Adult Orthopedics Clinic Adult Orthopedics Clinic

Hip joint endoprosthesis replacementЭндопротезирование тазобедренного сустава

Endoprosthesis replacement is a surgery aimed at complete replacement a defective joint or its separate part with a painless artificial element. Hip joint endoprosthesis replacement contributes to the resumption of the patient’s motion abilities and the restoration of the habitual rhythm of life.

There are several types of such surgical interference:

  • total endoprosthesis replacement is the replacement of the entire joint;
  • revision endoprosthesis replacement is the replacement of an already installed endoprosthesis.

Modern endoprostheses belong to complex technical products, which are selected individually.

Artificial prosthesis includes a stem, round head, liner and cup. The head rotates in a concave cavity, which helps to perform the desired range of motion.
The friction point in the endoprosthesis is a place where materials interact with each other when moving in an artificial joint. The materials include metal, ceramics, polyethylene, and their quality determine the service life of the product after installation.

Friction pair

Hip joint endoprosthesis replacement with 3D prosthesis

In a standard situation, endoprosthesis replacement involves the selection of a finished endoprosthesis for a patient on the basis of his/her X-ray images. Complicated clinical cases involve the creation of an individual prosthesis, taking into account all the physiological characteristics of the patient. Endoprosthesis replacement with the order of an individual prosthesis includes several steps:

  • creation of 3D virtual models of pelvic bones based on imaging examinations;
  • determining the concentration and size of bone damage according to the project and assessing the quality of bone tissue;
  • development of a personal acetabular system and planning the location of screws for fixing the structure;
  • printing models of the acetabular system and pelvic bones by means of 3D printer;
  • the structure by using titanium alloys and 3D printing.

The individual model completely replaces the damaged bone tissue. It is safe, durable, functional and much “closer” to the body, compared with artificial pelvic components of mass production. The Hip joint endoprosthesis replacement with the use of a personal 3D prosthesis is conducted by the leading clinics of the world. Endoprosthesis replacement with 3D structures restores the supporting ability in the first days after surgery and accelerates osseointegration.
The hip joint endoprosthesis replacement is a procedure of increased complexity with the use of high technologies, in which all stages are important, from preoperative examination to the rehabilitation period.

The following attachment types of endoprostheses are distinguished:

  • cement;
  • cementless;
  • hybrid.

Total endoprosthesis replacement

Indications for using the technique: gross post-traumatic pelvic deformity. Medical consultation is required.

During the consultation, indications and contraindications that interfere with endoprosthesis replacement are determined, studies are conducted and prosthesis is selected. The degree of the joint deterioration is determined by radiological examination. The patient is warned about the possible risks and complications that endoprosthesis replacement may entail.

Among them:

  • infection development in the area of intervention;
  • pneumonia;
  • thromboembolism (vascular blockage);
  • blood loss;
  • dislocation of the endoprosthesis.

A complete clinical examination of the patient and an anesthesiologist consultation are provided before the surgery. The patient is hospitalized a day or two before the date on which the endoprosthetic replacement is prescribed.

Operation progress

Endoprosthesis replacement is carried out in no more than 2 hours in a standard situation. Hip joint endoprosthesis replacement involves the permanent removal of a damaged joint and the installation of an endoprosthesis instead. The surgeon reams the cotyloid cavity and inserts an artificial one, fixing it with cement or screws. After the functions of the limb are checked, the wound is closed in layers.

The surface type of hip joint endoprosthesis replacement resembles the principle of the dentist’s work: the surgeon grinds the surface of the bones and puts a prosthesis on them. Endoprosthesis replacement includes wound drainage and other measures to prevent possible complications, as well as blood loss replacement.

Postoperative period

Endoprosthesis replacement provides a small rehabilitation period. After the operation, antibiotics and pain medications intake continues. A roller is placed between the patient’s legs, which will hold the operated limb in the desired position.
You can move in bed on the first day after the endoprosthesis replacement, sit down on the 2nd day, and after 3 days you can walk with additional support.
The patient is discharged immediately after sutures release, 10-12 days after the endoprosthesis replacement. If necessary, it is possible to transfer to a rehabilitation center. Recovery of the patient takes place under the supervision of specialists in this case. Limitations are imposed on physical loads for 1.5-2 months after operation. The use of additional support is recommended during this period.