Entrust Your Hip Replacement Surgery to an Arthroplasty Specialist
Although, today, it is considered to be one of the most successful forms of orthopaedic intervention of our times, it has taken a lot of time and experimentation to develop the various surgical techniques that have made it both a safe procedure and one that is able to provide patients with an effective, long-term treatment to overcome their pain and loss of mobility.
In practice, the first attempt to perform hip replacement surgery dates back to the 19th century – long before the appearance of modern arthroplasty and its specialists. On this historic occasion, it was a German professor named Themistocles Gluck, who in 1891, surgically implanted a prosthesis fashioned from ivory, as a means to replace the eroded femoral head of a patient whose hip joint had been badly damaged as the result of a TB infection. Later attempts saw other surgeons experiment with various tissues, such as fascia lata, taken from the patient’s thigh muscle or pig bladder, to reduce friction between the articulating surfaces and alleviate pain in arthritic joints.
Progress continued apace, and in 1925, an American surgeon named Smith-Petersen created a moulded hollow hemisphere designed to fit over the head of the femur, in order to provide a smooth articulation, and restore free rotation and circumduction of the ball and socket joint. However, though biocompatible, it shattered under stress, prompting the use of a stainless steel prosthesis bolted to the bone.
In parallel, the technique known as arthroscopy, which began with the use of a cystoscope to view the internal arrangement of the knee joints in cadavers, was also under development. In time, it would progress to the point where it would become a valuable tool for investigating joint pathology, and eventually, allow the use of keyhole incisions for a number of orthopaedic procedures.
Today, although still seen, osteoarticular tuberculosis is less prevalent, and the services of a hip replacement specialist are more often required to deal with the consequences of osteoarthritis. In this condition, the cartilage, which normally provides a protective layer that covers the articulating surfaces of the bones, is gradually worn away, leading to erosion, pain and reduced mobility. Once mainly associated with aging, it is now occurring more frequently in younger subjects, and has been linked to the increased incidence of obesity and the additional mass that results in increased pressure on the joints.
Regardless of what may have caused the damage, the demand for prosthetic joints has continued to escalate, and the number of these procedures performed to date can be reckoned in the millions, and statistics suggest that between 200 and 300 are now performed each month in South Africa. Modern prosthetics continue to evolve and include metal-on-metal, metal-on-polyethylene, and ceramic-on-ceramic structures secured with or without specialised cements.
The gratifyingly high success rate can be attributed to the fact that the various surgical procedures involved have all been thoroughly tried and tested over a period of many years. Nevertheless, whether a partial or a total hip replacement may be required, patients should always be certain to seek the assistance of an orthopaedic specialist with extensive experience in the techniques of arthroplasty.
New, minimally-invasive techniques are currently under development, and look set to minimise blood loss, reduce hospital stays, and speed rehabilitation. In keeping with the unit’s well-established policy of ongoing translational and clinical research, and leveraging state-of-the-art technology, Pretoria Hip, Knee and Shoulder Surgeons is certain to be among the forefront of those who will embrace and further develop the best of these new procedures. Under the direction of arthroplasty specialist Dr Jan De Vos, the unit has established itself both in South Africa and internationally as a leader in the field of hip and knee replacement surgery.