Total and Partial Hip Replacement

Total and Partial Hip Replacement

About Hip Replacement

Hip replacement is a very common type of surgical procedure in which a damaged hip is replaced by a prosthesis (an artificial hip). The procedure is usually conducted to relieve pain caused by arthritis or correct fractures. Usually, hip replacements are done when all other forms of treatment have failed to reduce pain thus limiting one’s ability to perform daily routines and chores. There are two types of hip replacement procedures depending on the extent anatomical portions of the joint need to be removed and replaced. These are total hip replacement and partial hip replacement.

Relevant Anatomy

To understand how the procedure is conducted, it is imperative that one understands the functional anatomy of the hip joint. The hip joint is one of the largest joints in the body. It is a ball and socket joint consisting of a socket formed by the bony pelvis and a ball which is the femoral joint. These are surrounded by a synovial membrane. The bony surfaces are covered by a cartilage which cushions the bones allowing them to move smoothly as the range of movement changes. Within the joint is a small amount of synovial fluid that provides lubrication.

Conditions that result in wear and tear of the articular cartilages lead to chronic pain and disability. A common culprit for this is arthritis especially the osteoarthritis and rheumatoid arthritis. These are the common conditions that necessitate the need for hip replacements. Others include avascular necrosis of the femoral head due to trauma and childhood hip disease.

How is the procedure performed?

As stated, there are two types of hip replacement procedures. Total hip replacement involves the substituting a prosthetic implant for the acetabulum and the femoral head while partial replacement involves the replacement of only the femoral head.

Basically, a surgeon makes an incision along the side of the hip and the muscles surrounding the joint are separated to expose the bone. The surgeon then removes the head of the femoral bone by cutting through it using a saw. It is then replaced by a metallic stem that is placed on the hollow centre of the femur. A ceramic ball is attached to the upper part of the stem and used in place of the damaged femoral head. Depending on whether the procedure is total or partial, the acetabulum is removed and cement or screws are used to hold the socket.

Who will benefit from a hip replacement?

Hip replacement is a common procedure and can be conducted on any person depending on the degree of disability caused by the underlying condition. There is no age or weight limit for hip replacement. However, most people who undergo the procedure are between 50-80 years old. This is because of the increased predisposition in this population to conditions such as arthritis.

Preparing for the surgery

Before the day of operation, your doctor will want to take a medical history and perform a complete physical examination. It is important that you provide  details including any underlying illnesses from which you may be suffering and any current medications.

There are several medical tests you will undergo such as a “complete blood count” (CBC) which will involve drawing of blood, plus a urinalysis and possibly an electrocardiogram.

Sometimes, surgeons will recommend that you donate blood to  be stored and then used if needed during your operation.

Some problems affecting the hip joint are caused by excess weight. Accordingly, prior to surgery, the surgeon may ask you to lose some weight to lower the stress that will be put on the hip joint.