Doctor insights on:
Total Hip Replacement Pathophysiology
Wonderful: The hip replacement is one of the best procedures we can perform. It takes patients with daily pain and inability to live a quality life, and within weeks allows the patient to start a new life. It does have risks, and those need to be weighed against the benefits. Knee replacements and shoulder replacements are similar. ...Read more
Total hip replacement: surgery in which the diseased ball and socket of the hip joint are completely removed and replaced with artificial materials. A metal ball with a stem (a prosthesis) is inserted into the femur (thigh bone) and an artificial plastic cup socket is placed in the acetabulum (a "cup-shaped" ...Read more
Snapping hip: Snapping can be due to tendons in front of the hip or along the side. Pt can help by teaching you how to stretch these to reduce the snapping. Painful snapping should be evaluated by your surgeon, especially if your replacement has been in for a while. ...Read more
At home or center: Hip replacement rehabilitation begins in the hospital shortly after hip surgery. Continued rehab may then continue at home with the proper home nursing rehab team or in a rehabilation center. See which your surgeon prefers and your insurance covers. Don't cut corners on this type of procedure only to develop problems years later. ...Read more
Young THA: Dysplasia, trauma, avascular change, developmental issues, among others, may make tha a good choice in a teenager. Other considerations to pelvic, acetabular, and femoral osteotomies should be entertained as well. ...Read more
Medication: Pain after total hip replacement is expected and will be most severe the first day or two after surgery. It can be easily managed with perioperative narcotic pain medicines. After discharge from the hospital, most patients will take pain medication for 2-4 weeks and then not require more than a tylenol (acetaminophen) or advil occasionally. The pain after tha should be resolved with in 6 weeks in most patients. ...Read more
Not many: After hip replacement, I allow my patients to return to any activity that they are comfortable doing. Every patient finds certain things they can and certain things they cannot do comfortably. For example, I have a champion powerlifter, but he is not comfortable jogging. I have a bilateral hip replacement patient who is training for a marathon. All I ask is that they get an x-ray every 1-2 yrs. ...Read more
No: A hip hemiarthroplasty does not include lining the socket with metal and a new bearing. It only replaces the femoral head. A total hip does both. ...Read more
Blood and toxins: During a hip replacement, muscles and tissues aree cut and torn. Toxins are released from the tissues. Blood gets in the area and blood outside vessels, is an irrittant. There are many mediators of the inflammatory response after this extensive tissue injuring surgery that cause pain, swelling and issues. This is with proper surgery. Not being critical of these great surgeons. It is jsut it. ...Read more
Wear debris: The most common cause of loosening is from the reaction of the bone to the wear particles from the metal and plastic implant. All mechanical devices produce wear particles and your hip is no exception. These particles case a resorption of bone called "lysis". Loosening can also be caused by infection. Sometimes a fall can cause a fracture around an implant and this may loosen the component. ...Read more
Mild to moderate: The pain with hip replacment surgery is a function of the damage to the tissues as one tries to accurately place the new joint. Surgeons using techniques to minimize the damage will have less pain post op. The direct anterior approach to hip replacement offers the least damage to the muscles when performed by a surgeon experienced in this technique. ...Read more
A lot of reasons: Usually, we try to avoid because of the activity demands of teens, continued growth, and expected longevity of the person. Each of these can place the person at risk for needing more surgery down the road. Each time the likelihood of success goes down while the likelihood of complications goes up. However, there are conditions for which teens get joint replacements. Care should be individualized. ...Read more
Femur and bearing:
A hip resurfacing and total hip both involve relining the inside of the socket.
A resurfacing does not remove the entire head, but rather caps the head with a cemented metal piece. A total hip does replace the entire head, and the head is attached to a piece of metal that goes down inside the femur 5 - 6".
A critical difference is that a resurfacing requires a metal on-metal bearing (bad idea). ...Read more
The biggest issue with hip replacement devices currently is the ones that use a metal against metal bearing. This articulation produces small amounts of cobalt and chrome debris that in some patients has caused hypersensitivity reactions, necessitating further surgery.
Occasionally, poorly designed devices break, but this is unusual. ...Read more
Depends: Each surgeon will allow their patients to go back to different exercises and activities. Many physicians will allow their patients to ski, in a very casual, controlled manner after a joint replacement. This is a discussion you need to have with your particular surgeon. Prior to returning to any sports... Make sure your legs are very strong and up to task! :-). ...Read more
I had a thp (total hip replacement) months ago and I am still having a lot of pain, should I be concerned?
Yes: Everyone takes different amount of times to heal, however, talking it over with your doctor is never a bad idea. ...Read more
I have had two total hip replacement about three years ago. I am 42 and very active. I have been having some constant pain for the last week. I have h?
Total Hip: Both the femoral and acetabular components are replaced. Typically, modular components are used of various materials (titanium, polyethylene, ceramic, oxinium, or other metallurgy) are employed. ...Read more
Be informed...: Ask questions, understand the procedure, the risks, the recovery time frame, the number of procedures a year your physician performs and whether or not the hospital has an orthopedic unit to manage you after surgery. Exercising as tolerated is always useful too. The stronger you are heading into surgery, the stronger you are coming out. ...Read more
Pain...: The decision to pursue a joint replacement is based on your perception of how significantly your quality of life is being limited by the pain you are suffering due to arthritis. This is primarily a quality of life decision. You should be the person who determines when it needs to be done after your surgeon mentions that it is a consideration. ...Read more
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