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Sunday 7 September 2014

Hip Replacement Patients Agree: Easier Than It Sounds


By Neil P. Hines


Arthroplasty or hip replacement is the surgical procedure through which a diseased (that is, damaged or otherwise dysfunctional) hip joint is replaced with artificial parts in order to restore functionality or to relieve pain. Hemiarthroplasty is the analogous procedure to replace only one component of the hip joint (from the Greek word hemi meaning half). Despite untoward notions that candidates may have about the procedure, it is a routine operation and they should not suffer undue anxiety preceding its performance, so that hip replacement patients agree: easier than it sounds.

There are several reasons why an arthroplasty is prescribed. The most common is the presence of osteoarthritis in the hip joint or hip area. Other conditions, such as rheumatoid arthritis or arthritis caused by external trauma, are also treated by the procedure. In addition to these, spondylitis and bone tumors may necessitate substitution of the joint, either partially or entirely.

There are a number of different types of arthroplasty. They are distinguished by the direction of approach to the affected joint, so there are the anterior, posterior and lateral methods. The fourth method, namely minimally invasive surgery, involves making the smallest possible incision, and to this end the surgeon may deploy sophisticated devices such as computer imaging tools or fluoroscopy.

The different variations are named after the direction of incision used to access the targeted hip. They are therefore self-explanatory: anterior (from the front), posterior (from the back) and lateral (from the side). The exception is the minimally invasive approach, which attempts to utilise the smallest possible incision, but the installation of the artificial parts is then harder to accomplish successfully, and the surgeon using this approach may require the assistance of more advanced equipment, such as computer imaging or intraoperative X-rays.

The prosthetic components are identical in dimension and function to the body's own versions. The three components involved in the operation are the femoral component, which takes the place of the femur's ball, the acetabular cup, which is inserted into the hip to serve as the socket (acetabulum), and the articular interface, which is the material between the other two parts.

The prostheses are made in a selection of materials at present. Patients should obtain information on each material in order to choose the most sensible one for their particular situation. They thereby empower themselves in their own treatment.

Any operation in hospital elicits feelings of apprehension and unease. However, with an established track record of several decades and different prosthetic options, maybe patients may take heart, and they should therefore not anticipate their surgery with unnecessary pessimism or fear.




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