Anterior Hip Replacement Video
Hip replacement is an astonishingly successful medical technology, with some of the highest quality of life increases of all medical interventions. It has tranformed the lives of millions of mostly elderly people who were suffering from hip osteoarthritis.
There are a variety of techniques available to the hip surgeon for hip arthritis treatment. Cemented total hip replacement is the gold standard treatment for managing hip arthritis in the older (over 65 years) person and the complications, particularly loosening and dislocation, have been reduced to low levels by improved techniques. See an anterior hip replacement video to get the feel for what exactly goes on during the operation, this one's from YouTube and has a good, if rather technical, commentary:
Surgeons have what they call a variety of different “approaches” to the hip surgery. This means that they cut into the joint from a particular direction, meaning that specific structures such as tendon, muscle or bone have to be cut through and repaired afterwards. Each approach has advantages and disadvantages in terms of ease of access, a good view, more or less damage to important structures and post-operative risks such as dislocation.
The posterior approach gets at the hip from behind the joint and gives a good view and space to work, but may be more likely to dislocate postoperatively. The hip replacement operation can also be done from an anterior approach as in the video.
Hip resurfacing is an alternative method from standard hip replacement, in which much smaller amounts of bone are removed, leaving much of the upper femur bone in a normal state. A metal on metal resurfacing is used, avoiding the problems of polyethylene wear as occurs in hip replacements, with a lower incidence of dislocation and an ability for the patient to return to vigorous activities once the healing period is over.
In the hip replacement video, treatment of the arthritic hip consists of the surgical approach, dislocation of the hip to get at the socket and head, removal of bone from both sides, cementing of the components in place, relocation and testing of the joint and careful repairing of the cut structures. The total hip replacement video can be confusing and it is difficult to figure out which way up or way round things are but it still gives a clear idea of the complexity of the operation.
A hip resurfacing video is an excellent way of getting the hang of what is going on here and it is quite clear the method is entirely different to that in a hip replacement video, although the process is a bit gruesome and there is quite a bit of hammering and drilling.
Total Knee Replacement
Total knee replacement is a comparable medical technology to hip replacement and may soon be more common and more expensive that for the hip. Again, a total knee replacement video can be very illuminating in understanding what is removed and how the new components are fixed in place. This gives a patient some clarity as to what is inside the knee and may help them cooperate in their rehabilitation with the physiotherapist.