Our Summary

This research paper focuses on the topic of total hip arthroplasty (THA) - a type of surgery where a damaged hip joint is replaced with an artificial one. Specifically, the paper looks at the use of cement in these surgeries, something that is not as common in Japan as it is in other countries.

The paper reviews the history of THA and how it is currently performed around the world. It then weighs the pros and cons of using cement in these surgeries. Some of the advantages include a more secure fitting of the artificial hip, a wider range of options for the stem (the part inserted into the thigh bone), the ability to include antibiotics in the cement to prevent infection, a lower risk of the artificial hip needing to be replaced, and a lower risk of fractures around the artificial joint. In fact, for patients over 75, the use of cement resulted in the lowest risk of needing a revision surgery.

The paper also notes that guidelines in many countries recommend the use of cement in these surgeries, particularly in half-joint replacements (hemiarthroplasty). However, the authors point out that in Japan, there are some contradictions regarding the cost of implants and surgeries, which may be why cement is less commonly used. The authors argue that it’s necessary to reconsider these issues for the benefit of the patients.

FAQs

  1. What are some advantages of cemented total hip arthroplasty (THA)?
  2. What is the current trend in Japan regarding cemented THA and hemiarthroplasty procedures?
  3. Why is cemented THA more recommended for patients older than 75 years of age?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hip replacement is to carefully follow the post-operative instructions provided by their healthcare team. This may include physical therapy exercises, restrictions on certain activities, and proper wound care. By following these instructions, patients can help ensure a successful recovery and long-term success of their hip replacement surgery.

Suitable For

Patients who are typically recommended for hip replacement surgery include those with severe arthritis, hip fractures, avascular necrosis, and other conditions that cause significant pain, limited mobility, and decreased quality of life. It is important to consider the age of the patient, their overall health, and their activity level when deciding on the most appropriate type of hip replacement surgery, whether it be cemented or uncemented. Additionally, patients with certain medical conditions such as osteoporosis or a history of previous hip surgery may benefit from cemented THA due to its potential advantages in stability and longevity. Ultimately, the decision on the type of hip replacement surgery should be based on individual patient factors and discussions with their healthcare provider.

Timeline

Before hip replacement:

  • Patient experiences hip pain and stiffness, decreased range of motion, and difficulty walking or performing daily activities.
  • Patient consults with a doctor or orthopedic surgeon who recommends hip replacement surgery.
  • Pre-operative appointments and tests are conducted to assess the patient’s overall health and readiness for surgery.
  • Patient may undergo physical therapy or pain management treatments before surgery to improve strength and mobility.

After hip replacement:

  • Patient undergoes cemented total hip arthroplasty (THA) surgery, where the damaged hip joint is replaced with artificial components made of metal, plastic, or ceramic.
  • Patient stays in the hospital for a few days for monitoring and rehabilitation.
  • Patient undergoes physical therapy and rehabilitation to regain strength, mobility, and function in the hip joint.
  • Patient follows post-operative care instructions, including medication management, wound care, and activity restrictions.
  • Patient gradually resumes normal activities and experiences improved hip function and reduced pain.
  • Patient may require follow-up appointments with the doctor or physical therapist to monitor progress and address any concerns.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with cemented total hip arthroplasty?

  2. How long does the recovery process typically take after a cemented total hip arthroplasty?

  3. How long can I expect the implant to last before needing a revision surgery?

  4. Are there any restrictions or limitations on activities I should be aware of after having a cemented total hip arthroplasty?

  5. What type of physical therapy or rehabilitation will be necessary after the surgery?

  6. How experienced are you in performing cemented total hip arthroplasty procedures?

  7. What alternatives to cemented total hip arthroplasty are available and what are the differences in outcomes?

  8. How will the cost of the surgery and rehabilitation be covered by insurance or other payment options?

  9. Are there any specific factors or conditions that would make me a better or worse candidate for cemented total hip arthroplasty?

  10. What is the success rate of cemented total hip arthroplasty compared to other types of hip replacement surgeries?

Reference

Authors: Oe K, Iida H, Saito T. Journal: Expert Rev Med Devices. 2025 Jan;22(1):31-48. doi: 10.1080/17434440.2024.2448741. Epub 2025 Jan 2. PMID: 39748157