The hip joints (HJ) are the largest in size among all the joints in the human body. Every day they experience serious stress and, as the body ages, they tend to wear out, which leads to the development of coxarthrosis. Injuries to the hip joint of various kinds, as well as a number of other disorders, cannot be excluded. All this can lead to a decrease in the functionality of the hip joint, up to its complete immobilization. In such situations, the only way to avoid disability is to undergo surgery. Today, the most effective and safe is endoprosthesis replacement or replacement of the hip joint with an artificial endoprosthesis.
Clinical example No. 1.
Patient P., 64 years old, has been experiencing severe, gradually progressive pain in the area of the right hip joint for 3 years. I contacted K+31 in May 2021, was examined by an orthopedist, and x-rays of the hip joints were taken. Coxarthrosis was diagnosed on the right, stage 3, on the left, stage 2. Surgical treatment is recommended - total endoprosthetics of the right hip joint.
Taking into account the age of the patient, it was decided to use a cementless fixation prosthesis from Zimmer, a ceramic/ceramic friction pair.
Preoperative planning was carried out, calculated dimensions: Avenir 6 stem, Trilogy 60 cup, ceramic liner with an internal diameter of 40 mm, ceramic head 40 mm.
In May 2021, surgery was performed, total arthroplasty of the right hip joint.
The patient was activated and erect on the day of surgery. (in popular language, 6 hours after the operation the patient was seated in bed and stood up with additional support on a walker).
The next day after surgery, the patient was trained to walk with additional support on a walker. The pain syndrome was minimal due to the use of narcotic and non-narcotic analgesics, as well as intraoperative injection of soft tissue in the intervention area with a long-acting analgesic. On the second day after surgery, the patient was trained to walk up the stairs with crutches. The patient was discharged on the 4th day after surgery for outpatient follow-up care.
Possible complications
Any surgical intervention is traumatic for the body and carries a certain risk of complications, even with the installation of an expensive endoprosthesis. They can occur both during and after surgery. These include:
- fracture of the femoral diaphysis;
- failure of prosthetic components;
- bleeding;
- fat embolism;
- vein thrombosis;
- inflammatory and infectious processes.
Prosthetic operations are so well developed that the likelihood of complications is extremely low. Negative reactions after anesthesia have also been significantly reduced, as more and more interventions are performed without general anesthesia.
Clinical example No. 2
Patient K., 68 years old, over the course of 1 year noted a gradual increase in pain and limited range of motion in the right hip joint. I contacted K+31 in August 2021, and an x-ray revealed aseptic necrosis of the head of the right femur and stage 3 coxarthrosis.
Total endoprosthetics of the right hip joint was performed using a cementless fixation endoprosthesis from Zimmer, a ceramic/polyethylene friction pair. Smooth course of the postoperative period.
X-rays after surgery, the position of the endoprosthesis components is correct. The patient is activated the next day after surgery, trained to walk with additional support on a walker. On the second day after surgery, the patient walks around the ward and corridor without assistance with additional support from a walker.
The patient was discharged on the 4th day after surgery in satisfactory condition. Currently, the function of support and walking has been completely restored, he walks without additional support, there is no pain, and the normal gait pattern has been restored.
Safety and effectiveness of knee replacement
Today, this surgical operation is included in the standard of care, that is, it is a proven and safe medical practice. However, after it the following complications are possible:
- rejection of the artificial joint by the immune system;
- development of infectious and inflammatory process;
- impaired sensitivity and mobility of the operated limb;
- intra-articular bleeding and hematomas;
- dislocation of the head of the endoprosthesis.
In general, the manifestation of such complications is observed as a result of poorly performed surgery. Therefore, hip replacement should be performed in a licensed, well-equipped clinic with a qualified and experienced doctor. Correctly performed surgery allows you to completely restore mobility and functionality of the limb in 90% of cases.
