Possible complications of hip replacement

Endoprosthetics is called surgical intervention, aimed at replacing the injured as a result of illness or injury of the hip joint by an artificial one. Sometimes such an operation is the only way by which you can return the patient the opportunity to move.

For the elderly, the artificial joint in most cases serves them all life.

Indications and contra-indications for endoprosthetics

Indication for surgical intervention

Replacement of the joint is a complicated procedure that requires a long time for rehabilitation, therefore its appointment requires strict indications.

To diseases in which a hip replacement is required, it is possible to refer:

• rheumatoid arthritis;
• defeat of the hip joint with Bekhterev's disease;
• fracture of the femoral neck;
• hip joint trauma, which can not be cured by other methods;
• long-term chronic diseases of a degenerative-dystrophic nature - deforming arthrosis (coxarthrosis), arthritis;
• benign or malignant neoplasm of the joint;
• aseptic necrosis of the head of the femur.

When appointing an operation, the following are considered:

• stage of the disease;
• intensity and duration of painful attacks;
• results of conservative therapy;
• the need to use an additional support when driving;
• decreased motor activity in the joint;
• possible prospects for other surgical techniques.

The main contraindications for endoprosthetics

Among absolute contraindications to surgery:

• decompensated diseases of the cardiovascular and respiratory system;
• untreated foci of purulent infection;
• mental illness or disorders of neuromuscular activity;
• infectious process, localized in the region of the hip joint;
• a young age, which assumes incomplete formation of the structure of the skeleton;
• thromboembolism or thrombophlebitis of the lower extremity veins in the active stage;
• presence of polyallergy;
• impossibility to carry out movements in the patient;
• in the femur there is no cerebral canal.

Relative contraindications are:

• presence of hormonal osteopathy;
• acute liver failure;
• third degree of obesity.

Types of endoprostheses

Material for the endoprosthesis can be metal, especially strong ceramic or plastic.

Selection of the prosthesis is carried out individually. To date, there are more than sixty variations (modifications) of these designs. You can classify them depending on the procedure for performing the operation and on the method of attachment to the bone.

Depending on the technique of performing an operation, it is possible to distinguish:

1. Single-pole endoprostheses, used if necessary to replace the head of the femur (hemiarthroplasty).
2. Bipolar prostheses - when in replacement need and an acetabulum, and a bone head (total endoprosthetics).

Depending on the method of attaching the prosthesis to the bone, you can distinguish:

1. Prostheses cementless fixation - fastening is carried out with the germination of the patient's bone tissue in the structure of the endoprosthesis.
2. Combined or hybrid endoprostheses provide fastening of a cup by means of cementless method, and legs with special bone cement.
3. Prostheses of cement fixation - fixation of both parts of the endoprosthesis is carried out with the help of cement.

Modern hip joint prostheses should have the following characteristics:

• provide a large number of movements;
• protect the bone tissue of the acetabulum;
• have a head diameter close to natural;
• to have high abrasion resistance;
• Allow the doctor during a surgery to make a small incision or change the length of the patient's limb.

Preparation for the operation and its conduct

During the preparation for an operation, it is necessary:

• to hand over analyzes;
• make fresh x-ray images of the joint in two projections;
• to have an examination with a therapist;
• cure all diseases in acute form and chronically current infectious diseases;
• To pass examination at the stomatologist and to eliminate problems of an oral cavity;
• if the patient has excess weight, consultation of the endocrinologist and the dietician (superfluous weight of a body creates an increased load on the hip joint, which can lead to the development of postoperative complications);
• In advance, be concerned about purchasing crutches for the rehabilitation period.

Conducting surgical intervention

The hospitalization of a person takes place a day, on the first day an anesthesiologist's consultation is needed in order to choose the technique of anesthesia (endoprosthetics is performed both under general anesthesia and under the spinal anesthesia).

Stages of conducting:

1. After anesthesia, a cut and removal of the damaged joint surfaces is performed.
2. Fixation of endoprostheses (sometimes, in addition to the prescribed method of fixation, special screws are used).
3. Orthopedic examination of a new joint.
4. Sewing the wound (to drain the exudate and blood drainage is left).

Organizational matters

Endoprosthetics - a rather expensive surgical intervention (its cost depends on the clinic and can be from 70 to 200 thousand rubles).

For implementation, you can use two funding channels:

1. Personal funds of the patient - the person himself pays the cost of the endoprosthesis and the drugs used during the operation and the post-operation period.
2. Quota operation (high-tech medical care) is performed at the expense of the state, which is buying the prosthesis for the patient. In order to use the quota, it is necessary to collect a package of documents and stand in line, contacting the health department at the place of registration. From the time of submission of documents to conducting a free operation, it can take from 6 to 12 months.

Possible complications in the surgical intervention for hip arthroplasty

Complications that develop due to a doctor's mistake include:

• fracture of bone structures during the operation;
• violation of the sensitivity or innervation of the extremity due to the intersection of the neural bundle.

Among the other postoperative complications, we can distinguish:

• infectious process arising in the wound or in the area of ​​the artificial joint;
• development of pain syndrome (there are pains in the back, leg or pelvic area);
• dislocation of the endoprosthesis head;
• loosening of artificial prosthetic structures.

Features of the rehabilitation period

After the surgical intervention for the replacement of the hip joint, the patient is discharged after the removal of the sutures for 12-14 days.

In order to extend the life of joints, you must follow simple rules:

• When lifting, make sure that there is no turning of the foot inside;
• At least 7-8 days after surgery wear compression stockings;
• , -2 months after walking can only be relying on crutches, walking stick or walker;
• It is strictly forbidden to lift or carry objects weighing more than 10 kg;
• try to follow the body weight, not allowing it to increase;
• You can not fall, climb stairs or trees;
• You can not make sharp flops with your foot or lay your foot on your leg while sitting.

For a quick recovery after consulting a doctor, you can practice on an exercise bike (other simulators recommended by a specialist) and swim.

Re-replacement of the joint (revision endoprosthetics) is required if the joint has become unusable, infection or destruction of bone tissue occurred at the site of fixation of the endoprosthesis. After a second operation, the rehabilitation period will take at least 10-12 months, during which the person should be observed by an orthopedic doctor.