Hip replacement is an operation performed on patients with advanced osteoarthritis or damage to the hip joint and involves replacing the damaged joint. This operation is also called total hip replacement and total hip arthroplasty. The quality of life of the person increases to a great extent with the prosthesis application, which is a life saving operation for people who have limited movement in their hips and have problems in their social life.
The hip is composed of a socket and ball type of joint. The ball part of this joint defines the top of the thigh bone, and the other part consisting of cartilage and bone defines the socket. Hip replacement surgery is also a procedure that involves replacing the damaged ball and socket with a synthetic structure with similar properties.
Total hip replacement is generally applied in tumors, rheumatic disorders, hip dislocation, osteoarthritis, childhood disease sequelae and hip fractures seen in advanced ages. People who experience such disorders are the most suitable candidates for surgery if they have not achieved positive results with non-surgical treatments or if it was thought that they cannot be treated by a doctor.
Hip prostheses developed as a result of advances in technology have different types according to main and intermediate parts. The main parts are generally titanium, cobalt or chrome. Spacers can be made of polyethylene, metal or ceramic. These substances are produced with features that are fully compatible with the body.
Hip replacement surgery is usually applied to people between the ages of 50 and 80. In addition, it is preferred for people who have a disorder that breaks down the cartilage in their hips. This condition is called hip arthritis. There are 3 different types of arthritis for which prosthesis application offers solutions. These:
- Rheumatoid arthritis: It is an autoimmune disease that causes joint inflammation.
- Traumatic arthritis: It usually occurs as a result of an injury.
- Osteoarthritis: It is a degeneration seen with age.
Doctors recommend a cane, walker, low-paced exercise program or medication depending on the condition of the person to control arthritis. However, at the point where these applications are insufficient, hip joint prosthesis is the most correct solution. The new hip applied to the person consists of four components: a socket made of metal, a lining structure that allows the ball to move comfortably in the socket, a ceramic or metal ball to act as the head of the thigh, and a metal rod to fix the ball.
Hip replacement surgery is not preferred for every patient. The people and situations for which this surgical procedure is not suitable are as follows:
- People with psychological problems
- Those who do not care about their personal hygiene
- Dementia patients
- Those who have an infection in their hip
- Patients with advanced arterial or venous insufficiency
- People with hip paralysis due to neurological disorders
One of the most effective solutions for hip prosthesis treatment is surgery. If the person has not had an accident/trauma and the operation is not performed for this reason, the planning of the operation considered for the prosthesis application is done a few weeks before. In this process, it is aimed to make the person's body suitable for the operation. In this direction, people with excess weight are asked to lose weight or those who use blood thinners are asked to stop using this drug for a while. In addition, it is recommended to redesign the person's living space in a way that he will move less and force his body less. Thus, the person can have a more comfortable recovery period after the surgery. It is also recommended that the patient stops eating and drinking 1 night before the surgery day. One should definitely take this suggestion into consideration. When the day of surgery comes, the person is examined in detail and the operation process begins.
The duration of hip replacement surgery varies according to the extent of the damage to the hip joint and the experience of the doctor who performs the procedure, however it takes between 45 and 120 minutes on average.
After hip replacement surgery, it is extremely important for the success of the operation to make some arrangements in some of the routines and pay attention to certain points. For this reason, the patient to be discharged is explained in detail and in practice how to climb and descend stairs using crutches. In the first periods, armchairs and chairs that will facilitate the sitting and standing activities of the patient are also preferred. It is extremely important that the chair in which the person will sit in the postoperative period are not too low. In addition, necessary precautions should be taken for situations that create a risk of slipping at home and a safe area should be created for the patient. Taking a shower on a high shower chair after the surgery or holding on to a support while standing are among the conditions that should be considered. Since there will be improvement in the movement limitation and pain experienced by the person after the surgery, the patient is carried out after 1 day at the latest. In this process, the patient is given a walker or a stick. After 2-3 weeks, the patient leaves the walker or chair he uses. What activities to start and when to start after the surgery is also among the topics that are wondered. These activities and the time to start can be listed as follows:
- The person can start running and light sports after the 4th month after the surgery.
- The patient can take a bath 2 weeks after the operation.
- The patient can start driving a car 1 month after the operation and cycling 2 months after the operation.
- It is recommended that the person pray in a chair after the operation.
- After the procedure, it is forbidden for the patient to use a squatting toilet for the first 6 months.
- The patient can cross his legs 2 months after the procedure.
- He can have sexual intercourse 6 weeks after the procedure.
After the surgery, the physiotherapist prepares an exercise program that can be done at home in order to speed up the recovery process of the patient and add comfort, and recommends the person to follow this program. Compliance with this program is necessary to re-strengthen the joints and muscles. The process followed at home is decisive in the recovery of the person and the success of the operation. For this reason, the doctor advises the patient to be discharged and their relatives about the care of the new hip. In this process, it is recommended that the person keep the items he often uses in a high and close area in order to avoid bending over.
The prosthesis, which is applied by a specialist surgeon with quality materials, can last a lifetime, but this process is closely related to the person's lifestyle and care after the operation, and in this direction, the prosthesis is expected to last up to 15 years. This process can last up to 30 years in some patients. When it is determined that the life of the prosthesis has expired in patients who are followed up in the long term and at routine intervals after the surgery, only the intermediate parts instead of the whole prosthesis may be replaced. However, in some cases, the entire prosthesis may require replacement.
What are the disadvantages of delaying hip replacement surgery?
Non-surgical applications such as drugs, PRP, physical therapy, stem cells and cane use are employed according to the general condition and needs of the patients. However, the process should be accelerated for patients who need surgery as a result of these applications. If this treatment is delayed, deterioration or calcifications may occur in the intact knees, hips, back and waist regions. Therefore, the necessary surgery should be performed on time.
What is the age limit for hip replacement surgery?
In some special cases, although it is applied for the early adult period, this process is applied for after the middle age. This procedure, which has no upper age limit, can be applied to any patient who has completed or is about to complete bone development.
Are there any complications after hip replacement surgery?
Walking and performing other activities after hip replacement surgery do not pose any problems, but this is closely related to a successful operation. The success of the prosthesis application is also related to the expertise of the doctor. However, in some cases, the person may experience an infection after the surgery. In such cases, the prosthesis is changed if necessary. However, if it is not necessary, the situation can be corrected with the use of antibiotics. After the procedure, the person may rarely experience long-lasting pain, which can shorten the life of the prosthesis and cause premature wear of the intermediate parts the prosthesis. This may require revision surgery for some patients. In addition, prosthesis dislocation, fractures around the prosthesis, nerve and vascular injuries are complications that can be seen. While all these complications are not seen in all patients, they may be experienced in some patients.
What is the price of hip replacement surgery?
The price of hip replacement surgery varies according to the expertise of the doctor performing the application, the center, the location of the center, the quality of the material used and the condition of the patient.