A hip replacement can be required for a number of reasons, the most common being to relieve severe arthritis pain or to correct joint damage as part of a total hip fracture treatment. Though a fairly intensive surgical procedure, a hip replacement conducted by an experienced specialist can not only help to reduce the amount of pain a patient must endure on a daily basis but provide far more mobility in the long term.
There are two types of hip replacements that can be performed – total or hemi (half). In a hemi hip replacement surgery, only the femoral head of the femur is replaced, while in a total surgery both the head and the acetabulum or hip socket are also replaced. The first recorded attempts at hip surgery stem from the 1890s in Germany, and improvements in technique and materials have been steady since that time – the most recent innovations have been in ensuring that all components in a hip replacement system are attached firmly to the underlying bone structure using either bone cement or treated femoral head stems that are treated to match the pore size of a patient's native bone. Currently, most hip replacements used are of a metal-on-metal type with a ball and socket design that allows for maximum movement.
Doctors performing hip replacement surgery have several choices in technique when it comes to implanting the hip device. Some prefer a posterior (back) approach, allowing excellent access to the acetabulum and femur, others favor a lateral (side) approach – this approach provides a lower risk of hip dislocations over time but can cause pain and weakness in the hips that is hard to treat once the surgery has been completed. It is also possible to use a minimally invasive approach with a smaller incision, but this often reduced the accuracy of the surgeon and may lead to soft tissue damage.
Complications that a patient may experience after surgery include dislocation of the hip called osteolysis in which bone mass is lost due to wear debris coming from the hip replacement itself. Over time, this wear debris can cause an inflammatory process to occur which eats away at bone around the hip replacement. It is also possible for a patient to develop metal sensitivity as a result of a hip replacement, which causes the development of pseudotumors around the replacement site. Alternate hip replacement materials are being investigated as possible replacements for metal ones that cause this issue.
Unfortunately, the complications set forth above have been added to in recent years with the implantation and recall of several implant devices made by DePuy Othopaedics which were the subject of a recall by the company in 2010. Studies have shown these devices have a failure rate that far exceeds the failure rate for similar devices and frequently have led patients to undergo a second surgery to repair damages caused by the initial surgery. Patients who were implanted with a Depuy device that has been the subject of the recall are urged to consult with their doctor regardless of whether they have experienced discomfort or pain.