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Hip Arthritis and Hip Replacement

Hip Arthritis and Hip Replacement. By: Victoria Chambless. Reasons for replacement procedures. Defined as inflammation of the joint More than 100 different types Two primary types Rheumatoid Osteoarthritis Most common Ball & socket become rough rather than having the smooth surface.

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Hip Arthritis and Hip Replacement

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  1. Hip Arthritis and Hip Replacement By: Victoria Chambless

  2. Reasons for replacement procedures • Defined as inflammation of the joint • More than 100 different types • Two primary types • Rheumatoid • Osteoarthritis • Most common • Ball & socket become rough rather than having the smooth surface Arthritis

  3. Osteoarthritis(in all joints) • 23 million in U.S. • 60 million by 2030 • Risk factors • Family history • Obesity • Trauma • Malalignment • Knee more common than hip • 375,000 THR/year • 500,000 TKR/year

  4. Symptoms of Arthritis • Joints warm to the touch • Joint swelling • Joint pain and immobility • Joint stiffness • Decreased activity • Impaired lifestyle • Joint deformities

  5. Hip Joints

  6. Hip X-rays

  7. important numbers • Average age of THR: 68 • usually no younger than 50 and no older than 85 • # THR per year: 300,000 annually • How long THR lasts: 80% of THR lasting 20 years • Weight can cause failure of THR • Extensive and aggressive use

  8. Non-surgical (conservative) Treatment Options • Activity modification • Physical Therapy • Antiinflammatory drugs (NSAIDS) • Cortisone injection (x-ray guidance)

  9. Physical therapy • Light exercise on a daily basis • Aquatic therapy • Stationary bike! Dr. B’s favorite

  10. NSAIDS(nonsteroidal anti-inflammatory drugs) • Many available options • Mobic, Voltaren, Relafen, Naproxen, Lodine, Celebrex, etc • Often effective for early disease • Watch for side effects • Gastrointestinal • Drug interactions • Liver

  11. Injections • Cortisone- maximum 4x/year • Temporary relief • X-ray guidance to reach hip joint • Not much success for hips

  12. Hip Replacement • Cementless THR • Titanium stem • Cobalt Chrome or Ceramic ball • Polyethylene spacer or socket • Cementless THR and Ceramic implants are more commonly used on younger patients • Brittle • Expensive! • More active

  13. Hip Replacement

  14. Hip Resurfacing Relatively new procedure mainly used for young and very active patients

  15. decision for Surgery • Pain limits daily activities • Conservative treatment options provide little relief • Night pain • Patient factors, not age, dictates ability to undergo joint replacement • Bone on bone- wear of cartilage

  16. Expectations • Improved Quality of life is the main goal • Pain Relief • Dramatic improvement in mobility • Greater range of pain-free activities • Mechanical joint, not normal cartilage • Fail at a rate less than 1% per year

  17. Hip and Knee Surgery • 1 ½ to 2 hours long • Antibiotics for 24hrs • Anesthesia • Spinal vsGeneral • Regional blocks • Local injection • Blood loss- knee vs. hip • Cell saver

  18. Complications/ risks • Rare, fewer than 2% • Blood clot (DVT)- 6-12 wks of anticoagulation • Infection- antibiotics and/or repeat surgery • Nerve injury • Hip dislocation • Leg length may change • Major medical complications (1:3000)

  19. Recovery • Stay in hospital for 3-4 days • Begin therapy and walking directly following surgery • Wound healed by 2 weeks • Shower when wound is no longer draining • Walker for 2-3 wks then cane for 3-4 wks

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