Our Summary

This paper discusses total hip arthroplasty (THA), a surgical procedure where a damaged hip joint is replaced with an artificial one. This procedure is usually very successful, but there can be challenges when dealing with unusual conditions such as rare diseases, unusual anatomy, or previous injuries.

The paper looks at several of these challenging conditions, including developmental hip dysplasia (a condition where the hip joint doesn’t form properly), osteopetrosis (a disease that makes bones abnormally dense and brittle), skeletal dysplasia (a group of disorders that affect bone and cartilage growth), Paget’s disease (a condition that interferes with your body’s normal bone recycling process), and extraarticular deformities (abnormalities outside the joint area).

The authors discuss the different factors that need to be considered in these complex cases, such as the type of implant used, what to watch out for during the operation, and what to think about after the operation. By carefully planning and considering these factors, the authors hope to reduce the risk of complications while still meeting the patient’s expectations for a well-functioning, pain-free hip.

FAQs

  1. What are some challenging conditions that can affect total hip arthroplasty?
  2. How can the type of implant used in a hip replacement surgery impact the success of the procedure?
  3. What are some considerations for post-operative care in complex hip replacement cases?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hip replacement is to follow the post-operative instructions carefully. This may include physical therapy exercises, restrictions on weight-bearing activities, and taking medications as prescribed. By following these instructions, the patient can help ensure a successful recovery and minimize the risk of complications. It’s also important to attend follow-up appointments with your healthcare provider to monitor your progress and address any concerns that may arise.

Suitable For

Patients who are typically recommended for hip replacement surgery include those who have severe hip pain that limits their daily activities, have significant hip joint damage due to conditions such as osteoarthritis, rheumatoid arthritis, or avascular necrosis, have not had success with non-surgical treatments such as medications, physical therapy, or injections, and have a good overall health status and are able to tolerate the surgery and rehabilitation process.

In cases of challenging conditions such as developmental hip dysplasia, osteopetrosis, skeletal dysplasia, Paget’s disease, or extraarticular deformities, patients may still be candidates for hip replacement surgery, but additional considerations and planning may be necessary to ensure a successful outcome. It is important for patients with these conditions to work closely with their healthcare team to determine the best course of treatment and to address any potential challenges that may arise during the surgical process.

Overall, hip replacement surgery can be a highly effective treatment option for patients with severe hip joint damage and pain, and with careful planning and consideration of individual patient factors, even those with complex conditions can benefit from this procedure.

Timeline

Before hip replacement:

  1. Patient experiences chronic hip pain, stiffness, and limited mobility.
  2. Patient consults with orthopedic surgeon to discuss treatment options.
  3. Surgeon evaluates patient’s hip joint through physical examination, imaging tests, and medical history.
  4. Surgeon recommends total hip arthroplasty as the best treatment option.
  5. Patient undergoes pre-operative tests and preparation for surgery.

After hip replacement:

  1. Patient undergoes total hip arthroplasty surgery to replace damaged hip joint with an artificial one.
  2. Patient stays in the hospital for a few days for monitoring and rehabilitation.
  3. Patient follows a post-operative care plan, including physical therapy and medication management.
  4. Patient gradually regains strength, flexibility, and mobility in the hip joint.
  5. Patient experiences reduced pain and improved quality of life.
  6. Patient follows up with surgeon for regular check-ups and monitoring of hip joint function.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hip replacement include:

  1. What is the reason for recommending a hip replacement?
  2. What are the potential risks and complications associated with the surgery?
  3. What type of implant will be used and why?
  4. What should I expect during the recovery process?
  5. How long will the replacement hip last?
  6. What activities should I avoid after the surgery?
  7. Will I need physical therapy after the surgery?
  8. Are there any specific precautions I should take to prevent complications?
  9. What are the signs of infection or other post-operative complications that I should watch for?
  10. How can I best prepare myself for the surgery and recovery process?

Reference

Authors: Staats K, Kubista B, Windhager R. Journal: Z Orthop Unfall. 2019 Aug;157(4):445-460. doi: 10.1055/a-0736-3649. Epub 2019 Aug 17. PMID: 31421652