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Total Hip Replacement (THR)

INTRODUCTION

Total hip arthroplasty is also known as total hip replacement (THR).

It is a surgical procedure which consists of replacing both the hip joint -including the acetabulum or hip cavity, and the femoral head. It is most commonly used to treat cartilage and bone wear caused by osteoarthritis, and also to treat a degenerative joint disease. A total hip replacement is necessary when the cartilage wears away. At this point, damaged bones may start to grow outward and form bone spurs, causing pain and making mobility difficult. 

 

                          Hip osteoarthritis and total hip replacement 

 

SURGICAL TECHNIQUE

An incision 10 - 12 cm long is made along the side of your hip joint. Typically, this incision will be made from an anterior or lateral approach to the hip. The joint muscles, tendons and capsule are lifted from the joint in order to access the head of the femur and the acetabulum. 

During the THR procedure, the surgeon will make a series of cuts on the cartilage and damaged bone and the damaged joint surface will be replaced with a device made very resistant metal and plastic. 

This artificial hip joint allows pain free movement in the joint.

There are many different types of prosthesis available, and your surgeon will choose one or another based on the stage of your condition, your age, your weight, your medical history and activity level. 

It is important to bear in mind that overweight and obesity will directly affect the prosthesis durability in a negative way.

 

TIEMPO DE RECUPERACIÓN 

0 – 2 WEEKS: 

You will need to stay in the hospital for 3 - 4 days for managing pain and avoiding post-operative complications.

A drainage is routinely used for 24 -48 hours after the surgery to avoid the formation of haematoma inside the hip.

Once the drainage or Redon drain has been removed, patient will be able to sit and walk using walking sticks or a frame, according to the preferences and skills of each patient. 

It is perfectly normal to experience some swelling and pain during this initial period. In spite of these symptoms, it is important to


continue your walks and exercises recommended upon discharge.

Avoid hip flexion when sitting -you can use cushions for the chairs and a raised toilet seat. Also, do not cross your legs. Follow these recommendations to avoid complications like prosthesis dislocation during the first 3 months after the surgery. 

Keep your wound clean and change its dressing every two days. Stitches or staples will be removed on the second week after surgery.

It is important to take low-molecular-weight heparin or other approved drugs to prevent complications like thrombosis. 

After the second week, Dr Peña Rodríguez will see you to check the wound and the progress made since the surgery.

Do not hesitate to contact me before this appointment is due if you have any complications. 

 

2 – 6 WEEKS: 

It is normal to still feel some discomfort.

You will need to improve your strength and muscle tone. Most patients need a physical therapy programme.  

At the end of this period, patient should be able to walk without any walking support.

Dr Peña Rodriguez will review the patient for the second time, and an X-ray examination will be performed.  

 

6 – 12 WEEKS: 

At the end of this period, you hip will have full range of movement and minimal swelling and pain.

The risk for dislocation will be reduced, but hip position should not be forced anyway. 

A follow-up appointment will not be necessary during this period, but please do not hesitate to request an appointment or contact me with any problem that may arise. 


3 – 6 MONTHS:

It is important that you control your weight, as overweight negatively affects the prosthesis longevity and the mechanics of the hip joint.

You might experience some pain after long walks. This is normal as your body gets used to this new activity, which most probably you could not perform before the surgery due to the advanced stage of osteoarthritis.

Try not to lose your hope, as it usually gets better over time. 

After the sixth month, you will have another follow-up appointment with Dr Peña Rodriguez to assess your hip stability, muscle tone, proprioception and range of motion as he did on the second radiological review. 

From this moment, we recommend follow-up appointments on a yearly basis, to assess the prosthesis condition.