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Hip prosthesis

Osteoarthritis and arthritis in the hip are the main causes of hip replacement

Osteoarthritis and arthritis in the hip are the main causes of hip replacement. Both conditions cause wear and tear on the joint cartilage that covers the head of the femur. This, in turn, causes pain and lack of mobility in the affected area. In the early stages, these symptoms are usually treated with pain relief medication, but in more advanced stages, surgery is necessary to ensure the patient has an optimal quality of life.

In most cases, patients who undergo hip replacement (hip arthroplasty) are over 50 years of age, but it is increasingly common to find younger patients.

What symptoms does the patient have?
Patients who undergo hip replacement suffer from pain in the affected area, which can prevent them from regularly participating in sports or even walking continuously or climbing stairs.

They also tend to suffer from reduced hip mobility, which can prevent them from performing ordinary activities such as tying their shoelaces.
What diagnostic tests are necessary?
During your consultation, the specialist will examine you and ask you a series of questions to determine the degree of pain and mobility. To confirm the diagnosis and the level of wear and tear on the hip, you may request X-rays.

The specialist may also request other tests to check whether the osteoarthritis has occurred as a result of a previous condition.
Is surgery always necessary?
In advanced stages, hip replacement surgery is the most appropriate treatment. In hip conditions prior to the onset of osteoarthritis, and depending on each patient, it is possible to perform arthroscopy, a minimally invasive technique that allows the cartilage to be cleaned or predisposing factors to be corrected, in order to delay the placement of a prosthesis.
What types of prosthetic replacements can be performed, and what materials are they made of?
- Surface prosthesis. These are procedures in which the femoral head and the acetabulum (hip socket or concave part of the pelvic surface) are replaced and covered with metal material (metal-on-metal surface prosthesis). This type of prosthesis is usually fitted in men under 70 and women under 60, as it involves preserving the bone, resulting in better patient recovery, a lower risk of dislocation and more durable material. In the event of deterioration or fracture of the femur bone, it can be replaced with a full prosthesis.
  
  Full prostheses (conventional). These are procedures to replace the femoral head and neck, and also the acetabulum. Normally, the femoral neck is replaced by a titanium piece (stem) inserted into the femur, measuring between 10 and 15 centimetres, with or without cement. The friction surfaces of total prostheses, where movement occurs between the head and the acetabulum, can be made of metal, ceramic or oxinium against polyethylene (plastic), or ceramic against ceramic, depending on the patient's age, needs and expectations for physical activity. Current materials have a lower risk of breakage, allow for greater hip stability, and experience less wear and tear.
How is the surgery performed?
The surgery is performed under general or epidural anaesthesia. The surgeon makes an incision to access the area and replace the acetabulum, the femoral head, and, if necessary, the femoral neck. Several surgeons at Centro Médico Teknon perform this surgery with the assistance of a navigator, enabling precise placement of the implant, which not only reduces the risk of possible complications associated with this surgery, such as dislocation, but also increases the longevity of the implants.

The minimally invasive surgical techniques currently in use also mean that the average stay in hospital is only four days, blood transfusions are rarely needed, and recovery is quicker and less painful. In fact, after 48 hours, most patients control their pain with paracetamol and a conventional anti-inflammatory drug.
How long does a prosthesis last?
The materials currently used in hip replacement allow for mobility very similar to that of the original joint, depending not so much on the implant, but rather on the degree of previous mobility and subsequent rehabilitation. Although prostheses have a limited lifespan, current materials are increasingly resistant, meaning that prostheses can last more than 15 or 20 years, even when subjected to regular physical activity. Therefore, it will not always be necessary to replace the prosthesis in the future.
When can you return to your normal routine?
A patient will normally need a pair of crutches for the first 2 to 4 weeks after the operation, then a single crutch for a further 2 to 4 weeks, attending mandatory check-ups whenever indicated by the specialist. It may also be necessary to perform rehabilitation exercises to regain maximum mobility, with or without the help of a physiotherapist.

After one year, check-ups will begin to be annual or biannual, depending on the specialist's instructions.

Hip prosthesis

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