Anterior Approach Total Hip Replacement
The most frequent reasons for chronic pain are rheumatoid arthritis, avascular necrosis, etc. The articular cartilage covering the surfaces of the bones softens, thins and breaks down, leading to pain, limited joint mobility and lameness (lower limbs). In the terminal stages, the patient is forced to use additional support in order to be able to move. All this, if left without treatment such as the hip arthroscopy, affects the psycho-emotional state of the patient (even physiological functions are difficult).
Anterior Approach Total Hip Replacement involves removing the diseased joint, and an artificial one is placed in its place, it allows getting rid of pain, restoring the support ability of the diseased limb, as well as normal or as close to normal range of motion.
In the case of Anterior Approach Total Hip Replacement, 2 types of fixation are used: cement and cementless.
The first kind of the total hip replacement fixation involves the use of a special high-strength polymer. In the second case, the surfaces of the parts of the endoprosthesis are processed with a special material during manufacturing, which ensures a strong connection with the bone. For young and active physical patients, cementless artificial prostheses are most often installed during the surgery, for older people – cement ones. The final decision on the choice of the most suitable design and method of fixation is made by the total hip replacement surgeon based not only on age, but also on other features of the patient’s body.
Each mechanical structure, including the endoprosthesis, wears out gradually after the total hip replacement. To a large extent, the service life depends on the loads tested. It is clear that a young patient will suffer from wear and tear much faster following the surgery. Accordingly, with age and decline in physical activity, the service life of the prosthesis will increase. If the Anterior Approach Total Hip Replacement patient follows all the doctor’s recommendations, the structure functions normally for more than 15 years after the treatment.
What Happens during a Total Hip Replacement?
The first stage of the hip arthroscopy is access to the hip joint, the skin, subcutaneous tissue and fascia are dissected. At the same time, bleeding vessels coagulate. Then, in the course of the surgery, the femoral head is excised, which is usually already at that time devoid of cartilage, then the head is resected with an oscillating saw. The next step of the surgery involves developing the bone canal with successive rasps and the acetabulum is developed with cutters to the desired size. The cup is wedged in the acetabulum, providing stability so that the patient can walk the day after the surgery with full leg load. After that, the osteophytes that surround the cavity are removed because they interfere with normal movement. High-strength ceramic liners with zirconium ceramics are then inserted with minimal risk of fracture. The stem of the endoprosthesis is installed in a prepared bed. After inserting the femoral component, fit the ceramic head of the appropriate size. As a result of the surgery, a friction pair is formed, which practically does not imply any wear and should last a lifetime.
The duration of the surgery under general anesthesia is about 1.5-2 hours.
Risks and Complications
The total hip replacement, like any other surgery, may provoke complications. However, this is extremely rare nowadays. However, the most dangerous of them should be indicated:
- Infectious process;
- Thromboembolism.
To prevent infection, antibiotics are used, which are prescribed to the patient before and after the surgery. To prevent the formation of blood clots after the surgery, or thromboembolism, modern medicine uses a whole arsenal of highly effective anticoagulants.
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