It is almost inevitable that, over the years, one or more of the body’s joints will begin to show some signs of wear and tear. Naturally, the chance of succumbing to such damage is greatest in those joints that are required to support its full weight. During standing, walking, and running, the knees and hips, together with the ankles, tend to be most susceptible. Over the past few decades, techniques for surgical hip replacement (arthroplasty) have been perfected, and for many patients, the procedure is proving to be a life-changing experience.
A Brief History of the Procedure
It was a German Professor named Themistocles Gluck who, in 1891, first attempted to replace the damaged femoral head of a patient whose joint had been destroyed by TB. The concept was sound, but the ivory implant failed because it was not strong enough. In practice, finding a suitably tough, biocompatible replacement material proved as much of a challenge as developing the surgical techniques now used for a hip replacement.
Metals such as stainless steel, titanium and its alloys, together with plastics and ceramics in various combinations, have since led to more durable and efficient prostheses with the potential to last several decades or longer. More than 60 years elapsed between Gluck’s early efforts and the consistently successful use of a stainless steel femoral head and acetabular cup.
Today, the preferred combinations are ceramic-on-metal, ceramic-on-polyethene, ceramic-on-ceramic and ceramic-on-metal. In each pair, the first-named material is used to create the femoral component. The latter materials replace the damaged acetabular surface to complete the hip replacement process.
Who Might be a Candidate for this Procedure?
Each of the articulating surfaces of these joints is normally protected from damage due to abrasion by a layer of cartilage. The cartilage acts somewhat like a lubricant to ensure smooth, frictionless movement. However, injury, disease, and ageing can all contribute to the erosion of this protective layer. The most common cause of wear is a condition called osteoarthritis, but rheumatoid or septic arthritis, a fracture of any form of abnormal bone growth, can all lead to the need for a hip replacement.
Typical signs that a patient might eventually require arthroplasty are severe pain in the joints, often accompanied by swelling and stiffness. That said, because there is a degree of risk attached to any form of surgery, rather than encouraging patients to pursue this option immediately, a physician will typically take a less stringent approach, combining physiotherapy with analgesics and perhaps steroids if the pain persists.
However, these conditions are progressive. Once the pain affects sleep and quality of life and reduced mobility begins interfering with everyday tasks, a hip replacement will remain the only viable option. Either one or both components of the joint may be replaced depending on the focus of the damage. However, in the long term, opting for total hip arthroplasty (THA) is likely to avoid the need for further intervention at a later date.
The Life Wilgers Hospital in Pretoria is known both in South Africa and internationally as a referral destination of choice for patients who may require a hip replacement or similar arthroplasty procedure.