What is Hip Replacement? A Review of Total Hip Arthroplasty, Hip Resurfacing, and Minimally-Invasive Hip Surgery.
Edited By: Seth S. Leopold, M.D. Last updated Friday, January 12, 2007
About the procedureWhat are the technical details of total hip arthroplasty, hip resurfacing, and minimally-invasive hip surgery for hip arthritis? What is actually done?
Because there are now so many techniques that are used to perform
total hip replacements, and because the issues pertaining to those
techniques have been reviewed earlier in this article (need t link to
prior sections), this section will summarize the “basics” of
traditional total hip replacement.
Any of several techniques for anesthesia are possible: general
(going to sleep), spinal, or epidural. After anesthesia has been
successfully achieved, total hip replacement surgery begins by
performing a sterile preparation of the skin over the hip to prevent
infection.
Next, a well-positioned incision is made down the side of the hip.
As already discussed, the location and length of the incision varies
widely by approach, and based on the patient’s own anatomy.
Deeper tissues (muscles and tendons) are either spread or incised
and prepared for later repair. The hip capsule (a thick covering
directly on top of the ball and socket joint), is then opened. The ball
is gently levered out of the socket, and the arthritic ball is removed
using a saw.
At this point, the damaged, arthritic cartilage on the socket is
removed using a scraping tool called a reamer, and the socket (which
may be misshapen from arthritis) is shaped to form a hemisphere. An
artificial socket (called the acetabular component) is now inserted,
usually without using bone cement. Sometimes additional screws are used
to hold the component firmly to the bone during the critical weeks
following surgery when the patient’s bone will attach itself to the
metal on the artificial socket.
Next, the inside of the thigh bone (femur) is prepared using
motorized and hand-held tools to shape it to accept a stem, at one end
of which is the new artificial ball, called the femoral head. Once the
stem is inserted, leg length and joint stability are verified, and the
final components, are inserted.
The tissues are cleaned with sterile saline solution (liquid), any
deep tissues that were incised are now repaired, and the skin is
closed. A surgical drain may be used, at the surgeon’s discretion. What is the typical anesthetic used for total hip arthroplasty, hip resurfacing, and minimally-invasive hip surgery for hip arthritis? As mentioned, total hip replacement may be performed under epidural,
spinal, or general anesthesia. The choice is made in consultation with
the surgeon and anesthesia provider.
How long does total hip arthroplasty, hip resurfacing, and minimally-invasive hip surgery for hip arthritis usually take? No two hip replacements are alike, and there is some variability in
operative times, but the range is typically between one and two hours
of actual operative time.Surgery for hip arthritis at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call the Bone & Joint Surgery Center at 206-598-3354 or Eastside Specialty Clinic at 425-646-7777 to make an appointment.
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