Total Hip Replacement U/L Surgery | Unilateral Hip Replace

Total Hip Replacement U/L

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Total Hip Replacement (THR), also known as Hip Arthroplasty, is a surgical procedure performed to relieve pain and improve mobility in individuals suffering from severe hip joint damage. This damage is most commonly caused by osteoarthritis, rheumatoid arthritis, avascular necrosis, or traumatic injury. In a Unilateral Total Hip Replacement (U/L), only one hip joint—either the left or right—is replaced with a prosthesis. This artificial joint is designed to mimic the natural movement and function of the hip, allowing patients to regain pain-free mobility.

The Hip Joint is a ball-and-socket joint, where the femoral head (the “ball” at the top of the thigh bone) fits into the acetabulum (the “socket” in the pelvis). Over time, conditions like arthritis can wear down the cartilage that cushions these bones, leading to pain, stiffness, and difficulty in walking or performing daily activities. When non-surgical treatments such as medication, physical therapy, or lifestyle changes fail to provide relief, a total hip replacement may be recommended.

Indications for Unilateral Total Hip Replacement

Severe Osteoarthritis: A degenerative joint disease-causing pain and
stiffness.
Rheumatoid Arthritis: An autoimmune condition that leads to joint
inflammation and damage.
Hip Fractures: Severe fractures that do not heal adequately with
conservative treatments.
Avascular Necrosis: A condition where the blood supply to the hip bone is
disrupted, leading to bone death and joint collapse.
Persistent Pain and Limited Mobility: When non-surgical treatments (such
as physical therapy or medications) fail to provide relief.

Diagnosis

Medical History: The physician gathers information about symptoms,
previous injuries, and treatments attempted.
Physical Examination: Assessment of hip range of motion, strength, and
any visible deformities.
Imaging Studies:
– X-rays: To evaluate the extent of joint damage and bone structure.
– MRI (Magnetic Resonance Imaging): Occasionally used to assess soft
tissues and more detailed joint conditions.

The Unilateral Total Hip Replacement Procedure

Anesthesia: The procedure is usually performed under general anesthesia
or spinal anesthesia.
Surgical Technique:
– Incision: A surgical incision is made over the hip area, which can vary in size
depending on the surgical approach (anterior, posterior, or lateral).
– Joint Exposure: The surgeon carefully moves muscles and tissues aside to
access the hip joint.
– Removal of Damaged Bone and Cartilage: The femoral head (the top of the
thigh bone) is removed along with any damaged cartilage from the acetabulum
(the hip socket).
– Implantation of Artificial Components
– Acetabular Component: A metal cup is placed into the hip socket.
– Femoral Component: A metal stem is inserted into the femur, topped with
a ball that mimics the natural femoral head.
– Closure: After ensuring proper alignment and stability, the incision is closed
with sutures or staples, and a dressing is applied.

Recovery

Initial Recovery: Patients typically stay in the hospital for 1 to 3 days. Pain
management and mobility assistance will be provided.
Physical Therapy: Rehabilitation usually begins the day after surgery,
focusing on strengthening, flexibility, and regaining range of motion. A physical
therapist will design a personalized exercise program.
Activity Restrictions: Patients are often advised to avoid high-impact
activities and certain movements (like crossing legs) for several weeks.
Gradual return to daily activities is encouraged.
Follow-Up Visits: Regular follow-up appointments with the orthopedic
surgeon are essential to monitor healing and assess progress.

Risks and Considerations

Infection: Risk of infection at the surgical site
Blood Clots: There is a risk of blood clots in the legs, which can be mitigated
through preventive measures like compression stockings and anticoagulants.
Dislocation: The new hip joint may dislocate, especially in the early stages of
recovery.
Implant Failure: Although rare, the artificial components may wear out or
loosen over time, necessitating revision surgery.
Nerve or Blood Vessel Damage: Rarely, surrounding nerves or blood vessels
may be injured during the procedure.

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