Artificial Hip Joint Replacement for Arthritis
Arthroplasty Can Relieve Joint Pain and Restore Independence
Sep 5, 2009
The hip is a ball-and-socket joint in which the roughly spherical top of the thighbone (femur) is able to rotate freely within a cup-shaped socket in the pelvis. This freedom of movement can be severely limited by osteoarthritis of the hip, with accompanying pain, stiffness and loss of mobility. Artificial hip replacement (also known as ‘hip arthroplasty’) plays an important role in the management of this debilitating condition.
How Does Arthritis Damage the Hip Joint?
Most people develop some degree of osteoarthritis as they age. Weakening of the cartilage that lines the joints leads to inflammation and changes in the ends of the bones that cause stiffness and pain. In younger people, osteoarthritis may occur following a joint injury or infection, or as a result of obesity.
In an elderly person, osteoarthritis of the hip can severely impact quality of life. Hip pain and swelling can make everyday activities such as driving, shopping and socializing impossible. People with severe arthritis can become isolated and rapidly lose their independence, with all the psychological problems that brings. When other treatments such as painkillers have failed, a hip replacement can reverse these problems, allowing the patient to return to a more normal life.
Other reasons for hip replacement surgery include rheumatoid arthritis (when the body’s own immune system attacks the cartilage), bone tumours and injuries to the joint.
In younger people, a hip prosthesis is unlikely to last a lifetime, and other forms of treatment are often preferred.
Types of Artificial Hip Prosthesis
Dozens of different types of hip implant have been developed over the years, though in practice each surgeon uses only a small range with which he or she is familiar. Modern hip joint replacements comprise a polyethylene or ceramic socket and a titanium, metal alloy or ceramic ball attached to a titanium shaft.
The prosthetic parts may be cemented into the bone using an acrylic compound, or may be designed to hold in place without cement.
Hip Replacement Procedure
Hip surgery is one of the most common procedures performed by orthopaedic surgeons. In the UK alone, more than 50,000 total hip replacements are implanted each year. Hip arthroplasty is performed with a general anaesthetic, or using an epidural anaesthetic that numbs the body from the waist down.
- In a total hip replacement, the surgeon removes the cartilage from the natural cup in the hip and fits the artificial socket in its place. The top of the femur is then cut off and the bone hollowed out to fit the metal shaft.
- In a metal-on-metal hip replacement or hip joint resurfacing procedure, only the surfaces of the joint are replaced, so much less bone is removed.
- Minimally invasive hip replacement surgery uses the standard types of prosthesis, but these are implanted through smaller incisions that allow a quicker recovery. This is a new technique and the long-term results have yet to be fully evaluated.
After Hip Replacement Surgery
Patients usually stay in hospital for seven to ten days following a hip replacement procedure. A physiotherapist and/or occupational therapist may be helpful with returning to normal activities and identifying any special equipment that may aid daily life. Regular follow-up appointments are needed to check for any problems, particularly loosening of the prosthesis, which can sometimes require further surgery.
References
American Academy of Orthopaedic Surgeons. Joint Replacement. Accessed 05-09-09
Bulstrode CJK. The Pelvis and Lower Limb. In: Russell RCG et al., eds. Bailey & Love’s Short Practice of Surgery. 23rd ed. London: Arnold, 2000: 363–400.
Hassett G, Spector TD. Osteoarthritis. Medicine 2002; 30(8): 40–3.
NHS Choices. Hip Replacement. Accessed 05-09-09
Disclaimer
The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
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