Question:
I’m considering having a hip replaced. What are the odds that this operation
will work?
Answer:
The American Academy of Orthopaedic Surgeons says
joint replacement surgery is successful in more than 9 out of 10 people. And
replacement of a hip or knee lasts at least 20 years in about 80 percent of
those who have the surgery.
In
the procedure, an arthritic or damaged joint is removed and replaced with an
artificial joint called a “prosthesis.” Artificial
joints are medical devices, which must be cleared or approved by the FDA before
they can be marketed in the United States
The
goal of surgery is to relieve the pain in the joint caused by the damage done
to cartilage, the tissue that serves as a protective cushion and allows smooth,
low-friction movement of the joint. Total joint replacement is considered if
other treatment options will not bring relief.
In
an arthritic knee, the damaged ends of the bones and cartilage are replaced
with metal and plastic surfaces that are shaped to restore knee function. In an
arthritic hip, the damaged ball and socket of this joint are replaced by a
metal ball and plastic socket. Several metals are used, including stainless
steel, alloys of cobalt and chrome, and titanium. The plastic material is
durable and wear-resistant polyethylene.
The
two most common joints requiring this form of surgery are the knee and hip,
which are weight-bearing. But replacements can also be performed on other
joints, including the ankle, foot, shoulder, elbow and fingers.
After
total hip or knee replacement you will often stand and begin walking the day
after surgery. Initially, you will walk with a walker, crutches or a cane. Most
patients have some temporary pain in the replaced joint because the surrounding
muscles are weak from inactivity and the tissues are healing, but it will end
in a few weeks or months.
Exercise
is an important part of the recovery process. After your surgery, you may be
permitted to play golf, walk and dance. However, more strenuous sports, such as
tennis or running, may be discouraged.
There
can be complications from joint-replacement surgery. These include infection,
blood clots, loosening of the prosthesis, dislocation
of the joint, excessive wear, prosthetic breakage and nerve injury. There are
remedies for all of these complications, but sometimes the correction will take
more surgery.
Surgeons
are refining techniques and developing new ones such as minimal-incision
surgery. Instead of a 6- to 12-inch-long incision used in a standard total knee
replacement, some surgeons are using a 4- to 5-inch incision. And instead of
the typical 10- to 12-inch incision in a total hip replacement, surgeons are
operating through one 4-inch cut or two 2-inch cuts.
Minimal
incisions reduce trauma, pain and hospital stays. Not all patients are
candidates for minimal-incision surgery.
There
is a surgical alternative to total hip replacement. It’s called hip
resurfacing. The primary difference in hip resurfacing is that the surgeon
doesn’t remove the ball at the top of the thigh bone. Instead, the damaged ball
is reshaped, and then a metal cap is anchored over it.
Hip
resurfacing, unlike hip replacement, preserves enough bone to permit a total
replacement if it is necessary later. Resurfacing is not recommended for
patients with osteoporosis, a disease that makes bones porous and vulnerable to
fractures.
Some
healthcare experts advise getting a replacement hip joint, not a resurfacing,
if you are older than 65.
If
you have a question, please write to fred@healthygeezer.com
©
2008 by Fred Cicetti. All rights reserved.