TOTAL HIP REPLACEMENT: A BRIEF HISTORY

IVORY AND GLASS HIP REPLACEMENT

The modern era of Total Hip Replacement began in the 1960’s, however you might be surprised to learn that the first attempts at hip replacement began in the 1890’s in Germany. In this operation ivory was used to replace the femoral head in patients with Tuberculosis.

During the 1920’s moulded glass was used as a bearing surface, but not surprisingly, this device failed due to the brittleness of the device.

METAL ON METAL HIP REPLACEMENTS

In the 1950’s surgeons from England made a total hip replacement which looks more like the modern day implant. This was invented by George McKee and was a metal on metal bearing surface. The survival rate for this total hip replacement was much better than its predecessors and encouraged the growth of the technology.

Around the same time, French surgeons were experimenting with acrylic femoral head replacements. These devices did not last well in the bone and loosened early.

MODERN ERA OF HIP REPLACEMENT

The modern era of total hip replacement began in the 1960’s when English surgeon Sir John Charnley developed his “Low friction arthroplasty” which consisted of a metal femoral stem and a polyethylene acetabular cup which were seated in the bone using acrylic bone cement. The success of this implant established a gold standard in hip replacement by which newer devices are judged.

Interested surgeons from all over the world visited Charnley’s hospital in Wrightington, England and brought the knowhow home with them. Surgeons in Australia imported his techniques and began hip replacement surgeries in Sydney in the early 1970’s. Since then countless numbers of patients have benefitted from the steady progression of technology, surgical technique and pain management.

TECHNOLOGY DELIVERS BETTER OUTCOMES

The progression of technology has focused on two main areas. The most important is the development of durable bearing surfaces. In Charnley’s total hip replacement, the wear particles generated could cause failure of the device within 10-15 years, especially in younger patients. These days improved biomaterials such as advanced ceramics, cross linked ultra-high molecular weight polyethylene (UHMWPE) can deliver a hip replacement that will last for decades.

The other area of technological development is the removal of cement from the construct. Today many modern hip replacements are placed in the bone without cement. The surrounding bone grows onto the complex roughened implant surfaces to secure the implant for decades. This not only saves time during surgery, but also reduces the rare risk of an allergic type response to the bone cement. 

Ceramic and polyethylene options with uncemented cup.

HIP REPLACEMENT TODAY

Total Hip replacement is now a durable, safe and cost effective procedure which restores mobility and function for patients as young as twenty or as old as ninety. 

Revolutionary Treatment For Total Hip Replacement Surgery

The Improvements made, since ivory was used in 1891 to replace the femoral heads of patients, have been numerous. Skin and other tissues, glass and then stainless steel, have all been used to replace degraded joint surfaces, in an attempt to make the movement of the hip joint smooth and pain-free.

In the 1960's Sir John Charnley, designed what he called a 'low friction arthroplasty', which was in principle the same as the prostheses used today. His prosthesis came in three parts; a metal femoral stem, a polyethylene acetabular cup, fixed with acrylic bone cement. The feature of 'low friction', Charnley managed to achieve by the smaller surface area of his femoral head design.

One of the great surgical advances over the last century is the total hip replacement. Total hip replacement revolutionised the treatment of hip ailments and is today one of the most successful, safe and reliable orthopaedic interventions in practice. 

Hip Replacement Recovery

In large part, the pace and quality of your recovery post a total hip replacement is down to how well you follow the advice given by your surgeon. The first weeks after an operation are crucial to the success of your recovery and the advice you are given should be followed.

Sometimes feeling well can put you in a state of mind where you are less likely to be cautious. This can lead to unnecessary accidents and setbacks, but equally, being too cautious can limit the return of your flexibility and your capacity for activity overall. Provided you are not taking risks the exercises should be done routinely even if you are feeling a little unwell.

There are many aspects to your homecare regimen. The first concern of hip replacement recovery is taking care of the healing process of the incision site. Usually, at around two weeks the stitches or staples will be removed. During this first fortnight, it is very important to keep the area dry at all times. Special waterproof patches can be bought, partners or relatives can help, or you can organise general homecare assistance.

Some people overlook that during their hip replacement recovery they might experience a loss of appetite. This reaction can last several weeks into the recovery process and if not countered can contribute to poorer recovery rates. The main reason is that a good diet promotes the healing process and will restore muscle strength. Often the loss of muscle strength is a contributing factor to any unwillingness to perform the necessary exercises crucial to regaining mobility. Iron supplements are also recommended.

The exercises you are assigned to do during your hip replacement recovery are particularly important. For the first few weeks post surgery, the care and regularity of your exercises will contribute to its overall success.

Normally, patients will have a customised exercise routine recommended by their doctor, but some of the more common exercises are:

• A graduated walking program to slowly increase mobility

• Slowly taking on normal household activities; like sitting, standing, and climbing stairs

• Tailored exercises several times a day.

