Hip replacement (Hip arthroplasty)

An X-ray and examination by an orthopedist is required to establish a diagnosis of joint damage. Patients are experiencing pain when walking or moving in the joint and in later stages of joint destruction also pain at the rest.

Initially, rehabilitation and adjustment of the regime (hip-sparing and exercise, weight management) is used.

There are 4 stages -  degrees of coxarthrosis:

• Stage 1 (Minor hip joint damage) - narrowing of the joint space and thinning of the cartilage
• Stage 2 (Mild hip joint damage) - more pronounced narrowing of the articular fissure and osteophyte formation
• Stage 3 (Moderate hip joint damage) - joint deformities, prominent osteophytes
• Stage 4 - disappearance of the articular fissure (Serious coxarthrosis, Severe hip joint damage)

The first stages are treated using physiotherapy (ultrasound, laser, magnetotherapy) and rehabilitation. Pain is alleviated with analgesics, nutrition is supplemented with cartilage-supporting supplements. Injections into joints containing hyaluronic acid, platelet rich plasma (PRP) or stem cells are also used to improve cartilage nutrition.

• The operation consists in replacing the damaged joint using an endoprosthesis - an artificial joint. 
• Currently, cemented implants (from cobalt and chromium alloys) and non-cemented implants (from titanium alloys) as well as their combination (hybrid endoprosthesis) are used. The choice of the type of artificial joint depends on the anatomical situation, the quality of the bone tissue and other criteria.
• The artificial joint has 2 parts – the hip socket, which is inserted into the pelvis and the stem, which is inserted into the femur (servers as ball of the joint). 

We decide different types of hip joint replacement:

• Total hip replacement - THR (total hip arthroplasty) with replacement of both parts of hip joint - the acetabulum (hip socket) and the femoral head.
• Partial hip replacement (Hemiarthroplasty) - replaces only the ball (the head of the femur).
• Hip Resurfacing - The femoral head is trimmed and covered with metal implant and the hip socket is fitted with a metal cup.

The operation takes place under general anesthesia and lasts about 120 minutes.

On the day of the operation immediately after the procedure, the patient is monitored with monitoring of vital functions, she/he receives analgesics for pain treatment and antibiotics.

On the 1st - 2nd day after surgery the patient can get out of bed with the help of a physiotherapist, walking is only possible for 20 - 30 minutes using crutches or a walker.

On the 3rd - 4th day after surgery the patient can go to the toilet, learn how to get out of bed, how to sit, dress and put on shoes. She/he will learn to use crutches.

• After the operation the bone must be adapted to the artificial joint - it takes 7 months for the bone to fuse with the implant.
• Heavy loads should be avoided during this period.
• The patient must walk with the help of crutches.
• Walking up stairs, lifting heavy objects, sitting with crossed legs is not suitable - it is advisable to use a seat pad to increase the sitting position, you should sit at a 90° angle.
• After 7 months the bone has grown together with the implant and it is possible to start putting weight on the limb.
• Suitable sports are: cycling, swimming and Nordic-walking.
• Unsuitable sports are: ball sports (football, soccer, basketball, handball, etc.), tennis, skiing, squash or horse riding.

Patient receives a “Joint Replacement Passport” - a card that identify the holder of the card as a joint replacement patient.

This card can be heplful - it confirms that the implant may activate metal-detectors (e.g. during in-flight checks).