It is also important to research the hospital or facility where you will have your operation, as well as its supporting staff, such as the anesthesiologists. The success rate for hip replacement surgery at HSS is very high.
In a study, HSS interviewed patients to learn about their progress. Two years after their surgeries, Below, explore detailed articles and other content on this topic, or find the best hip replacement surgeon at HSS to suit your specific condition, location and insurance. Get more detailed information on different types of hip replacement surgeries and related topics, such as hip arthritis and postsurgical rehabilitation.
Learn more about reliability data so you can avoid unnecessary risks. Hip Replacement. What is hip replacement surgery? How do you know if you need a hip replacement? What are the different types of hip replacement? How should I prepare for a hip replacement? Can hip replacement be done as an outpatient? How long does hip replacement surgery take? What is hip replacement surgery recovery like? Can I have both hips replaced at the same time?
How long do hip implants last? What are the risks of hip replacement? Hip replacement surgery overview articles Get more detailed information on different types of hip replacement surgeries and related topics, such as hip arthritis and postsurgical rehabilitation.
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Updated visitor guidelines. You are here Home » Partial Hip Replacement. Top of the page. Surgery Overview A partial hip replacement removes and replaces the ball of the hip joint. It is firmly fixed in the femur in one of two ways: Cemented to the bone. This kind of stem has a porous coating that the bone grows into.
What To Expect Right after surgery When you wake up from surgery, your pain will be controlled with intravenous IV medicine. Moving around As soon as possible, you will be taught how to move your body without dislocating your hip.
You keep your shoulders, hips, knees, and feet facing forward. You do not let your affected leg cross the center of your body toward the other leg. Your therapist may suggest that you: Do not cross your legs or feet. Be very careful as you get in or out of bed or a car.
Make sure your leg does not cross that imaginary line down the middle of your body. Keep a pillow between your knees when you are lying down. When you are on your back, the pillow rests under the affected leg and on top of the other leg. This helps you turn onto your side without twisting at the hips. Leaving the hospital Your doctor will let you know if you will stay in the hospital or if you can go home the day of surgery.
Continued recovery During the first week or so after surgery, you will need less and less pain medicine. Don't drive until: Your doctor says it is okay for you to drive.
You're not taking an opioid pain medicine. Living with a hip replacement Exercise such as swimming and walking is important for building your muscle strength. You probably will be able to resume activities that you did before surgery, such as golfing, biking, swimming, or dancing. Your doctor may discourage you from running, playing tennis, and doing other things that put a lot of stress on the joint.
Your doctor will probably want to see you at least once every year to check your hip. Why It Is Done A partial hip replacement surgery is most often done to repair certain types of hip fractures. How Well It Works Surgery usually works well. Other theoretical benefits include improved range of hip motion, decreased risk of dislocation and improved hip function, to provide a better clinical outcome over UH[ 25 , 29 - 31 ].
However, the proven benefits of BH over UH remain to be confirmed[ 25 , 29 - 31 ]. A hip hemi-arthroplasty with a unipolar component head A ; a hip hemi-arthroplasty with a bipolar component head B ; a hip hemi-arthroplasty with an uncemented femoral stem C ; and a hip hemi-arthroplasty with a cemented femoral stem D.
There are three recent meta-analyses[ 29 - 31 ] and one Cochrane review[ 25 ] which compare the outcomes of unipolar to bipolar hip hemi-arthroplasties for femoral neck fracture. The most recent meta-analysis is by Zhou et al[ 29 ].
The authors performed a systematic database search, till April , to identify all RCTs which compare UH to BH, as treatment of displaced femoral neck fractures[ 29 ]. Eight RCTs were included in the meta-analysis, providing a synthesis cohort of patients[ 29 ]. The authors concluded that there was no apparent difference in clinical results between UH and BH, when used as treatment for displaced intra-capsular neck of femur fractures[ 29 ].
The second of the recent meta-analyses was that by Jia et al[ 30 ]. The authors performed a systematic literature search, until April , to identify all RCTs which compared UH to BH as treatment of displaced intra-capsular neck of femoral fractures[ 30 ]. The meta-analysis comprised ten RCTs, providing a synthesis cohort of patients[ 30 ].
On systematic review of the included studies, the authors found descriptive evidence that BH was superior to UH for post-operative hip function, quality of life and post-operative hip pain; however on meta-analysis, there was no significant difference in post-operative Harris Hip Scores between UH and BH MD, The authors concluded that, comparing UH to BH, no significant difference could be found between post-operative result and longer term rates of acetabular erosion; however BH was consistently noted to be the more expensive implant[ 30 ].
The last of the recent meta-analyses was that by Yang et al[ 31 ]. The authors performed a systematic database search, till July , to identify all prospective RCTs that compare UH to BH for the treatment of neck of femur fractures in patients aged 65 years and over[ 31 ].
Six RCTs were included in the meta-analysis, with a combined cohort of patients[ 31 ]. The authors concluded that there was no significant difference noted in clinical outcome for UH compared to BH when used as treatment of displaced intra-capsular neck of femur fractures in patients aged 65 or over[ 31 ].
Given the similar clinical outcomes, they advised that unipolar implants appear the more economical prosthesis[ 31 ]. Lastly, the most recent Cochrane review on the topic is that Parker et al[ 25 ].
The authors performed a systematic database search till September , to identify all RCTS and quasi-RCTs comparing the use of different arthroplasty prostheses as management of femoral neck fractures[ 25 ].
In total, twenty-three studies were included, with a synthesis cohort of patients[ 25 ]. A sub-group analysis was performed, assessing all studies which compared UH to BH: this comprised seven studies, with a combined cohort of patients fractures[ 25 ].