These exercises restore movement and strengthen your hip. A lot of people opt for the services of a physical therapist. They can assist you at home for the first few weeks after surgery, or there is also the option of choosing the services of a therapy center instead. In fact, the role of rehabilitation centers in a patients hip replacement recovery can be instrumental, in the rate of recovery and the patients proper understanding of the ‘do’s and don’ts’ of the recovery process.

The standard resumption of light daily duties usually takes anywhere in between 3-6 weeks, with the possibility of discomfort during activity and at night.

Understanding Total Hip Replacement Surgery

A procedure in which the damaged or broken hip parts or areas are replaced with synthetic and artificial materials with durable and smooth substance to help make joints work properly is called hip replacement. To know what type of surgery is needed, the person that will undergo replacement should be examined by orthopedic surgeon. Nowadays, one of the most effective solutions to recuperate damaged hip due to arthritis or injury is hip replacement surgery.

Understanding Partial and Total Hip Replacement

Understanding hip replacement is important to be able to prepare for the surgery. First, we need to understand the difference between partial and total hip replacement. Now, both partial and total replacement will need a replacement in certain or all areas of the hip. In partial hip replacement, only half of the hip joint needs replacement. This occurs once the ball of the femur gets worn-out hence limiting movement and motion of the leg and creating ache and discomfort while walking. Total hip replacement, however, uses a synthetic joint in order to replace whole damaged hip framework. The process is similar to the partial replacement surgery, just this point the socket is replaced as well with synthetic. 

Some Preparations You Can Do Before Undergoing Hip Replacement Surgery

Oftentimes, when you have made a decision to go for hip replacement surgery, you’ll be given a full physical examination by the GP to make sure you are generally in good health and sufficient to undergo the surgery and find out regardless of whether you have conditions or problems which may affect the procedure or even your healing. Other tests you need to go through like a chest x-ray, cardiogram, and urine and blood samples. If you are taking any medicine, it is important that you let your GP know about this so that they can give you advice prior to the surgery.

It's good to donate blood prior to surgery.  You may need blood while in or following the surgery. Moreover, overweight may increase risks of surgery and will put more force on your artificial joint which could affect to your recovery. Have a dental check-up prior to the surgery. Even regular teeth’s cleaning isn’t recommended for a few months following the surgery. Finally, your skin must not have problems or bacterial infections when you go through surgery. Consult your GP to get a treatment if you are experiencing any of these.

In conclusion, it is important to understand what the hip replacement surgery can affect you. Hip replacement surgery won't allow you to perform greater than was doable before. After the surgery, it is strongly recommended that you refrain from certain actions and high-impact sports such as jogging, basketball or cycling. You should also need to avoid particular posture of hip joint that could result in dislocation.

Hip replacement surgery has become an excellent and efficient treatment to repair hip injury. It is important to consider your alternatives by consulting with your GP so that you could be sure if this procedure suits your current condition.

When to Consider Hip Replacement Surgery?

If you suffer from osteoarthritis, rheumatoid or septic arthritis, or you have Paget's disease or hip dysplasia, you may experience significant hip pain and reduced movement, which is often significant enough to affect your day-to-day life. While non-surgical treatments, such as medications, physiotherapy and lifestyle changes, are available and can offer some success, these are not always sufficiently effective to relieve pain and improve your functional ability. In these instances, a hip replacement also termed a hip arthroplasty is usually recommended to restore your mobility and quality of life. With a variety of centers in the capital offering surgery to replace a damaged hip joint with an artificial prosthesis, it is important that you do your research before choosing a clinic for your surgery. Choosing a surgeon with expertise in hip arthroplasty makes sure that you will receive the best possible result from your joint replacement surgery so that your expectations of treatment are fully met.

Most doctors have more than 20 years of experience in performing surgical hip replacements. As they keep abreast of developments within the field of orthopedics, they work with the most up-to-date techniques and prostheses, all of which are backed by evidence from clinical studies to guarantee their effectiveness. Besides their commitment to the latest advances in hip arthroplasty, He or She also makes sure he delivers patient-centered care. This means that he involves you in decision-making and tailors your treatment to your individual needs. With his level of expertise and commitment to best practice you can trust that you will receive a complete hip replacement recovery.

Surgery Options:

Before you have your surgery you will meet with an orthopaedic surgeon for an initial assessment. This not only allows him to check your suitability for a hip replacement, but also enables him to advice on the most appropriate prosthesis for your circumstances. In cases where your hip damage is not sufficiently advanced to justify surgery, he will discuss more conservative treatment options with you and may suggest hip resurfacing as an alternative. Certain health problems are sometimes a contraindication to joint replacement surgery, surgeon will also review your medical history before making a decision. When it comes to the type of procedure he recommends, a complete clinical assessment to decide whether a partial or total hip replacement is more suitable, and whether you would benefit most from a metal-on-plastic, ceramic-on-plastic or a metal-on-metal artificial hip joint. Where necessary he may also advise weight loss or recommend other lifestyle changes to aid your recovery following hip replacement surgery.