Dr. Hong Zhihong from the Department of Orthopaedics, Affiliated Hospital of China Medical University pointed out that some anti-inflammatory and analgesic drugs can be used when the hip joint is painful, but when the hip joint structure is damaged, artificial hip replacement surgery is needed to avoid the deterioration of the hip joint problem.
In order to solve the problem of hip joint injury, as early as 1930, doctors tried to use stainless steel artificial hip joint for total hip replacement. Because the hip joint needs to bear the weight and move frequently, the material, design and surgical technique of artificial hip joint have been continuously improved.
"To do artificial hip replacement surgery, you must first pass through multiple layers of muscles and soft tissues. Dr. Hong Zhihong explained, "Traditional surgery will directly cut off muscles, causing more damage, more severe postoperative pain and longer recovery period. In recent years, the "anterior approach artificial hip replacement" has been developed, which will enter from the muscle space, reduce the damage to muscles and soft tissues, make patients recover faster, have less pain and have a stable gait. 」
After years of transformation, in addition to the progress of surgical technology, the materials of artificial hip joint are constantly evolving.
Several key points to be paid attention to in total hip arthroplasty
The components of total artificial hip joint include acetabular cup, acetabular pad, femoral head and femoral stem. At this end of the acetabulum, the doctor will lock the acetabular cup into the acetabular fossa and then install the acetabular liner; At the femoral end, the doctor will take out the damaged femoral head, put the femoral shaft into the femoral shaft, and then lock the artificial femoral head.
Dr. Hong Zhihong explained that when choosing a total artificial hip joint, we will pay attention to several key points, including that the acetabular cup should be firmly fixed in the acetabular fossa, the artificial femoral head and acetabular liner should be wear-resistant and have low friction, and the femur should grow and heal to firmly fix the femoral stem, because the tasks of each component are different and the material requirements are different.
"acetabular cup": fixed in acetabular fossa, mostly made of metal.
"Acetabular liner": Plastic liner is quite common. It used to be made of polyethylene, but after repeated rubbing, debris may appear, leading to complications, so various high wear-resistant polyethylene were developed to improve it. Subsequently, the acetabular lining made of ceramics was developed, which has high biocompatibility and considerable stability.
"Artificial femoral head": The contact surface between artificial femoral head and acetabular pad is the main friction surface of artificial hip joint. At present, there are different antifriction and wear-resistant materials to choose from. Can be made of alloy with plastic liner; It can also be made of ceramic with plastic or ceramic pads. Ceramic materials have high polishing and fracture resistance, which can effectively reduce the friction between contact surfaces and prolong the service life of artificial joints.
"Artificial femoral stem": It is made of alloy and will be inserted into the femoral shaft. In order to prevent loosening, the contact surface between the femoral shaft and the bone will be treated in various ways to help the bone heal and firmly fix the femoral shaft. Some people roughen the surface of the femoral shaft to increase friction; Some use "hydroxyapatite".
Hydroxyapatite coating is similar to human skeleton and has good biocompatibility. In the process of bone healing, new bone tissue can be combined with hydroxyapatite coating. Full coating of femoral stem can increase long-term stability and reduce the probability of falling off. Because bone cement is not used, allergic reaction and post-embolization with bone cement can be avoided.
At present, there are many kinds of total artificial hip joints, including health insurance and self-funded projects, with different materials, characteristics and designs. Patients can consult with doctors and choose the appropriate total artificial hip joint.
Pay attention to the weight-bearing activities after total hip replacement.
Pay attention to weight bearing and range of motion after total hip replacement. You can walk just after surgery, but you can only bear part of your weight. You can't run and jump at will for the time being. Dr. Hong Zhihong reminded that after six months, the contact surface between the bone and the implant will heal and grow, so that you can get rid of crutches or walking AIDS and gradually resume gentle exercise.
Dr. Hong Zhihong said that after total hip replacement, special attention should be paid to the adduction or flexion of the hip joint. If it exceeds 90 degrees, the artificial hip joint may dislocate.
When lying flat, please keep your hips abduction, that is, put a pillow flat between your legs. You can't cross your legs. When turning over, your legs must keep the distance between the two pillows. Chairs and toilets should be high enough, knees should not be higher than hips, and feet should not be tilted. It is recommended to take a bath instead of sitting directly in the bathtub. Remember not to bend over too much to pick up things on the ground. It is best for patients to maintain an ideal weight and avoid excessive hip pressure.
If the surgical site is red and swollen, oozing blood, you hear abnormal sounds or feel abnormal pain in the hip joint during activities, you should return to the clinic as soon as possible.
A sweet little reminder
Dr. Hong Zhihong said that when there is pain in the hip joint and the range of motion is limited, it is necessary to seek medical attention as soon as possible. Hip joint injury, without taking painkillers, is just barely painless. If the injured bone is allowed to bear the weight, it will continue to damage the hip joint, increase the risk of complications and affect the follow-up treatment.
The progress of artificial hip joint surgery technology, such as the development of anterior approach artificial hip replacement, can reduce postoperative pain and increase gait stability; The progress of artificial hip joint materials can reduce friction and increase durability, which are helpful to improve the quality of treatment. Early medical treatment can achieve a better prognosis.