"Hip" has its own skills, "walk" without worries

Author: Guo Donghong, attending physician, Nanfang Hospital, Southern Medical University

Reviewer: Wang Jian, Chief Physician, Nanfang Hospital, Southern Medical University

In the field of modern medicine, the emergence of artificial hip replacement is a revolutionary breakthrough. It uses artificial hip joint parts to replace diseased or damaged hip joints, thereby effectively relieving pain, correcting deformities, and restoring joint movement function. Every year, a large number of patients around the world undergo this surgery to regain freedom of movement and improve their quality of life.

1. Can the surgery for artificial hip replacement be postponed?

Some patients in the clinic hope that the doctor will postpone the operation because they are afraid of surgery and worried about the effect of the operation. Artificial hip replacement, like other surgeries, has certain surgical risks. However, the surgical technology has been developed very maturely in clinical practice, and medical staff will try to reduce the surgical risks as much as possible. Before the operation, the doctor will conduct an overall assessment of the patient's physical condition, assess the surgical risks and complications, and develop corresponding treatment and prevention plans. It is usually not recommended to postpone the operation for too long, and delaying the operation for a long time will also have a certain impact on the patient.

1. Patients with femoral head necrosis have obvious pain symptoms and their quality of life is seriously reduced. Long-term use of analgesics, traditional Chinese medicine and other drugs also have certain adverse effects on the body.

2. The bones of the limb on the side with femoral head necrosis may develop osteoporosis due to reduced limb activity. When the patient wants to undergo surgery, the probability of prosthesis loosening will increase.

3. Necrotic hip joint wear can cause severe osteoarthritis, and the bone on the joint surface will harden, which will prolong the time it takes for the hardened bone and artificial joint to fuse after surgery.

4. The muscles and ligaments around the joints may contract and atrophy, and the recovery time of gait after surgery will also be prolonged. Therefore, patients with surgical indications should consult a doctor and choose the appropriate time for surgery instead of blindly delaying the surgery.

2. What is total hip replacement and hemiarthroplasty?

There are two main types of hip replacement: ① Total hip replacement, which is to replace the entire hip joint, including installing an artificial femoral head, artificial femoral stem and acetabulum; ② Hemiarthroplasty, which is to replace only the artificial femoral head and artificial femoral stem without installing an artificial acetabulum. The artificial femoral head of hemiarthroplasty is matched with the patient's own acetabulum, and because the acetabulum retains the patient's own cartilage, its wear resistance is weak. Therefore, hemiarthroplasty is mainly suitable for elderly patients with femoral neck fractures for three reasons: ① The acetabulum structure is relatively normal; ② The surgical trauma is relatively small; ③ The amount of activity is small.

Since acetabular wear may occur after surgery, young patients with high activity levels are not suitable for hemiarthroplasty. Total hip replacement is recommended for such patients.

3. After replacing an artificial hip joint, can I move like a robot?

In real life, some patients think that artificial hip replacement surgery involves removing all joints and replacing them with metal joints. After the surgery, the joints become inflexible and can only move stiffly like a robot. This is because patients lack a full understanding of artificial hip replacement surgery.

Figure 1 Copyright image, no permission to reprint

When joints are damaged due to various reasons such as femoral head necrosis and osteoarthritis and cannot be treated or repaired by other methods, artificial hip replacement is an effective treatment method. Just like repairing a worn tabletop, first trim the worn surface and then apply a new layer. Artificial hip replacement is to remove the worn and damaged joint surface and replace it with a new set of artificial hip joints to restore the smooth joint surface and realize the functions of weight bearing, movement and walking.

With the rapid development of artificial hip joint materials, processes and surgical techniques, most patients can basically restore normal movement function after surgery, so that they can return to social life. Artificial hip replacement is one of the great advances in the field of orthopedics in the 20th century. Nowadays, almost all joints in the body can be replaced by artificial joints. It is widely used in clinical practice, and the postoperative effects of hip replacement and knee replacement are good.

4. What are the advantages and disadvantages of total hip replacement?

1. Advantages of artificial hip replacement

Pain relief: By rebuilding the hip joint structure, joint pain can be relieved or even eliminated.

The patient can take care of himself: After the operation, the patient's hip joint function is restored, daily life is basically no longer affected, and the quality of life is improved.

Correction of joint deformity: Joint deformity can be corrected by performing artificial hip replacement.

Normal walking: Many elderly patients with femoral head necrosis cannot go out due to inconvenience in walking. After artificial hip replacement surgery, they can resume walking 3 to 6 months later, and those who recover well can even go out for travel.

Figure 2 Copyright image, no permission to reprint

2. Disadvantages of artificial hip replacement

① The artificial joint is not completely consistent with the original structure of the human body, and it is unlikely to restore the function of the original joint to be completely consistent. Generally speaking, recovery of 90% to 95% function can be considered a relatively good postoperative state.

②The implanted joint is made of artificial materials, and the service life of different artificial materials is also different. The longer the service life of the artificial material, the more expensive it is.

③Artificial joints are foreign bodies to the human body and may cause infection or loosening of the prosthesis. These are two issues that artificial joint surgeons attach great importance to and are concerned about, and they have been working hard to prevent such problems from occurring.

④ Artificial joints are made of metal and may be subject to certain restrictions when undergoing MRI examinations. Although the materials used in most patients' joint replacements are low-magnetic or non-magnetic materials, some patients are still worried that these materials will still affect the results of MRI examinations. In short, the main purpose of artificial hip replacement is to relieve joint pain, correct joint deformities, and restore joint function. If surgical treatment is required, you must follow the doctor's advice and actively cooperate with the treatment to improve your quality of life.