Hip Joint Replacement

 

Indications for Orthopedic Surgical interventions

  1. unstabilized fracture
  2. deformity
  3. joint disease
  4. necrotic or infarcted tissue
  5. tumors

 

Indications for Joint Replacement

 

  1. severe joint pain
  2. severe disability
  3. osteoarthritis
  4. rheumatoid arthritis
  5. trauma
  6. congenital deformity
  7. femoral neck fractures where blood supply has been disrupted

 

Joint Implant Types

 

  1. Metal and high-density polyethylene components
  • implants are usually cemented in place with polymethacrylate (PMMA)
  • PMMA is a bone binding agent that has similar properties to bone
  • Loosening of prosthesis is the main reason for prosthesis failure

bone ingrowth on right:

 2. Press-fit ingrowth prosthesis

  • porous-coated and cementless
  • bone grows into the implant

 

Pre-operative considerations: organ functioning

  1. Cardiovascular
  2. Respiratory
  3. Renal
  4. Hepatic

 

Risk factors for DVT and Pulmonary embolism

  1. age
  2. obesity
  3. preoperative leg edema
  4. DVT Hx
  5. Varicose Veins

 

Post-operative complications

 

  1. hip prosthesis dislocation
  2. excessive wound drainage
  3. thromboembolism
  4. infection
  5. heel pressure ulcers
  6. heterotrophic ossification = bone growth in the periprosthetic space
  7. avascular osseous necrosis
  8. loosening of the prosthesis

 

Martin, Glenn and Porth, Carol, Mattson. 2009. Pathophysiology Concepts of Altered Health States. 8th ed. Lippincott Williams and Wilkins. Philadelphia

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