The authors concluded that from the available evidence, UH and BH implants demonstrated no significant clinical difference when used as treatment for displaced femoral neck fractures[ 25 ]. From the current evidence, it would appear, that while UH can be associated with increased rates of acetabular erosion at short-term follow-up up to 1 year , there is no significant difference between the two prosthesis types for surgical outcome, complication profile, functional outcome and acetabular erosion rates at longer-term follow-up 2 to 4 years.
Thus, with BH being the more expensive prosthesis, UH would appear to be the recommended option. However, the use of cement intra-operatively potentially confers the risks of cardiac arrhythmias and cardio-respiratory compromise, secondary to fat embolism and cement reaction phenomena[ 25 , 32 - 34 ]. Revision of a cemented hemi-arthroplasty is also considered more challenging than that of an uncemented hemi-arthroplasty[ 25 , 32 - 34 ]. Uncemented hemi-arthroplasties theoretically incur a shorter operating time, due to the lack of cementation required; they also have been noted to be the cheaper of the two prosthesis types[ 25 , 32 - 34 ].
As such, the optimal technique for femoral stem insertion remains to be decided[ 25 , 32 - 34 ]. There are three recent meta-analyses[ 32 - 34 ] and one Cochrane review[ 25 ] which compare the outcomes of cemented to uncemented hip hemi-arthroplasties for femoral neck fracture.
The most recent meta-analysis is that by Veldman et al[ 32 ]. The authors performed a systematic database search, till April , to identify all RCTs comparing outcomes for cemented versus uncemented hemi-arthroplasties for femoral neck fracture, which used contemporary generation femoral stems only[ 32 ].
Five RCTs were included in the meta-analysis, with a synthesis cohort of patients hips [ 32 ]. Complications were categorised as: prosthesis-related dislocation, aseptic prosthesis loosening, peri-prosthetic fractures ; cardiovascular-related; local deep and superficial wound infections ; and other general complications[ 32 ]. However, cementless hemi-arthroplasties were associated with a shorter operating time compared to cemented hemi-arthroplasties WMD The authors concluded that, for fracture-related hip hemiarthroplasty using contemporary femoral stems, cemented hemi-arthroplasties were associated with fewer prosthesis-related complications, though with similar mortality rates, as compared to uncemented hemi-arthroplasties[ 32 ].
However, it must be noted that the data regarding implant-related complications, in this meta-analysis, was heterogeneous[ 32 ].
Review of the three studies, which reported on implant-related complications, revealed the most common complication was peri-prosthetic femoral fracture[ 32 ]. However, no formal break-down of the individual implant-related complications was provided in the meta-analysis[ 32 ]. As such, a more detailed meta-analysis is required to properly define the increased risk posed by uncemented prostheses.
Nevertheless, the current evidence suggests that the cemented technique is safer. The second most recent meta-analysis is that by Ning et al[ 33 ]. The authors performed a systematic database search, till March , to identify all RCTs which compared cemented to uncemented hemi-arthroplasty for fracture, including all available prosthesis types[ 33 ].
Twelve RCTs were included in the meta-analysis, providing a synthesis cohort of patients[ 33 ]. On meta-analysis, cemented hip hemi-arthroplasties were associated with a prolonged operative time when compared to uncemented hemi-arthroplasties SMD The authors concluded that the outcomes of uncemented and cemented hip hemiarthroplasty for femoral neck fracture, showed no significant difference[ 33 ].
The last of the recent meta-analyses was that by Luo et al[ 34 ]. The authors performed a systematic database search, till December , to identify all RCTs comparing uncemented and cemented hip hemiarthroplasty all prosthesis types included , as treatment for neck of femur fractures[ 34 ]. Eight RCTs were included in the meta-analysis, providing a synthesis cohort of hips[ 34 ]. The authors concluded that, while the cemented prostheses were associated with lower rates of post-operative pain as compared to the uncemented prostheses, the two types of hemi-arthroplasty showed no significant difference in complication rates, reoperation rates and mortality rates[ 34 ].
On sub-group analysis, six studies were identified which compared cemented to uncemented hemi-arthroplasties for neck of femur fracture, providing a synthesis cohort of participants[ 25 ]. All prosthesis types were included in the review[ 25 ]. On meta-analysis, cemented hemi-arthroplasties had a significantly prolonged operation time MD 7. The authors concluded that cemented hip hemi-arthroplasties can reduce the risk of peri-operative femoral fracture, reduce post-operative pain levels and provide improved post-operative mobility, when compared to uncemented hip hemi-arthroplasties for displaced femoral neck fractures, with no significant difference between the two techniques for mortality at any of the follow-up time points[ 25 ].
The current evidence would suggest that while uncemented hemi-arthoplasties can allow for a shorter operative time, cemented hemi-arthroplasties are associated with lower rates of prosthesis-related complications particularly peri-prosthetic femoral fracture and improved post-operative results in terms of residual thigh pain and mobility.
In addition, there appears to be no significant difference between the two techniques for intra-operative blood loss, medical complications and mortality peri-operative and 1-year. In accordance with the current literature, a cemented hip hemi-arthroplasty would appear to be the superior technique.
There are two main types of prosthesis assembly that can be used in hip hemi-arthroplasty: monoblock prosthesis and modular prosthesis[ 35 ]. After you receive a hemiarthroplasty you will recover for a few days in the hospital. You will then be discharged from the facility and you will be transferred to a skilled nursing facility or allowed to go home. Physical therapy will start when you are still in hospital and will continue after you leave.
It is a long road to recovery from an injury of this nature and some people may never be able to return to their previous lifestyle without modification. High impact activity will probably need to be limited as well as heavy weight bearing. Surgeries of this magnitude depend just as much on the care after your surgery as the skill of your surgeon. It is important to follow all post-operative instructions, diligently attend physical therapy as prescribed, and do not miss your follow up doctor appointments.
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