Total hip replacement is surgery 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.
Procedure total hip replacement or total hip arthroplasty It is generally performed on patients who have hip joint disorders due to injury, joint damage due to aging, or arthritis that cannot be treated with other treatments.
Indication Total Hip Replacement
Conditions that can be treated with total hip replacement, among others:
- Osteoarthritis
- Arthritis or rheumatoid arthritis
- Arthritis due to long-term effects of severe injury to the hip bone
- Avascular necrosis or osteonecrosis
- Pelvic abnormalities that have occurred since childhood
Operation ttotal hip replacement done if medical therapy is no longer effective to deal with the pain felt due to the conditions above. The medical therapy in question includes the administration of pain medication, glucosamine and chondroitin sulfate, physiotherapy, and the provision of walking aids.
Total hip replacement It is also carried out with consideration of the patient's quality of life. Patients need to undergo total hip replacement if you experience pain that:
- Interfere with sleep quality
- Makes it difficult to stand up after sitting
- Decreased ability to go up and down stairs
- Worsens when walking, even when using a cane or walkerwalker)
WarningTotal Hip Replacement
The doctor will determine whether total hip replacement is an appropriate treatment for patient complaints. 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.
Moreover, before planning the procedure total hip replacementThere are several things that patients need to know, namely:
Recovery period after surgery
Operation total hip replacement It 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 from the outset.
When planning this surgery, patients are 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 the patient's family may also need to prepare equipment to assist with daily activities during the recovery period, such as installing handrails or tidying the house from anything that could trip the patient.
Operation result
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 jump.
Prosthesis joint resistance
Usually, the prosthesis joint can last for 10–20 years, depending on the wearer and the patient's condition. Damage to the joints 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 in order 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 healthy and ready for surgery.
Some other preparations that may be made before surgery are:
- Investigations, such as urine tests, blood tests, echocardiography, and chest X-ray
- Consultation with other specialists regarding other health 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
- Dosage changes or discontinuation of some routine medications before surgery
ProcedureTotal Hip Replacement
Usually, the procedure total hip replacement lasts 1-2 hours. The actions taken in the surgical process may vary, depending on the patient's condition and the surgeon's specialization.
Before the procedure total hip replacement When 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.
The hip prosthesis consists of 3 parts, namely stem which attaches to the femur, the bowl that attaches to the pelvis, and the head of the joint that connects the two. The joint head can be made of metal or ceramic, while stem and the bowl is made of metal.
After the artificial joint is fully attached, the incision will be closed with special sutures or staples. A tube may still be attached to the surgery area to drain blood and fluids 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 several 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, painkillers 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.
Surgical sutures will be removed at the time of the patient's control to the doctor, approximately 2 weeks after the patient was discharged from the hospital. During recovery, the patient is advised to take pain relievers 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:
- Bends over 90 degrees, both standing and sitting
- Crossing the newly operated leg over the healthy leg
- Turning the foot inward
However, patients are still advised to move, such as walking, sitting, or climbing stairs, with a note that they must be careful. The patient can also do light exercise, but the movements must be in accordance with the physiotherapist's recommendations.
The patient 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 Total Hip Replacement
Although rare, total hip replacement can cause complications such as:
- Formation of blood clots in the veins of the legs or pelvis
- Infection around the prosthesis
- One leg is longer than the other
- Hip dislocation
- Loose hip implants
In addition to some of 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 the procedure. total hip replacement.
Immediately consult a doctor if the following symptoms occur during the healing period:
- Severe pain in the hip and groin
- The prosthesis feels uncomfortable
- A “pop” sound is heard when the foot is moved
- Difficulty walking or unable to walk
- Artificial joint cannot be moved
- The length of the leg that has just been replaced is shorter than the other
