Table of contents:
- Indication of Total Hip Replacement
- Total Hip Replacement Warning
- Before Total Hip Replacement
- Total Hip Replacement Procedure
- After Total Hip Replacement
- Complications and Side Effects of Total Hip Replacement
Total hip replacement is an operation performed to replace a damaged or problematic hip joint with a new artificial joint (prosthesis). This action is done to relieve pain and make it easier for the patient to walk normally
Total hip replacement or total hip arthroplasty is generally performed on patients with hip joint disorders due to injury, joint damage due to aging, or arthritis that cannot be treated with other treatments.
Indication of Total Hip Replacement
Conditions that can be treated with a total hip replacement include:
- Arthritis or rheumatoid arthritis
- Arthritis due to long-term effects of severe injury to the hipbone
- Avascular necrosis or osteonecrosis
- Pelvic disorders that have occurred since childhood
Total hip replacement surgery is performed if medical therapy is no longer effective in treating the pain caused by the above conditions. The medical therapy in question includes the provision of anti-pain drugs, glucosamine and chondroitin sulfate, physiotherapy, and the provision of walking aids.
Total hip replacement is also done with the patient's quality of life in mind. Patients need to undergo a total hip replacement if they experience pain that:
- Disturbing sleep quality
- Makes it difficult to stand up after sitting
- Lowers ability to go up and down stairs
- It gets worse when walking, even when using a cane or walker
Total Hip Replacement Warning
The doctor will determine whether a total hip replacement is an appropriate treatment for the patient's complaint. Therefore, patients need to inform all symptoms and complaints related to the hip joint, ranging from pain, disturbed activities, to a history of injuries that occurred.
Patients also need to provide a history of other diseases they have and all types of medicines, including herbal medicines and supplements used.
Besides that, before planning a total hip replacement procedure, there are several things that patients need to know, namely:
Healing period after surgery
Total hip replacement surgery takes about 3-6 weeks to heal. During the healing period, the patient cannot move freely. So, sabbaticals or work waivers may need to be discussed in advance.
When planning this surgery, the patient is advised to have someone who can accompany and help move, starting from the completion of the operation until during the recovery period.
The patient or patient's family may also need to prepare equipment to assist with daily activities during the healing period, such as installing handrails or tidying the house from anything that could trip the patient.
Total hip replacement can make it easier for patients to carry out daily activities, such as walking, going up and down stairs, driving, and doing light exercise. However, the patient remains restricted from activities or sports that can put a strain on the joints, such as running, jogging, and jumping.
Prosthesis joint resistance
Usually, a prosthesis joint can last for 10–20 years, depending on the use and condition of the patient. Joint damage can occur more quickly if the patient does a lot of strenuous activity, is obese, or has diabetes.
Although the condition is not a barrier to surgery, patients are advised to lose weight and have stable blood sugar levels before surgery. In addition, patients also need to stop smoking to speed up the wound healing process.
Before Total Hip Replacement
The preparation required for this operation can be a lot, depending on the patient's condition. Before the surgical procedure is performed, the doctor will usually check the patient's medical history and perform a physical examination to ensure that the patient is he althy and ready for surgery.
Some other preparations that may be made before surgery are:
- Supporting examinations, such as urine tests, blood tests, echocardiography, and chest X-ray
- Consultation with other specialists regarding other he alth problems the patient may have, such as heart disease, diabetes, or prostate problems
- Consultation with dentist
- Skin examination to make sure the patient is free of infection, especially in the area to be operated on
- Changes in dosage or discontinuation of some routine medications before surgery
Total Hip Replacement Procedure
Usually, a total hip replacement procedure takes 1–2 hours. The actions taken during the operation process may vary, depending on the patient's condition and the surgeon's specialization.
Before the total hip replacement procedure is performed, the patient will be given general or partial anesthesia, from the waist down. This choice is determined according to the doctor's consideration and agreement with the patient.
After entering the operating room, the patient will be placed in an IV in the arm or hand. Then, the patient will be asked to lie down on the operating table, then the catheter will be attached to the patient's body.
The anesthesiologist will check the patient's heart rate, blood pressure, respiratory rate and oxygen in the blood during the operation.
The patient's skin on the part to be operated on is cleaned with antiseptic liquid, then an incision will be made to open the hip joint. Next, the damaged hip joint will be replaced with a prosthesis or artificial joint.
Hip prosthesis consists of 3 parts, namely the stem that attaches to the thigh bone, the bowl that attaches to the hip bone, and the head of the joint that connects the two. The joint head can be made of metal or ceramic, while the stem and bowl are made of metal.
Once the artificial joint is properly attached, the incision will be closed with special sutures or staples. A tube may remain in the surgical area to drain blood and fluid from the surgery.
After Total Hip Replacement
After the operation, the patient will be taken to the recovery room to be monitored. If the patient's blood pressure, pulse, pulse, and breathing are stable, the patient will be taken to the inpatient room. The patient will need to be hospitalized for a few days after this procedure.
The duration of hospitalization for each patient may vary, depending on the condition. During hospitalization, the physiotherapist will train the patient to move around using the new joint. During exercise, pain medication may be given, so that the patient can undergo therapy smoothly.
After being discharged from the hospital, the patient must keep the operated area clean and dry. The nurse will teach you how to take a safe bath to keep the wound dry. Patients also need to cover the scar with a bandage to prevent irritation from rubbing against clothing or other things.
The surgical suture will be removed when the patient is under control, approximately 2 weeks after the patient is discharged from the hospital. During recovery, the patient is advised to take pain medication prescribed by the doctor.
Discomfort from hip replacement is normal for several weeks, especially at night. During this healing period, there are several movements that need to be avoided to reduce the risk of joint shifting, namely:
- Bending more than 90 degrees, both standing and sitting
- Crossing the leg that was just operated on onto the he althy leg
- Turn your feet inward
Nevertheless, patients are still advised to move, such as walking, sitting, or climbing stairs, with a note to be careful. Patients can also do light exercise, but the movements must be in accordance with the recommendations of the physiotherapist.
Patients should also drink plenty of water and eat a balanced nutritious diet. Your doctor may prescribe iron supplements to speed up tissue healing and restore muscle strength.
Complications and Side Effects of Total Hip Replacement
Although it is rare, total hip replacement can cause complications such as:
- The appearance of blood clots in the veins of the legs or pelvis
- Infection around the prosthesis
- The size of one foot is longer than the other
- pelvic dislocation
- hip implant loosening
In addition to the complications above, complications such as injury to nerves and blood vessels, bleeding, stiffness and fractures in the pelvis, and ongoing pain can also occur after a total hip replacement procedure.
Immediately consult a doctor if the following symptoms occur during the healing period:
- Extreme pain in hip and groin
- The prosthesis feels uncomfortable
- You hear a “pop” sound when you move your feet
- Difficulty walking or unable to walk
- Artificial joints cannot be moved
- The length of the leg you just replaced is shorter than the other one