Total hip replacement is an operation to replace a hip joint that has been damaged for various reasons and has advanced arthrosis. There is no upper age limit for this surgery, which is mainly performed after middle age. The most important criteria in patient selection are pain and limitation of movement. The primary goal with this surgery is to relieve pain and improve functions. Before surgical treatment, non-surgical (conservative) treatment methods should be tried. Although these treatment methods have been applied, total hip prosthesis is suitable for patients whose hip pain cannot be controlled, daily living activities such as walking and climbing stairs are severely restricted and there is severe damage to the articular cartilage.

It should be noted that it is always the patient who will make the final decision on whether his condition is serious enough to require hip replacement. Prosthetic Components and Types Almost all of the modern prostheses consist of 4 main parts that are fixed to the bones and pass to these fixed parts and make the movements of the joint. Shell (shell); After this piece, called the acetabulum, is prepared by carving, it is compressed and nailed into the slot. Today, almost all of them are titanium and cementless. The porous structure and hydroxyapatite coating on the bone-facing surface of the prosthesis ensures that the prosthesis and the bone are attached to each other, fixes the prosthesis as a part of the body. Prosthetic stem (stem); This part is the part that goes into the thigh bone called the femur. Today, this part is titanium in all prostheses. In some patients, cement (bone cement) with polymetimethacrylate active substance is adhered to the bone and this is called a cemented prosthesis. If there is no bone resorption, cementless prostheses are almost always used. The porous structure and hydroxyapatite coating on these prostheses ensure that the prosthesis and the bone are firmly attached to each other, fixing the prosthesis as a part of the body. Liner; It is locked inside the shell called the shell in the acetabulum. Its diameter varies according to the brand of prosthesis, what material it is made of, and most importantly, the diameter of the socket. It is made of plastic or ceramic called polyethylene. Head; It is fixed by clamping on the handle. Its diameter must be the same as the diameter of the liner. However, their height varies according to the shortness of the hips. With the head selection, 8-12 mm extension can be achieved. The materials of the head can be metal, ceramic, oxinium.

FREQUENTLY ASKED QUESTIONS

How long does the hip replacement last?

Although it depends on many factors, a properly placed prosthesis is expected to last at least 15 years. There are also patients for whom this period is 30 years or more. In patients with long-term follow-up at regular intervals; When the prosthesis reaches the end of its life, it is possible to replace only the spacers instead of replacing the entire prosthesis. In some cases when the prosthesis has completed its life, the entire prosthesis can be replaced, including the main parts that fit on the bone. Planning at home after hip replacement surgery Before going home, patients are explained and shown with detailed applications how to walk with crutches or a walker, and how to go up and down stairs. At first, armchairs and chairs with supports that the patient can hold on while sitting and getting up are preferred. Care should be taken that the chairs are not too low. When sitting, the knees should not be higher than the hips. Situations that will cause the risk of slipping at home should be avoided. Riser apparatus for the toilet, a high shower chair should be used while taking a bath or care should be taken to take a shower with standing support. Walking after hip replacement surgery If there is no condition that would require otherwise after hip replacement surgery, patients are carried out immediately the day after the surgery. In order to be controlled, patients are first walked with a walker. Depending on the patient's condition, the walker or crutches are abandoned within 3-6 weeks. Length of hospital stay after hip replacement surgery Patients stay in the hospital for an average of 3 to 5 days after surgery. In this process, a possible superficial infection that may develop in the surgical area is followed up and physiotherapy is applied. A long stay in the hospital is also negative in terms of hospital-acquired infections. Lying position after hip replacement surgery There are multiple surgical techniques for hip replacement. Depending on the technique applied, post-operative recommendations may also change. In general, patients are asked to lie on their back for a certain period of time after surgery. The time required to lie on the operated side or the other side depends on the type of surgery. Physiotherapists teach patients how to lie on their side. Driving after hip replacement surgery Although it varies according to the physical progress capacity of the patient after total hip replacement surgery, patients can start driving after an average of 6-9 weeks. After 3 months, patients can use a bicycle.

Kalça protezi ameliyatı sonrası komplikasyonlar nelerdir? 

İstisnasız tüm cerrahi girişimler risk taşımaktadır ve kalça protezi de bunun dışında değildir. Riskler, hastanın genel sağlık durumuna göre değişmektedir. Total kalça protezi ameliyatından sonra görülen ciddi komplikasyonlar çok düşük oranda ortaya çıkar. Belli başlı riskler şunlardır: Enfeksiyon: Total kalça protezinden sonra, enfeksiyon yani protezin iltihaplanması % 0.1 ile %2 arasında görülür. Vücudun başka bir yerinde (ör. İdrar yolunda, dişlerde) enfeksiyon olması, şeker hastalığı, aşırı sigara ve alkol tüketimi ve başka kronik hastalıkların varlığı bu riski arttırabilir. Ameliyat öncesinde vücudun başka bir yerinde olabilecek enfeksiyonların tedavisi gereklidir. Ameliyat sırasında koruyucu antibiyotik tedavisi yapılır ve cerrahi sırasında özel önlemler alınarak enfeksiyon riski azaltılır. Protezde enfeksiyon gelişirse, tekrarlayan cerrahiler, protezin çıkartılıp belirli bir süre sonra tekrar yerleştirilmesi gibi işlemler gerekli olabilir. Tromboz: En sık görülen sorun, bacaktaki kan akımının yavaşlamasına bağlı olarak toplar damarlarlarda pıhtı oluşmasıdır (derin ven trombozu). Bunu önlemek için cerrahiden sonra kanı sulandıracak ilaçlarla koruyucu tedavi ve varis çorabı giyilmesi uygulanır. Bu tedavi gerektiğinde 30 güne kadar uzatılabilir. Ameliyat sonrasında erken dönemde kalça hareketi ve yürüyüşlere başlamak ve hareketsiz kalmaktan kaçınmak, bu riski azaltacaktır. Trombozdan şüphelenildiğinde, yapılan tetkiklerin bunu teyit etmesi gerekmektedir. Tedaviye ancak bundan sonra başlanmaktadır. Çıkık (dislokasyon): En önemli ve sık görülen prblemlerden biridir. Genelikle ilk 3 haftada, hastanın istemsiz veya dikkatsizce yaptığı bazı hareketlerden (bacak bacak üstüne atma, yan dönerken yastık koymama, yere çömelme vb.) olmaktadır. Tedavisi, kalça eklemini anestezi altında yerine getirmek ve dışarıdan uygulanan özel bir breys ile tespit etmek veya yeniden ameliyat etmektir.