Things You Should Know About a Hip Replacement
Many will be surprised to learn that the first successful hip replacement was performed more than eighty years ago, in 1938. While there were numerous unsuccessful attempts during the previous half-century, a London-based surgeon named Philip Wiles made the breakthrough, using stainless steel to create a cup to line the acetabulum and a stem with a rounded head that he attached to the femur with screws and bolts. Later improvements saw the femoral prosthesis inserted directly into the bone and secured with cement or left to fuse with newly grown bone tissue. Articulation has since been improved by including a plastic liner between the metal surfaces.
Today, hip replacement, also known as hip arthroplasty, is widely regarded as the most successful procedure in orthopaedic history. Current statistics indicate that more than 450 000 patients undergo this type of surgery each year in the United States alone. In the past, most candidates were aged 65 or over. However, the number of younger patients requiring arthroplasty has been increasing.
Why Might One Need a Hip Replacement?
In most cases, it is a progressive condition known as osteoarthritis that, over time, may create the need for a total or partial hip replacement. Patients with this condition experience pain in the affected joint due to the erosion of the cartilage that usually coats the articulating surfaces of the bones, protecting them from damage due to friction. However, joint pain alone is not a sign that a patient needs surgery. Only if the pain persists even when at rest, the patient experiences reduced mobility, and painkillers cease to provide relief may arthroplasty become necessary. Referral to an orthopaedic specialist will be the next step.
Before recommending a hip replacement, the specialist will first conduct a thorough examination, including X-rays and, possibly, other forms of medical imaging. Before proceeding, further tests to ensure the patient is sufficiently fit to undergo surgery will also be necessary.
The standard procedure is usually performed under general anaesthetic and requires a long incision to expose the entire joint. However, some surgeons are skilled in arthroscopic surgery, which is a minimally invasive technique that utilises just three or four tiny incisions. The arthroscopic option reduces recovery time and the risk of infection.
Regardless of which hip replacement technique the surgeon employs, physiotherapy will normally begin within 24 hours. Patients will typically resume walking, albeit with an appropriate aid, within a few days. That said, the physiotherapy may continue for a month or more, and extra caution could be necessary for a further six to twelve months. The Pretoria-based Wilgers Life Hospital is an established centre of excellence for shoulder, knee and hip surgery, including joint replacement.