Proximal Hip Replacement
A proximal hip replacement surgery, also known as hip arthroplasty, is a surgical procedure that aims to restore strength and function back in a disabled, or damaged, hip joint. This is a better option for people affected with bone degenerative disease such as arthritis who experience pain and disability due to a damaged hip joint.
This surgery aims to replace the worn out, or damaged part, of the hip joint with an artificial prosthetic that functions just like a natural hip joint. This surgery is helpful in relieving pain caused by a damaged hip as well as in restoring strength and range of motion in the joint.
A hip joint is a normal ‘ball and socket’ joint but is one of the most important and weight-bearing joints in the body. It is one of the largest joints in the body and is formed by the acetabulum (part of pelvic bone) which makes the socket part while the ball part consists of the round head of the femur (thigh bone) on the upper end.
These two bones surfaces are covered with soft articular cartilage, called a synovial membrane, which is composed of a smooth and soft tissue that acts as a cushion between the ends of the bones and enables lubrication for free movement of the hip joint.
The hip joint is stabilized with a network of strong tissues called as ‘ligaments’ connecting the ball to the socket.
Causes of Hip Pain
The most commonly seen cause for constant (chronic) hip pain and dysfunction is arthritis, which develops into several different types, such as:
- Osteoarthritis – This type of arthritis is related to the wearing out of the bones and the cartilage due to aging. It is normally seen in people above the age of 50 years as well as in younger people with a family history of arthritis. This type of arthritis mainly causes the soft cushioning cartilage to wear away and this causes the joint bones to rub directly against each other. The rubbing of bones in such a manner results in stiffness and pain in the hip joint.
- Rheumatoid arthritis – This auto-immune disease causes the synovial membrane (soft cushioning tissue) to become inflamed and swell. This chronic swelling results in severe damage to the cartilage and causes stiffness and pain in the hip joint. This type of arthritis belongs to the group of ‘inflammatory arthritis’ diseases.
- Post-traumatic arthritis – This type of arthritis is commonly seen accompanying a serious trauma or injury to the hip region resulting in fracture of the hip joint bones. The cartilage might also be damaged and can cause pain and stiffness in the hip joint.
- Avascular necrosis – This type of arthritis develops due to lack of blood supply to the femoral head of the thigh bone and is also called as ‘osteonecrosis’. This is usually the result of a severe injury to the hip or a fracture that may disrupt the blood supply to the femoral head. This causes the femoral head’s bone surface to collapse and result in arthritis.
- Congenital hip disorders – Some infants or children may have hip problems right since their time of birth and may have been treated but are yet capable of causing problems in the musculoskeletal structure of the body. This is often the result of the joint surfaces being affected during development.
Also Read: Bilateral Hip Replacement Surgery
Candidate for Proximal Hip Replacement surgery
Although there are no obvious restrictions on weight and age for a proximal hip replacement the surgeon/doctor will decide on this procedure based on certain factors, such as:
- Disabling hip pain disrupts normal everyday activities
- Constant hip pain during day or night
- Hip become stiff and the range of movement gets restricted
- Unsuccessful previous treatment methods such as anti-inflammatory drugs, painkillers, walking devices and physical therapy
If you are being considered for a proximal hip replacement surgery, the surgeon/doctor will perform certain diagnostic tests to determine the extent of damage and the repair needed for it. Your medical history will be evaluated to gather information pertaining to your general health and other prevalent medical conditions, if any.
A physical examination in followed by x-ray tests to identify the location and extent of the deformity in the hip joint.
Proximal Hip Replacement procedure
This is a major type of orthopedic surgery using artificial implanting techniques for treating the painful and disabling symptoms of damage caused to the bone of the hip joint.
The surgeon will use an artificial hip joint prosthetic to replace the damaged natural hip joint components such as the femoral head and the acetabulum. This implant is made from a wide variety of materials and comes in different shapes and designs. The implant component may be made from ceramic, medical-grade metal, plastic or a combination of these. Some implants need to be attached with a stabilizing pin to the femur and the acetabulum while other devices can be attached using surgical adhesive. Any type of an artificial hip joint prosthetic will contain two main parts: the ball component, to be fitted on the femoral head, is made of ceramic material or of a strong and highly-polished metal and the socket component which is made from durable ceramic, metal or plastic with an outer covering made from strong metal.
The proximal hip replacement procedure begins with the administering of general anesthesia so as to avoid any discomfort or pain to the patient during the surgery. After this the surgeon will make a few small incisions along the damaged hip joint. These incisions will be used to gain access to the damages hip joint component bones after shifting aside the blood vessels, nerves and other soft tissues.
The surgeon will remove any cartilage debris and remaining bone pieces from the hip joint and shave, or scrape, the surface of the femoral head to reshape it in order to fit the ball component of the artificial hip joint prosthetic. The next step involves reshaping the acetabulum (socket) part of the pelvic bone to help fix the socket part of the artificial prosthesis. After the surgeon ensures that these components are firmly fixed to their respective joint bones the artificial femoral head is inserted into the prosthetic acetabulum socket.
The surgeon will then check to see if the movement of the hip joint is restored and close the incisions using fine sutures. It will take 2-4 weeks for the implants to get completely covered by the bone.
A proximal hip replacement surgery is one of the more preferred forms of treatment for chronic hip pain and disability using artificial prosthetic components to replace the original hip joint. This surgery has been found satisfactory in relieving the severe pain and disability that is often caused by a severe case of hip joint disorder or injury.