Clinical example No. 3
Patient Z., 28 years old, came to the clinic in September 2017, injured 7 years before treatment as a result of an accident, he received a fracture of the acetabular cavity, complicated by osteomyelitis, sanitation of the joint was performed, followed by arthrodesis. Walking was carried out using the lumbar spine.
Due to the lack of movement in the hip joint, active lifestyle and young age of the patient, a decision was made to perform total hip replacement. This type of operation is an extremely complex orthopedic intervention.
Another category of patients who are indicated for total hip replacement are patients with femoral neck fractures, especially subcapital fractures. For this category of patients, it is critical to perform surgery as quickly as possible, since, taking into account age and concomitant pathology, the risk of complications increases with every hour that passes from the moment of injury.
How much does a hip replacement cost?
This is a rather complex and labor-intensive operation that requires a highly qualified doctor, deep knowledge and skills in working with surgical instruments. Therefore, the average cost of hip replacement is high. However, it can be performed within the framework of compulsory medical insurance, which will allow the costs of it to be fully or partially reimbursed. The final price of the service depends on the following factors:
- the severity of the joint damage and, accordingly, the complexity of the operation;
- materials from which the prosthesis is made (this affects its cost);
- the qualifications of the surgeon, the reputation of the clinic and other factors.
At the first consultation with the patient, the doctor will definitely tell you how much the hip replacement surgery costs, how it goes, what type of prosthesis is best to choose, etc. He will also provide complete information about the risks and complications, and the benefits of this method. In general, despite the high costs, the operation gives a person the last chance to live a full life.
Author of the article:
Vyacheslav Samoilov
Clinical example No. 4
Patient R., 74 years old, was brought to the K+31 clinic by an ambulance team in September 2021, injured 3 hours before admission, at home, fell on her left side.
She was hospitalized in the Russian Academy of Education, examined, water and electrolyte disturbances were corrected for 5 hours, after which the patient was taken to the operating room. Total endoprosthetics of the left hip joint was performed.
On the second day of hospitalization, the patient was transferred to the hospital ward. In K+31, patients in this category are provided with the highest possible comfort and safety in the early postoperative period by providing single rooms with an individual nurse. After a course of dressings, antibiotic prophylaxis, and physical therapy, the patient was discharged for outpatient follow-up treatment.
Another category of patients for whom total hip replacement is indicated are patients with congenital hip dislocation. When treatment for congenital hip dislocation is not carried out, or is carried out incorrectly, underdevelopment of the entire proximal femur and acetabular cavity occurs. Due to the reduced area of the articular surface, the load on them increases significantly, which leads to the early development of coxarthrosis.
Reviews from patients after surgery
Hello dear Ruben Vachaganovich. Your patient in the past 2021 and now living Andrey Aleksandrovich from Uralsk Kazakhstan writes to you with words of gratitude. Briefly about our upcoming meeting with you... I’m not a fan of going to doctors unnecessarily, in fact, I have an active lifestyle, in 2021, somehow without noticing, lameness appeared on my right leg and discomfort in the hip joint on the right side. Months have passed. Pain appeared. First I contacted our specialist rheumatologist and took a picture. They recommended going to the Seredavin clinic in Samara. There the doctor diagnosed coxarthrosis of the second degree. They prescribed injections, pills and throughout 2021 and until the fall of 2021 I was treated to use many medications. There was no result. The pain intensified. While walking I had to stop several times. A pandemic began and in this regard, many clinics in Russia went into quarantine. The choice was Kazan and Moscow. I looked through a bunch of sites on the Internet. I stopped at your clinic and don’t have an ounce of regret. There was a lot of advice from relatives, but the decision was mine and only. By the way, while analyzing the fact that provoked this illness, I remembered an accident in my car in the past. I think that's all it is. This is how we met you in your clinic, in your ward. I also met a lot of wonderful people and have no regrets. In the end, I wanted to thank you Ruben Vachaganovich for your work, your experience and your golden hands. Thank you universally. Yours Andrey