Total hip replacement is a surgery performed to replace a hip joint that has been damaged for various reasons and developed advanced arthrosis (calcification). 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 movement limitation.  The primary goal of this surgery is to relieve pain and improve functions. Before surgical treatment, non-surgical (conservative) treatment methods should be tried. Total hip prosthesis is suitable for patients whose hip pain cannot be controlled despite these treatment methods, whose daily living activities such as walking and climbing stairs are severely restricted, and who have advanced damage to the joint cartilage.

It should not be forgotten that it is always the patient who will make the final decision about whether his condition is serious enough to require a hip replacement.  Prosthesis Components and Types Almost all modern prostheses consist of 4 main parts that are fixed to the bones and move to these fixed parts to perform the movements of the joint. Shell; After the slot called acetabulum is prepared by carving, this piece is clamped and nailed into the slot. Nowadays, almost all of them are titanium and cement-free. The porous structure and hydroxyapatite coating on the surface of the prosthesis facing the bone ensures that the prosthesis and the bone adhere to each other, fixing the prosthesis as if it were a part of the body. Prosthetic stem; This part is the part that goes into the thigh bone called the femur . Today, this part in all prostheses is titanium. In some patients, bone cement containing the active ingredient polymethylene methacrylate is glued to the bone and this is called cement prosthesis. If there is no osteoporosis, cementless prostheses are almost always used. The porous structure and hydroxyapatite coating on these prostheses ensure that the prosthesis and bone adhere tightly to each other, fixing the prosthesis as if it were a part of the body. Liner; It is placed by locking into the shell called Shell in the acetabulum. Its diameter varies depending on the prosthesis brand, what material it is made of, and most importantly, the diameter of the socket. It is made of plastic or ceramic called polyethylene. The head is fixed by clamping it on the handle. Its diameter should be the same as the diameter of the liner. However, their height varies depending on the shortness of the hips. 8-12 mm extension can be achieved by choosing the head. The materials the head is made of can be metal, ceramic, oxinium 

FREQUENTLY ASKED QUESTIONS

How long does a hip prosthesis last?

Although it depends on many factors, a properly fitted prosthesis is expected to last at least 15 years. There are also patients whose duration is 30 years or more. In patients who have been followed up at regular intervals in the long term; When the prosthesis reaches the end of its life, it is possible to replace only the spacer parts instead of replacing the entire prosthesis. In some cases where the prosthesis has reached the end of its life, the entire prosthesis, including the main parts that fit into the bone, can be replaced. Planning at home after hip replacement surgery Before going home, patients are explained and shown in detail how to walk with crutches or a walker and how to go up and down stairs. At first, sofas and chairs with supports that the patient can hold on to when sitting and standing are preferred. Care should be taken to ensure that the chairs you sit on are not too low. When sitting, the knees should not be higher than the hips relative to the floor. Situations that pose a risk of slipping should be avoided at home. Elevator apparatus for the toilet, a high shower chair should be used when bathing, or care should be taken to shower with standing support. Walking after hip replacement surgery. Unless there is a situation that requires otherwise after hip replacement surgery, patients can walk immediately the next day after the surgery. Patients are first walked with a walker to ensure control. Depending on the patient's condition, the walker or crutches are abandoned within 3-6 weeks. Duration of hospital stay after hip replacement surgery: Patients stay in the hospital for an average of 3 to 5 days after surgery. During this process, a possible superficial infection that may develop in the surgical area is monitored and physiotherapy is applied. A long stay in the hospital also has negative effects in terms of hospital-acquired infections. Lying position after hip replacement surgery. There are multiple surgical techniques for hip replacement. Postoperative recommendations may also vary depending on the technique applied. Generally, patients are asked to lie on their back for a certain period of time after surgery. The time required to lie sideways on the operated side or the other varies depending on the type of surgery. Patients are trained by physiotherapists on how to turn and lie on their side. Driving after hip replacement surgery varies depending on the patient's physical progress after total hip replacement surgery, but patients can start driving after an average of 6-9 weeks. After 3 months, patients can use a bicycle.

What are the complications after hip replacement surgery? 

All surgical procedures without exception carry risks, and hip replacement is no exception. Risks vary depending on the patient's general health condition. Serious complications after total hip replacement surgery occur at a very low rate. The main risks are: Infection: After total hip replacement, infection, that is, inflammation of the prosthesis, is seen between 0.1% and 2%. Having an infection elsewhere in the body (e.g., urinary tract, teeth), diabetes, excessive smoking and alcohol consumption, and the presence of other chronic diseases may increase this risk. It is necessary to treat any infections that may occur elsewhere in the body before surgery. Preventive antibiotic treatment is administered during surgery and the risk of infection is reduced by taking special precautions during surgery. If infection develops in the prosthesis, procedures such as repeated surgeries, removal of the prosthesis and reinsertion after a certain period of time may be required. Thrombosis: The most common problem is the formation of clots in the veins due to slowing of blood flow in the leg (deep vein thrombosis). To prevent this, preventive treatment with blood thinning medications and wearing compression stockings are applied after surgery. This treatment can be extended for up to 30 days if necessary. Starting hip movements and walking early after surgery and avoiding being sedentary will reduce this risk. When thrombosis is suspected, examinations must confirm this. Treatment is started only after this. Dislocation: It is one of the most important and common problems. It usually occurs in the first 3 weeks when the patient makes some involuntary or careless movements (crossing his legs, not placing a pillow while turning on his side, squatting on the floor, etc.). The treatment is to replace the hip joint under anesthesia and fix it with a special externally applied brace or to re-operate.