Total hipreplacement
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When there is an advanced wear of the hipjoint like on the photograph above, placing an artificial hip is a good solution for the pain complaints and the movement restrictions. Hip prostheses can be introduced with bone cement or without bone cement. Bone cement is a sort of two component glue which ensures that the prosthesis holds well permanently in the surrounding bone. The uncemented prostheses have been made in a way that ingrowth in / with the surrounding bone is possible. In this example an uncemented prosthesis is introduced.
On the shown x-ray you can see that the right hip - left for the vieuwer - has been deformed by wear (arthrosis). On top of the photograph a green stencil has been placed which gives already an impression of the measure of the prosthesis,
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The operation is done under general anaesthesia or under spinal anaesthesia. The skin is covered with a special plastic sheet to make the infection risk in this way as small as possible (3). After opening of the skin and the muscle the jointcapsule is reached (4).
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The joint capsule is partly removed and the hip head, strongly changed by wear, comes in site(5,6). With a special saw the hip head is removed (7). The measure of the head (8) is taken to estimate the size of the prosthesis.
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The hip bowl is stripped of cartilage (9,10.11.12) and space is made for the hip bowl prosthesis. This exists from a metal part that is brought in the old bowl and hereafter in the metal part a special plastic like part is introduced(13,14.15.16). In this part the future hip head will be rotating.
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Hereafter space is made for the stem of the prothesis in the upper leg with a special apparatus or by hand (17,18.19.20.21).
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Then a provisional head is placed on the stem (22) to estimate the length of the head/neck and the definite head is then placed on the stem (23). A wound drain is left behind to remove redundant wound fluid (24). This is removed after some days.
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The x-ray after the operation in two directions (25,26).