Hip replacement surgery

If your doctor has recommended a hip replacement surgery for you, this summary will help you with all the information including the necessary preparation, the complete procedure and the post-operative things to do.

Today prosthetics is the most successful intervention in modern medicine. Hip replacement surgery can result a full and painfree movement of the patient’s hip.

The hip joint is one of the most flexible joints of the body.

It is a ball-and-socket synovial joint formed between the hip bone and the femur. A round, cup-shaped structure on the hip bone, known as the acetabulum, forms the socket for the hip joint.

The head of the femur forms the ball of the joint. Hyaline cartilage, that acts as a shock absorber, lines both the acetabulum and the head of the femur, providing a smooth surface for the moving bones to glide past each other. It’s function is to prevent the collision of the bones during its movement.

The synovial membranes that are situated between the layers of hyaline cartilage, secrete the synovial fluid in order to lubricate the joint capsule.

Hip replacement surgery may be required in the following cases:

• Osteoarthritis that is commonly known as wear-and-tear arthritis. It damages the slick cartilage that covers the ends of bones and helps joints move smoothly.
• Rheumatoid arthritis that is caused by the over-functioning immune system. It results inflammation that can erode cartilage and occasionally underlying bone, that can causes damaged and deformed joints.

• Osteonecrosis. If the blood supply to the ball portion of the hip joint, is not adequate, the bone may collapse and deform.
• In case of femoral neck fracture, or femoral head fracture
• In case of femoral head necrosis
• After major accidents, when the articular cavity or the femoral head is affected.

1. During the hip replacement surgery, after opening the hip joint, the ortopedic surgeon removes the femoral head and prepares the bone surface of the gambrel to insert the gambrel part of the prosthesis (plastic component for cemented prosthesis, metal component plus plastic insert for non-cemented prosthesis)

2. After stabilizing the articular cavity. the surgeon prepares the cavum pulpa of the tighbone for the prosthetic shaft that is made of metal.

3. The prosthetic shaft can be fixed with or without bone cement. At the end of the procedure, a metal ball is placed on the upper end of the prosthetic leg component.

4. The metal ball sits inside the plastic part of the cavity component, creating a new, painlessly movable joint.

• It is necessary to undergo a few tests and examinations such as laboratory and urine tests, anesthetic examination, and if necessary internal medicine review examination and other consultation indicated by the anaesthesist.
• In most cases, our patients also have the option of autotransfusion. It means that the patient’s own blood is drawn before the surgery, so if anemia is detected during the post-operative period, the patient will have his/her previous blood taken back.
• If the operation can be performed on the basis of the examination results, the patient will be admitted to our ward the day before the surgery, where after the vein insertion, the blood required for the surgery, will be provided.
• Light dinner can be taken before surgery, but fluid is not allowed from midnight.
• At Medicover, prosthetic surgeries are performed under antibiotic protection.

The day after surgery, the patient can stand up and start physiotherapy with the help of a physiotherapist. With the permission of the surgeon, the operated limb can be used with total weight (gross load).

The total stay at our hospital is 5 days. Suture removal can be done 10-14 days after surgery.

During the first 3 months after surgery, certain movements (clenching knees, leaning deep, sitting with crossed legs) cannot be performed. Both, the ortopedic surgeon and the physiotherapist draw the patient’s attention to these rules.

After hospital stay, the post-treatment (rehabilitation) can be done in Visegrád. It is essential to perform the prescribed exercises at home too for full recovery.

During the 6 week period after surgery, we recommend the use of thrombosis prophylaxis for 30 days and compression socks for the lower limbs.

Control examinations are performed at the 6th week, the 3rd month and 6th month after surgery and anually thereafter.

Benefits

After surgery, the patient’s hip joint movement is complete and painless. After the operation, the patient can do sports (some movement types are exceptions) and live a full life again

Risks

The risks of the hip replacement surgery may include:

• Blood clots
• Infection
• Fracture
• Dislocation
• Change in leg length
• Loosening of joint replacement components over time

Your surgeon will discuss the possible complications with you before your surgery.

On the basis of the preliminary examinations and the consultation with an anesthesiologist your doctor will decide whether the surgery can be performed.