Cementless Total Hip Replacement (THR) Surgery at Yapita Health

Overview

Cementless total hip replacement surgery involves using prosthetic components that encourage bone integration without cement. This technique can promote long-term stability and reduce the risk of implant loosening.

Why Would Someone Need to Have Cementless Total Hip Replacement Surgery?

Cementless total hip replacement is preferred for patients with good bone quality, as it encourages natural bone ingrowth onto the implant surface. This method is suitable for younger, active individuals, reducing the risk of long-term complications such as loosening, and promoting a more durable and stable hip joint.

Conditions that can require Cementless Total Hip Replacement Surgery

• Osteoarthritis: Severe hip joint degeneration.

• Rheumatoid Arthritis: Chronic inflammatory joint disease.

• Avascular Necrosis: Loss of blood supply to the hip bone.

• Post-Traumatic Arthritis: Arthritis following hip injury.

• Young, Active Patients: Preferable for long-term durability in individuals with good bone quality.

Requirements & Evaluation for Cementless Total Hip Replacement Surgery

To be a candidate for cementless total hip replacement surgery, patients typically need good bone quality and overall health. Evaluation involves assessing hip joint damage due to conditions like osteoarthritis or avascular necrosis. The surgeon considers age, activity level, and medical history. Preoperative testing ensures the patient can tolerate surgery. Imaging, such as X-rays or MRIs, helps determine the extent of joint damage. Surgeons may also assess bone density. The decision for surgery is collaborative, involving the patient, surgeon, and medical team, to achieve optimal outcomes for long-term hip joint function and stability.

Different Types of Cementless Total Hip Replacement Surgery

• Direct Anterior Approach (DAA):

One variation of cementless total hip replacement surgery involves adopting a direct anterior approach (DAA). This technique entails accessing the hip joint from the front of the body. By doing so, surgeons can minimize muscle damage, potentially resulting in a faster and less painful recovery for the patient.

• Ceramic-on-Ceramic Implants:

• In certain cementless hip replacements, surgeons may opt for ceramic-on-ceramic implants. These implants utilize ceramic materials for both the femoral head and the acetabular socket. This combination offers advantages such as reduced wear rates and increased durability compared to some other materials.

• Metal-on-Highly Crosslinked Polyethylene (XLPE) Implants:

Another type involves the use of metal-on-highly crosslinked polyethylene (XLPE) implants. This design combines a metal femoral head with a socket made of highly crosslinked polyethylene. This combination aims to minimize wear and tear on the joint and improve the overall longevity of the implant.

• Dual Mobility Implants: Dual mobility implants represent a different category, featuring an additional bearing surface. This design enhances stability, reducing the risk of dislocation. This can be particularly beneficial for patients concerned about the potential for hip joint dislocation following surgery.

These various types of cementless total hip replacement surgeries provide surgeons with options to tailor the procedure based on individual patient characteristics, preferences, and specific medical considerations. The choice of approach and implant type is often made collaboratively between the patient and the surgical team.

Procedure for Cementless Total Hip Replacement Surgery

Before the Procedure:

Consultation:

• Patient evaluation, medical history review, and discussion of hip pain and limitations.

• Imaging studies, such as X-rays or MRIs, to assess joint damage.

Preoperative Testing:

• Blood tests, electrocardiogram (ECG), and other assessments to ensure surgical fitness.

• Discussion of potential risks and benefits.

Preparation:

• Instructions on pre-surgery lifestyle adjustments, medications, and fasting.

After the Procedure:

Recovery Room:

Monitored for initial recovery and pain management.

• Physical Therapy:

• Rehabilitation begins, including exercises to promote mobility and strength.

Hospital Stay:

• Typically 1-4 days, depending on individual progress.

Follow-up Care:

• Regular postoperative check-ups to monitor healing and address concerns.

Return to Activities:

• Gradual resumption of normal activities under the guidance of the medical team.

Long-term Follow-up:

• Periodic follow-ups to assess long-term outcomes and address any issues.

Risks and Benefits

Risks

Infection:

• Risk of postoperative infection, which may require antibiotic treatment or revision surgery.

Blood Clots:

• Potential for deep vein thrombosis (DVT) or pulmonary embolism.

Dislocation:

• Risk of hip joint dislocation, especially in the early postoperative period.

Implant Loosening:

• Though less common, there is a risk of the implant not integrating properly with the bone.

Nerve or Blood Vessel Damage:

• Possibility of injury to nearby nerves or blood vessels during surgery.

Benefits of Cementless Total Hip Replacement Surgery:

Reduced Wear and Tear:

• Cementless implants may lead to less wear and tear over time, potentially increasing longevity.

Quicker Recovery:

• Minimal trauma to muscles and tissues can result in a faster recovery compared to cemented techniques.

Stability and Range of Motion:

• Improved stability and range of motion, enhancing overall joint function.

Lower Risk of Allergic Reactions:

• Reduced risk of allergic reactions to cement materials.

Suitable for Young, Active Patients:

• Often preferred for individuals with good bone quality and an active lifestyle.

Recovery:

After cementless total hip replacement, immediate postoperative care includes pain management and monitoring in the recovery room. Physical therapy begins promptly, focusing on mobility and strength. Hospital stay ranges from 1 to 4 days, with gradual resumption of activities, driving restrictions, and long-term follow-up appointments to monitor progress and address concerns.

Recovery timelines can vary, and adherence to rehabilitation protocols is crucial for optimal outcomes. Individual progress depends on factors such as overall health, adherence to postoperative instructions, and the extent of pre-surgical joint damage. Patients should communicate openly with their healthcare team throughout the recovery process.