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What is total
An arthritic or damaged hip joint is removed and replaced with an artificial joint called a hip prosthesis.
What is a joint?
The ends of two or more bones that are connected by thick tissues form a joint. Your hip is a ball and socket joint, formed by the upper-end of the femur, the ball, and a part of the pelvis called the acetabulum, the socket.
The bone ends of a joint are covered with a smooth layer called cartilage. Normal cartilage allows nearly frictionless and pain-free movement. However, when the cartilage is damaged or diseased by arthritis, joints become stiff and painful. A fibrous tissue envelope or capsule encloses every joint with a smooth tissue lining called the synovium. The synovium produces fluids that reduce friction and wear in a joint.
Why is total joint replacement necessary?
The goal is to relieve the pain in the joint caused by the damage done to the cartilage. The pain may be so severe, a person will avoid using the joint, weakening the muscles around the joint and making it even more difficult to move the joint. A physical examination, possibly some laboratory tests and X-rays will show the extent of damage to the joint. Total joint replacement will be considered if other treatment options will not relieve the pain and disability.
How is total joint replacement performed?
Under anesthesia the surgeon will replace the damaged parts of the joint. In an arthritic hip, the damaged ball (the upper-end of the femur) is replaced by a metal ball attached to a metal stem fitted into the femur, and a plastic and metal socket is implanted into the pelvis replacing the damaged socket.
The materials used in a total joint replacement are designed to enable the joint to move just like a normal joint. The prosthesis is generally composed of two parts: a metal femur piece that fits closely into a matching sturdy plastic and metal pelvis piece. Several metals are used including stainless steel, alloys of cobalt, chrome, titanium and ceramic. The plastic material (polyethylene) is durable and resistant to wear. Plastic bone cement may be used to anchor the prosthesis into the bone. Joint replacements also can be implanted without cement when the prosthesis and the bone are designed to fit and lock together directly. This type of surgery generally takes between two and three hours.
Is total joint replacement permanent?
Most people can expect their total joint replacement to last 15 years or more. It will give years of pain-free living that would not have been possible otherwise. Younger joint replacement patients may need a secondary surgery at some point. Materials and surgical techniques are improving through the efforts of orthopedists working with engineers and other scientists. Total joint replacements can improve quality of life through greater independence and healthier pain-free activity.
What to expect from hip replacement surgery
The vast majority of individuals who undergo hip replacement surgery experience a dramatic reduction of hip pain and a significant improvement in their ability to perform the common activities of daily living. However, hip replacement surgery will not enable you to do more than you could before your hip problem developed.
Following surgery, you will be advised to avoid certain activities for the rest of your life including jogging and high-impact sports.
Even with normal use and activities, an artificial joint (prosthesis) develops some wear over time. If you participate in high-impact activities such as running, tennis and basketball or are over-weight, this wear may accelerate and cause the prosthesis to loosen and become painful.
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