Evolution of Technology

Total Hip Replacement

Total Hip and knee replacement surgeries have been performed for over a century, with continued evolution to the surgical techniques as well as component and manufacturing techonologies . Currently the most common material used for hip replacement implants are various metal alloys that include titanium, cobalt-chrome, as well as high grade plastics known as high molecular weight polyethylene or simply “poly”.

Most systems consist of three parts, the femoral component which replaces the native femoral head and neck, the acetabular component which replaces the acetabulum or “socket” portion of the ball and socket hip joint, and the poly which rests between these two component and acts as the new cartilage or bearing surfaceto allow for fluid motion. Many different companies produce components used in total hip replacement and all of the currently used implants have been extensively studied and approved to be safe for use by the US Food and Drug Administration.

Regardless of the implant chosen by the surgeon, todays implants and materials are at their pinnacle, due to the continued improvements in technology and material properties . The current implants demonstrate improved wear rates, longer survivorship, higher success rates, more anatomic designs, and decreased need for revision surgery due to wear than ever before

Evolution of Procedure

Hip Replacement Surgery

Hip replacement surgery is a surgical procedure designed to remove diseased bone and cartilage of the hip joint that is damaged and no longer healthy, and replace it with metal and plastic components. There are many various approaches to the hip joint, including the most commonly performed posterior approach, the increasingly popular anterior appraoch as well as the lateral approach. Each of these also have variations that allow the surgeon to comfortably and efficiently perform the operation.

All standard hip approaches have been shown to be relatively equal with regards to post-operative function and stability of the hip although there are some advantages and disadvantages to each technique. Typically, the decision for how the procedure will be performed is left to the surgeon and his or her comfort with the various techniques. Hip replacement surgery can be performed either under general or spinal anesthetic and the surgery generally takes one to two hours to perform.

Post-operatively patients can walk on their new hip the same day, barring any complications with the surgery and are generally discharged from the hospital within 24-48 hours post-operatively. Outpatient surgery, or same day surgery, for total hip replacement is also becoming very common and increasing in popularity as the techniques and anesthesia improve.

Evolution of Diagnosis

Osteoarthritis Of The Hip

Osteoarthritis of the hip is a degenerative condition of the joint which causes progressive loss of articular or joint lining cartilage. The disease process occurs over many years and is typically a result of natural aging and “wear and tear” over time although it can be accelerated by things such as a history of traumatic injury (ie. Prior hip fracture), or chronic problems such as developmental hip dysplasia or avascular necrosis.

Risk factors include previous injury to the hip as stated above as well as increased body mass index, obesity, abnormal cholesterol and triglycerides, high blood pressure and diabetes and autoimmune arthropathies. The condition affects women more commonly than men.

There are multiple treatment options to attempt to improve symptoms of hip pain and loss of function associated with hip arthritis. These include non-steroidal anti inflammatories, oral pain medications physical therapy, weight-loss, activity modification and injections into the joint. Ultimately, these conservative treatment options are designed to treat the symptoms of the disease and pain, and do not cure or delay the underlying cause, which is loss of cartilage. Eventually , as symptoms progress, you may be a candidate for surgery and hip replacement. . To date the only indicated surgery for osteoarthritis affecting the entire hip joint is total hip replacement, also known as total hip arthroplasty.