Hip replacement has helped restore the quality of life for thousands of people. Advances in the design and surgical implantation of artificial joints has made it possible for patients to take part in the activities they enjoy, free from pain and with a fully functioning, long-lasting prosthesis.
A total hip replacement implant has three pieces:
- The stem, which fits into the femur
- The ball, which replaces the head of the femur
- The cup, which replaces the hip socket
These pieces come in varying sizes to fit a wide range of body types. The implant you receive is based on your weight, age, quality of your bone and your overall health.
Most hip implants today are made with titanium or cobalt-based materials. Some have porous surfaces to that bones are able to grow into them. Together, the components of a hip implant weigh around 1 pound depending on the size needed.
All of the materials used in hip implants have several things in common:
- They are able to be used in the body without risk of a rejection response.
- They are just as good as your hip bones; they move against each other smoothly and can withstand loads without breaking.
- They are extremely resistant to wear and tear and corrosion. You can use them for many years.
Hip implants can be cemented, cementless or a combination of the two. This depends on the type of fixation is used to keep the implant in place.
Cemented total hip replacement
With a cemented total hip replacement, you will be able to put your full weight on the limb and walk without support quickly after surgery. Although there is a risk of loosening, the bond between the bone and cement is generally very strong and reliable.
Cementless total hip replacement
Cementless implants attach directly to the bone without the need for cement. Their textured surface also allows new bone to grow directly into the implant.
Cementless implants are generally stable long-term, but they have a risk of loosening if a strong bone between the implant and bone isn't achieved.
Hybrid total hip replacement
Hybrid hip replacements have one component inserted without cement, while the other is inserted with cement.
When only one part of the hip joint is diseased, your doctor may recommend a partial hip replacement. In this procedure, the head of the femur is typically replaced.
Hip resurfacing is a newer technique in which the socket is replaced while the femur is resurfaced with a component that is cemented over the head of the femur, sparing the bone of the femoral head and neck.
Hip resurfacing is most frequently recommended for younger patients. Because the procedure is still relatively new, the long-term success is still being evaluated.
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Your doctor and orthopaedic surgeon should know your full medical history, including metal sensitivities or allergies. Metal-on-metal implants may not be right for everyone.
There are currently no widely used tests that predict whether you will have a reaction to a metal-on-metal implant.
If you have a known sensitivity to metal, however, share the information with your doctor.
No. For artificial hip joints to work, one component needs to slide smoothly against the other component. This makes wear and tear inevitable.
One of the risks of metal-on-metal implants is that tiny metal particles and ions can be released into the joint and the bloodstream. Patients may have a reaction to these metals when they're released, though many patients may not experience any reaction.
Metal-on-metal implants aren't right for everyone. Your doctor will help you assess whether you are a good candidate.
Patients who should not have a metal-on-metal implant include:
- Patients with a sensitivity or allergy to metals
- Patients with a suppressed immune system
- Patients taking corticosteroids
- Women of child-bearing age
- Patients with kidney problems
- Patients with small body frames
Occasionally, metal particles from the implant can cause a reaction in the joint, which can lead to:
- Deterioration of the tissue around the joint
- Loosening of the implant
- Joint failure
- Metal particles entering the bloodstream, which may impact the nervous system, heart and thyroid