Hip replacement, also known as total hip arthroplasty, is a surgical procedure that involves replacing a damaged or worn-out hip joint with an artificial joint, called a prosthesis. This surgery is commonly performed to relieve severe pain and improve mobility in individuals with conditions such as hip fractures or advanced arthritis.
Loading the player...Diagnosing Who Needs Hip Replacement <p><a href="https://www.healthchoicesfirst.com/practitioner-type/orthopaedic-surgeon">Orthopaedic Surgeon</a> discusses diagnosis and treatment of hip replacement.</p>
Orthopaedic Surgeon discusses diagnosis and treatment of hip replacement.
Loading the player...Key Decisions of Hip Replacement Surgery <p><a href="https://orthopedics-now.com/local/orthopedic-surgeons">Orthopedic Surgeon</a><a href="https://www.healthchoicesfirst.com/practitioner-type/orthopaedic-surgeon"> </a>discusses diagnosis and treatment of key decisions in hip replacement.</p>
Orthopedic Surgeon discusses diagnosis and treatment of key decisions in hip replacement.
Loading the player...Hip Replacement: Materials for Hip Ball and Socket Surgery <p><a href="https://orthopedics-now.com/local/orthopedic-surgeons">Orthopedic Surgeon</a><a href="https://www.healthchoicesfirst.com/practitioner-type/orthopaedic-surgeon"> </a>discusses the different materials used in a hip ball and socket replacement.</p>
Orthopedic Surgeon discusses the different materials used in a hip ball and socket replacement.
Loading the player...What is Joint Replacement Therapy <p><a href="https://www.healthchoicesfirst.com/practitioner-type/physiotherapist">Physiotherapist,</a> discusses joint replacement therapy.</p>
Physiotherapist, discusses joint replacement therapy.
Hip Pain Caused by Osteoarthritis
Osteoarthritis is indeed one of the most common causes of hip pain in middle-aged individuals. Osteoarthritis is a degenerative joint disease that occurs due to the gradual breakdown and loss of articular cartilage, the smooth and protective covering of the joint surfaces.
The articular cartilage serves as a cushion and helps facilitate smooth movement within the joint. In the case of the hip joint, it covers both the femoral head (the ball-shaped end of the thigh bone) and the socket (acetabulum) in the pelvis. Over time, the cartilage wears away, leading to bone-on-bone contact, inflammation, pain, and stiffness.
Factors such as aging, genetic predisposition, joint overuse or trauma, obesity, and certain anatomical abnormalities can contribute to the development of osteoarthritis in the hip joint. It can cause varying degrees of pain, reduced range of motion, and functional limitations.
It's important for individuals experiencing hip pain to consult with a healthcare professional for an accurate diagnosis and appropriate management options. Treatment may involve a combination of conservative measures such as pain medication, physical therapy, lifestyle modifications, and in some cases, surgical interventions like hip replacement surgery.
An orthopaedic surgeon is a medical specialist who focuses on the diagnosis, treatment, and surgical management of musculoskeletal conditions, including joint disorders like arthritis. They are trained in both surgical and non-surgical methods to address various orthopaedic issues.
When it comes to arthritis and joint conditions, an orthopaedic surgeon may be involved in the following aspects:
Diagnosis: Orthopaedic surgeons can evaluate your symptoms, medical history, and perform physical examinations to diagnose arthritis or other joint-related problems. They may also request imaging tests such as X-rays, MRI scans, or CT scans to further assess the joint damage.
Treatment Options: Depending on the severity of the condition, an orthopaedic surgeon may recommend different treatment approaches. These can include non-surgical interventions such as medication, physical therapy, joint injections (e.g., corticosteroids or hyaluronic acid), and assistive devices (e.g., braces, canes, or orthotics). If conservative treatments do not provide adequate relief, the surgeon may discuss surgical options.
Surgical Interventions: If joint damage is significant and causing severe pain or functional limitations, the orthopaedic surgeon may suggest surgical procedures. Common surgeries for arthritis include joint arthroscopy (to remove damaged tissue or repair minor joint issues), joint replacement (total or partial joint replacement with prosthetic components), or joint fusion (joining bones together to eliminate joint movement and pain).
