Artificial hip replacement: a new look for healthy joints

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

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

The hip joint is one of the most important joints in the human body. Its normal functioning is essential for our walking, standing and daily activities. However, when the hip joint is severely damaged due to various reasons, such as arthritis, fractures, etc., causing pain, limited movement, and seriously affecting the quality of life, artificial hip replacement becomes an effective treatment option.

1. Is hip replacement surgery painful?

Any surgery is likely to be painful, but with the joint efforts of orthopedic surgeons and anesthesiologists, the following measures can make total hip replacement surgery almost painless.

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1. Preoperative analgesia: Before surgery, the surgeon and anesthesiologist will conduct a comprehensive assessment of the patient, formulate a comprehensive analgesia plan, and give preemptive analgesics based on the patient's individual condition.

2. Minimally invasive operation during surgery: shorten the operation time and try to complete the hip replacement in the shortest possible time while ensuring the quality of the operation.

3. Use a self-controlled analgesic pump after surgery: Allow the patient to control the frequency of taking analgesics. If the wound hurts, just press the control device of the analgesic pump to immediately pump the analgesic. Use as needed, and it will take effect quickly.

4. Postoperative functional exercise: Actively restore hip joint function, and further cooperate with drug treatment if necessary. In short, multimodal combined analgesia and other measures can bring patients who undergo hip replacement surgery a nearly painless surgical experience, and the degree of pain will also be reduced during functional exercise.

2. What are the preoperative preparations for total hip replacement?

1. Psychological preparation: Patients should understand the purpose and effect of the surgery and have a preliminary understanding of disease treatment, which is conducive to cooperation with postoperative functional exercises.

2. Medical history: Tell your doctor in detail your medical history and onset of symptoms, as well as whether you have other diseases or a history of surgery.

3. Preoperative examination: A detailed physical examination, laboratory and imaging examinations are performed before surgery to understand the patient's overall health condition and rule out factors that may affect the surgery.

4. Medication preparation: Tell the doctor what medications you are taking, and explain the time and dosage of medication. The doctor will adjust the preoperative medication according to the patient's condition.

5. Treatment of other diseases: treatment of chronic infections, skin diseases and other diseases that may affect surgery.

6. No drinking or smoking.

7. Daily life exercises: Practice how to use crutches correctly and practice defecation and urination in bed.

3. What are the surgical steps for total hip replacement?

The surgical steps for hip replacement are as follows.

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4. What complications may occur after total hip replacement surgery?

The most common complication after hip replacement surgery is loosening of the hip prosthesis, but the time of occurrence varies from person to person. Within 10 years after surgery, a small number of patients will experience loosening of the hip prosthesis, which cannot be avoided with current technology. Patients with loose hip prostheses and symptoms often have to undergo hip "revision" again, removing the loose or broken hip joint and re-implanting a new hip joint. This is difficult for patients to accept and is also a "hot potato" for doctors. Hip "revision" is a great challenge for patients and doctors, with higher medical expenses and higher requirements for doctors' experience and skills. The effect of hip joint function recovery after hip "revision" is generally worse than that of the initial hip replacement. Not only is the use time of the replaced hip joint shorter, but the risk of postoperative complications will also increase. Therefore, long-term follow-up and reexamination are required after artificial hip replacement surgery. Generally, X-ray examinations should be performed every 3 months within the first year after surgery, and then every 1 to 2 years to detect complications early and take active preventive and protective measures to extend the use time of the artificial hip joint.