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Hip Arthroplasty Definition

An arthroplasty is the surgical replacement or reconstruction of a joint which is abnormally formed, fractured or suffers arthritic degeneration. There are different types of hip replacement joints but typical replacements are made of metal or plastic, with various techniques available for differing clinical presentations.

Arthroplasty is performed for pain relief in arthritic joints and to realign joints with abnormal structures. Two types exist:

  • Joint resection or excision arthroplasty, such as the Girdestone arthroplasty of the hip, where the joint surfaces are removed and soft tissue is placed in the gap. This develops into scar and give some stability to the joint. However, in the hip where this is performed, it leaves a short and not particularly stable joint for which the patient always requires walking aids.

  • Joint replacement arthroplasty or interpositional arthroplasty, which refers to the fact that an artificial implant of some material is placed in the gap formed by the surgery.

Joint replacements, mostly hip replacement and knee replacement, are the common interpositional arthroplasties performed nowadays. Joint prostheses have also been designed and implanted for ankles, shoulders, elbows and fingers.

There are a number of types of hip replacement to fit the differing requirements for hip replacement surgery due to the differing clinical presentations. Hip replacement methods and hip prosthesis types vary but all come under three main groupings: cemented hip replacement; cementless hip replacement and hip resurfacing.

Hip replacement causes also vary but osteoarthritis is the most common reason as it is the main degenerative joint condition in the world and predominantly suffered by older people. Arthritic diseases such as rheumatoid arthritis demand different types hip replacement prosthesis due to the often small nature of the bones and the fragility and instability of the joints.

All types of total hip replacements suffer from potential risks and complications such as loosening, infections, dislocation and post-operative problems such as deep vein thrombosis. There are also significant differences in the performance of the various types of hip replacement joints, although the best have a very high survival rate at 15 years after operation and sometimes much longer. Long term published results are the key point in deciding which type of replacement to plump for.


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