Surgery total hip replacement (PTC) involves the replacement of the hip joint by an implant, i.e. a prosthesis. It consists of a femoral component and a stem or acetabular cup component or. Both components are articulated with a femoral stem head and applied to an insert in the acetabulum.
Types of hip prostheses
According to the system of fixation of the implant to the bone, prostheses can be cemented (fixed with methylmethacrylate), uncemented or biological, or hybrid (a cemented component and a non). There are excellent results with different techniques. The decision of the fastening system varies at the discretion of specialist Traumatology , the criterion is usually based on bone quality. In general, femoral level uncemented implants are used in men up to 75 years and women up to age 70. A acetabular level, are usually used cementless implants in most cases.
There are countries like the United States, where almost all are uncemented implants and others, like the UK, where a majority of cases cemented regardless of age or bone quality patient is given.
Another important difference is known friction torque, which refers to materials that will contact during hip mobility. Perhaps, this is where most progress has been made in improving the rubbing surfaces; either metal, ceramic or polyethylene.
- The friction torque is more experienced the metal / polyethylene. Currently, polyethylenes are better made, they are more resistant to wear (you do highly crosslinked) and some include antioxidants as vitamin E to lengthen its duration. Their long-term problems are known and detectable early.
- The pair ceramic / ceramic friction also has a long experience but the problems encountered some implants for years (noise or breaks material) and its price makes it not widely used. It seems to be the friction torque with less wear, but is less tolerant to errors surgical technique.
- The pair ceramic / polyethylene friction is a combination of past and is a good choice.
- The friction torque metal / metal, with a good implant and perfect technique there are good results; but today most current scientific discourages its use by the severity of problems that have arisen with prothesis implanted in recent decades.
The most important for the proper functioning of a prosthesis factor and for longer than 10-15 years, is its proper implementation. It is difficult to prove whether certain sporting activities can alter the length of the prosthesis, but it would be advisable to avoid impact sports.
Complications of hip
The most serious complication that can occur in a hip prosthesis is infection that can occur in acute or chronic. Acute may occur in the post immediately or years after operative due to an infection in another part of the body. It can also take place a chronic infection, which is not explicitly symptoms but can cause painful or loosening of the same prosthesis.
Another of the most feared complications is the dislocation or dislocation. The most common cause is often poor orientation of the components, although there are other causes as examples trauma, neurological problems or wear of components, among others.
Experts believe that the patient must be informed about the different options, the pros and cons about; but the decision of the implant must be the responsibility of the orthopedic surgeon. The patient can choose the surgeon.