When your own hip joint refuses to obey, in many cases it can be replaced with an artificial one. The quality of currently available endoprostheses guarantees fewer and fewer complications. However, it must be remembered that no artificial pond can fully replace the natural one. Moreover, as the prosthesis wears out, it should be replaced every few years.
Degeneration of the hip joint , the so-calledcoxarthrosis , affects about 4% of people over 60 years of age. The most common cause of the disease (as much as 40% of cases) is a malformation of the hip in the form of a too shallow acetabulum in which the femoral head moves. Part of the head slides beyond the acetabulum, leading to the gradual destruction ofof the hip joint . The development of coxarthrosis is favored by disorders of the body's lipid metabolism, diabetes, alcoholism, overweight, injuries and diseases of the hip in childhood. The symptom of hip degeneration is pain in the groin and hip when standing up and walking, often radiating to the knee (or just felt there!), And a limp. Pain at rest occurs after prolonged stress on the affected joint and persists for a few hours after lying down (then it is an expression of an inflammatory reaction). As the disease continues, there is a greater and greater limitation of the possibilities of movement in the joint. Treatment is primarily based on relieving the joint (losing weight, using a cane or elbow crutches) and regular exercise to improve the condition of the muscles. Ailments are relieved by physiotherapeutic procedures (outpatient or sanatorium), and in periods of exacerbation of pain - non-steroidal anti-inflammatory drugs. But advanced coxarthrosis (especially the appearance of night pains) is an indication for hip replacement.
ImportantThe beginnings of arthroplasty
The history of arthroplasty goes back to the 19th century. Initially, various materials were inserted between the damaged articular surfaces - from human tissue (skin, fascia), through animal tissue, to artificial materials (e.g. celluloid). The surfaces of the ponds were also covered with precious metals - platinum, gold and silver. Attempts have been made to construct replacement joints from, for example, ivory, various animal tissues and metals. Unfortunately, most of these experiences have been unsuccessful.
Endoprostheses in the past and today
Firsta full-fledged hip joint endoprosthesis was constructed in the middle of the last century by an American, prof. J. Charnley. The principles of its construction have not changed so far, only the materials used for the construction are different. The endoprosthesis consists of a socket (hollow hemisphere) and a ball ending in a pin. The first bushing was made of polyethylene, nowadays it is more and more often made of titanium, and only the inner lining is made of polyethylene. Initially, an alloy of cob alt, chromium, molybdenum and nickel was used to construct the head and the stem. Since nickel was allergenic, it was replaced with titanium. Another material used today for the construction of endoprostheses is alumina ceramics. This material is biologically inert and resistant to abrasion (the friction between the surfaces is similar to that in a natural pond). Initially, entire prostheses were made of ceramics, but now only endoprosthesis heads are made of it. Over the years, the method of attaching the prosthetic components to the bone has also changed. Initially, the so-called bone cement. It was a polymer which, however, released compounds harmful to the body and increased the temperature, destroying the tissues. Then it was replaced by acrylic cement, also not free from defects. That is why the so-called cementless dentures. The outer surface of the endoprostheses (acetabulum and stem) is covered with titanium and hydroxyapatite (a natural mineral component of bone). They become rough, have a large surface area, and therefore, over time, natural bone grows into their pores, holding it as tightly as glue. The nature of the changes in the joint, the quality of the bone tissue (uncemented is rather excluded in osteoporosis) and the age of the patient determine which type of prosthesis should be used. Endoprostheses should not be used until the end of the growth period.
New solutions in arthroplasty
For several years (recently also in Poland) hip arthroplasty can be performed differently. A metal acetabulum is implanted in the hip bone, but the head and neck of the femur are not severed. The head is covered with a spherical metal cover, and the movement of the metal over the metal is smooth, without painful rubbing. The advantage of the procedure is a very short rehabilitation and the fact that it does not close the way to a possible later classic operation. The disadvantage is that it is not (unlike normal arthroplasty) reimbursed by the National He alth Fund (the cost of the procedure is over PLN 20,000). Almost like your own. The structure of an artificial pond is adapted to the natural function (rotating, sliding, bending). However, it must be remembered that no artificial pond can fully replace the natural one, and moreover, it requires a change in lifestyle and compliancespecific rules that allow you to protect the endoprosthesis. It wears out - it wears down an average of about 0.02 mm annually, and it loosens slightly with time. Therefore, the endoprosthesis should be replaced every few years. In order to postpone this moment in time, you need to follow the recommendations, incl. avoid heavy physical work, do not jump or run, i.e. do not force the leg with the endoprosthesis. Do not put your leg on the leg (risk of spraining). It is important to lose weight (overloading destroys the joint faster) and to prevent osteoporosis (it increases the risk of loosening of the endoprosthesis and the possibility of its protrusion, i.e. the acetabular indentation into the pelvic bones).
ProblemAscending prosthesis
It is an endoprosthesis not of a joint, but of a bone. In Poland, the first one was implanted in a 14-year-old boy in March 2006. The implant is like two sleeves, one into the other. Thanks to the implantation of a miniature motor (triggered wirelessly), the endoprosthesis can be gradually extended (by a total of several centimeters) without the need for further operations.
Hip joint like new
The construction of modern endoprostheses allows to fully recreate the movements of the damaged joint. The surgically cut head and neck of the femur are replaced by a metal ball with a pin, i.e. a special pin embedded in the medullary cavity of the remaining femur. The new head slides over the new acetabulum, replacing the damaged hip joint.
Endoprostheses can replace many joints
Today, orthopedics has many types of artificial joints that perfectly recreate the functions of the real ones. The vast majority of prostheses are used in the area of the lower limbs - primarily the hips, then the knees. Much less often, the endoprosthesis is replaced with the upper ankle joint and the first metatarsophalangeal joint (big toe joint). In the upper limbs, on the other hand, arthroplasty of the shoulder-shoulder joints, elbows and small joints of the hands (metacarpophalangeal and proximal interphalangeal joints) are most often performed. Endoprostheses are not cheap - the cost of the procedure ranges from PLN 2,000 to PLN 9,000. PLN.
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