Our Summary

This research paper discusses posttraumatic arthritis, which is a type of arthritis that occurs after an injury, and can contribute significantly to the development of osteoarthritis in the hip joint. The paper suggests that performing a total hip replacement surgery for posttraumatic arthritis is more challenging than doing so for primary osteoarthritis or inflammatory arthritis. This is due to the presence of bone deformities and retained implants, which complicate the procedure.

Before the surgery, careful planning is needed to decide on the surgical approach, how to remove any existing hardware, and which implants are needed to replace any missing bone.

While hip replacement is generally a successful treatment for posttraumatic arthritis, the results are usually not as good as those seen in surgery for primary osteoarthritis. Additionally, the procedure carries a higher risk of both during surgery and post-surgery complications. These can include fractures around the implant, infection, instability of the joint, and a lower chance of the implant lasting as long as expected.

FAQs

  1. What is posttraumatic arthritis and how does it relate to hip replacement surgeries?
  2. What are the technical challenges when performing total hip arthroplasty for posttraumatic arthritis?
  3. What are the potential complications of arthroplasty for posttraumatic arthritis compared to surgery for primary osteoarthritis?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hip replacement for posttraumatic arthritis is to follow a thorough preoperative evaluation to prepare for any bone deformities and retained implants. This evaluation will help the surgeon determine the best approach, hardware removal strategy, and implants needed to address any bone deficiencies. Additionally, it is important for the patient to be aware that hip replacement for posttraumatic arthritis may have a higher risk of complications compared to surgery for primary osteoarthritis, including periprosthetic fractures, infection, instability, and decreased survivorship. It is important for the patient to follow postoperative instructions carefully and attend follow-up appointments to monitor their recovery and address any concerns.

Suitable For

Patients who are typically recommended for hip replacement surgery for posttraumatic arthritis include those with severe pain, limited mobility, and decreased quality of life due to their hip condition. These patients may have a history of trauma to the hip joint, such as a fracture or dislocation, that has led to the development of arthritis. They may also have deformities in the hip joint or retained implants from previous surgeries that make the procedure more challenging.

It is important for these patients to undergo a thorough preoperative evaluation to assess the extent of bone deformities, bone deficiencies, and other factors that may affect the success of the surgery. The surgeon will need to carefully plan the approach, hardware removal strategy, and implants to address these issues and ensure the best possible outcome for the patient.

While total hip arthroplasty is a highly successful procedure for posttraumatic arthritis, it is associated with a higher risk of complications compared to surgery for primary osteoarthritis. These complications can include periprosthetic fractures, infection, instability, and decreased survivorship of the implants. Despite these risks, hip replacement surgery can provide significant pain relief and improved function for patients with posttraumatic arthritis, ultimately leading to a better quality of life.

Timeline

  • Patient experiences hip pain and stiffness, often as a result of posttraumatic arthritis
  • Consultation with an orthopedic surgeon to discuss treatment options, including hip replacement surgery
  • Preoperative evaluation and planning, which may include imaging tests and medical clearance
  • Surgery to remove damaged bone and cartilage and replace with artificial components
  • Postoperative recovery period, including physical therapy and pain management
  • Gradual improvement in hip function and reduction in pain over time
  • Potential long-term complications such as periprosthetic fractures, infection, and implant instability
  • Regular follow-up appointments with the surgeon to monitor the hip replacement and address any issues that may arise.

What to Ask Your Doctor

  1. What is the specific reason for recommending a hip replacement for my posttraumatic arthritis?
  2. What are the potential risks and complications associated with hip replacement surgery for posttraumatic arthritis?
  3. How will my bone deformities and retained implants from previous injuries affect the hip replacement surgery?
  4. What is the expected recovery time and rehabilitation process following hip replacement surgery for posttraumatic arthritis?
  5. Will I need any additional procedures, such as hardware removal, prior to the hip replacement surgery?
  6. What type of implants will be used for my hip replacement, and how will they address any bone deficiencies?
  7. What are the expected outcomes and success rates for hip replacement surgery for posttraumatic arthritis compared to other types of arthritis?
  8. How long can I expect the hip replacement to last, and what factors may affect its longevity?
  9. Are there any specific lifestyle modifications or precautions I should take after hip replacement surgery for posttraumatic arthritis?
  10. Are there any alternative treatment options or conservative measures that I should consider before proceeding with hip replacement surgery?

Reference

Authors: Lu M, Phillips D. Journal: J Am Acad Orthop Surg. 2019 Apr 15;27(8):275-285. doi: 10.5435/JAAOS-D-17-00775. PMID: 30289797