Postoperative Care: After surgery, orthopaedic surgeons provide postoperative care and guidance. This may involve monitoring the healing process, prescribing pain management strategies, advising on rehabilitation exercises, and outlining precautions or restrictions during the recovery period.
It's worth noting that the specific treatment plan can vary depending on the individual's condition, overall health, and preferences. Consulting with an orthopaedic surgeon will help determine the most appropriate course of action for managing arthritis or joint-related concerns. Remember to verify the information provided by contacting the healthcare providers directly, as network participation and availability can vary over time.
Materials for Hip Ball and Socket Surgery
Traditionally, the bearing surface in hip replacements consisted of a metal femoral head articulating with a polyethylene (plastic) liner in the acetabulum. This combination provided satisfactory results for many patients. However, over time, concerns arose regarding the wear and longevity of the polyethylene liner, as well as the potential for the release of particles that could cause inflammation and tissue damage.
To address these concerns, alternative bearing surfaces were developed, offering different materials for the femoral head and acetabular liner. The goal was to improve the durability and reduce the wear of the implant, thereby potentially increasing its longevity and reducing the risk of complications.
Some of the different options for the bearing surface in hip replacement include:
Metal-on-Polyethylene (MoP): This is the traditional combination, where a metal femoral head articulates with a polyethylene liner. It is still commonly used and can provide satisfactory results for many patients.
Ceramic-on-Polyethylene (CoP): In this combination, a ceramic femoral head articulates with a polyethylene liner. Ceramic is highly resistant to wear and can provide a smoother articulation compared to metal. It is less likely to release particles and cause inflammation.
Metal-on-Metal (MoM): This combination involves a metal femoral head articulating with a metal acetabular cup. MoM bearings were developed to reduce wear, but concerns have been raised regarding the release of metal ions and potential complications related to metallosis (metal particle deposition) and adverse tissue reactions. As a result, the use of MoM bearings has significantly declined in recent years.
Ceramic-on-Ceramic (CoC): This combination involves a ceramic femoral head articulating with a ceramic liner. Ceramic-on-ceramic bearings offer excellent wear resistance and low friction, potentially providing increased longevity and reduced wear debris. They are particularly suitable for younger, more active patients.
The choice of bearing surface depends on various factors, including the patient's age, activity level, and surgeon's preference. Each option has its advantages and potential drawbacks, and the decision should be made after a thorough discussion between the patient and the orthopedic surgeon, considering the patient's specific needs and risks associated with each bearing surface.
Metal on plastic. And over the years, we have learned that plastic can wear with time, and the byproducts of the plastic wear can lead to significant bone loss and failure of the hip joint, leading to fairly catastrophic revisions.In the late 1990s, the old traditional plastics that we were using, which were ultra-high molecular weight polyethylene that was sterilized using gamma radiation and air, were replaced with what’s now called highly cross-linked polyethylene. And the vast majority of patients in North America now would get this highly cross-linked polyethylene.
What we have learned over the past decade is that the newer highly cross-linked polyethylene wears much, much less than the previous generations of plastic. And now we are no longer seeing the catastrophic wear and the catastrophic failures that we were seeing 15 and 20 years ago.And that has been very, very encouraging. And ceramic on ceramics were also an alternative to metal on plastic because of the older problems with wear of the plastic. With more current data, up to 10 years, the failure rate of ceramic on ceramic and metal on plastic is exactly the same.
However, some surgeons still recommend ceramic on ceramic for very young patients because of the potential less wear at 20, 30 and 40 years. So for really young patients, it may be an attractive option, although there is no evidence to support that it is better than metal on plastic. Often getting a referral from your local family phyisican, doctor to a orthopedic surgeon or physiotherapists is often wher you strt with hip pain.
There are two potential complications with ceramic on ceramic that are not present with metal on plastic. They’re rare, but they can happen. And that’s squeaking, so audible squeaking that can be quite bothersome in rare events.And also very rarely, the ceramics can fracture and need a revision. They’re rare events, but they can still happen. And this is why the standard of care in North America remains metal on plastic.