Cemented Total Hip Replacement at Yapita Health

Overview

Cemented total hip replacement is a surgical procedure involving the use of bone cement to secure the artificial components in the hip joint. The damaged femoral head is removed, and a prosthetic stem with a ball is inserted into the femur, while an artificial socket is fixed in the acetabulum using bone cement for stability and longevity.

Why Would Someone Need to Have Cemented Total Hip Replacement?

Cemented total hip replacement is recommended when individuals have deteriorating hip joints due to conditions like osteoarthritis or fractures. This procedure is suitable for patients with weakened bone structures, providing immediate stability through bone cement. It ensures the longevity of the prosthetic components by anchoring them securely, making cemented total hip replacement a viable option for those who may not have the optimal bone quality for other hip replacement techniques.

Conditions that can require Cemented Total Hip Replacement

• Osteoarthritis

• Rheumatoid arthritis

• Avascular necrosis

• Fractures

• Congenital hip disorders

Requirements & Evaluation for Cemented Total Hip Replacement

Candidates for cemented total hip replacement undergo a thorough evaluation. Criteria include severe hip pain, limited mobility, and compromised bone quality. Preoperative assessments consider overall health, bone density, and the ability to follow postoperative protocols. The decision is based on optimizing outcomes and ensuring that patients are physically capable of undergoing and benefiting from cemented total hip replacement, particularly when bone quality may be a concern for other hip replacement techniques.

Different Types of Cemented Total Hip Replacement

Cemented total hip replacement procedures primarily differ based on the design and materials of the prosthetic components. Some common types include:

1. Traditional Cemented Total Hip Replacement:

A standard technique using bone cement to secure both the femoral and acetabular components.

2. Hybrid Total Hip Replacement:

Combines a cemented femoral component with a press-fit acetabular component.

3. Bone-Conserving Cemented Total Hip Replacement:

Aims to preserve more bone by using a shorter stem for the femoral component.

4. Cemented Hip Resurfacing:

Involves capping the femoral head with a metal prosthesis and securing it with bone cement.

The choice of cemented total hip replacement type depends on factors such as the patient's age, bone quality, and surgeon preference.

Procedure for Cemented Total Hip Replacement

Before the Procedure:

• Preoperative Assessment: Comprehensive evaluation of the patient's overall health and hip condition.

• Diagnostic Imaging: X-rays, CT scans, or MRI to assess hip damage.

• Medical Clearance: Ensuring the patient is fit for surgery.

• Surgeon Consultation: Discussion of the procedure, potential risks, and expected outcomes.

During the Procedure:

• Anesthesia: Administering general or regional anesthesia.

• Incision: Making an incision, typically along the side or back of the hip.

• Joint Exposure: Gently moving tissues to expose the hip joint.

• Femoral Head Removal: Removing the damaged femoral head.

• Socket Preparation: Preparing the acetabulum for the artificial socket.

• Femoral Component Placement: Insert the artificial stem with a ball into the femur.

• Cement Application: Using bone cement to secure the prosthetic components.

• Trial Components: Checking fit and stability with temporary trial components.

• Final Implant Placement: Securely implanting final prosthetic components.

• Closure: Suturing or stapling tissues and closing the incision.

After the Procedure:

• Immediate Postoperative Care: Monitoring in the recovery room.

• Hospital Stay: Typically 2-5 days, depending on patient progress.

• Pain Management: Medications to control pain and discomfort.

• Early Mobilization: Encouraging movement and walking with assistance.

• Physical Therapy: Initiating rehabilitation exercises to restore hip function.

Risks:

• Infection: Risk of postoperative infections.

• Blood Clots: Potential for deep vein thrombosis (DVT).

• Implant Dislocation: Prosthetic components may dislocate.

• Nerve or Blood Vessel Injury: Rare but possible during surgery.

• Cement-related Complications: Allergic reactions or issues related to the use of bone cement.

Benefits:

• Immediate Stability: Bone cement provides immediate stability to prosthetic components.

• Predictable Outcomes: Well-established technique with predictable outcomes.

• Suitable for Weakened Bone: Ideal for patients with compromised bone quality.

Recovery:

• Immediate Postoperative Period: Gradual progression from assisted walking to increased mobility.

• Physical Therapy: Essential for regaining strength, flexibility, and balance.

• Weight-Bearing Progression: Gradual return to weight-bearing activities.

• Follow-up Appointments: Regular monitoring of healing and progress.

• Long-Term: Full recovery may take several weeks to months, with ongoing improvement over time.