniques in pain management and anesthesia, hip replacement surgery has become a more pleasant experience.
The advantages of mini-incision hip replacement are:
- Smaller incision approximately 4” versus 10” for non-obese patients, more cosmetic
- Preservation of the piriformis tendon and Capsular Noose capsular repair – violates less muscle and minimizes dislocation risk
- Shorter hospital stays (2-4 days vs. 1 week)
- Shorter recovery and return to usual activities in 4-6 weeks
- Less blood loss and need for transfusions
- Lower rates of complications such as blood clots, pneumonia, infection and stiffness
- Less pain and less need for pain medications
Mini incision hip replacement offers all of the advantages of traditional hip replacement surgery while providing for faster recovery and minimizing complications. This leads to very high rates of patient satisfaction. The posterior mini-incision technique causes less muscle damage than other techniques and provides good visualization of the femur and socket. Because of this, there are no additional risks with this procedure.
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| Materials for Hip Replacement |
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Implants: Porous titanium or trabecular metal allows bone to grow into the implant; once bone bonds with the titanium surface it does not loosen. Cementless technology avoids bone cement which tends to fragment and crack over time and can cause serious complications at the time of surgery when the cement is pressurized. Bearing surfaces: Metal on metal provides the largest surfaces available which maximizes range of motion and is also highly durable and expected to last a lifetime. Other option is ceramic-on-ceramic which is the hardest surface available and generates the least wear.
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| Navigation (Computer assistance) for Knee Replacement |
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| Navigation has been proven to increase surgical accuracy and precision in making bone cuts and placing components. It is expected to yield longer lasting knee replacements with less need for revision or repeat surgery. |
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