A hip replacement procedure is a major orthopedic surgical procedure which involves replacing the damaged components of a person’s hip joint with artificial prosthetic implants. This allows restoring the strength and movement back into the non-functional joint.
The procedure basically requires removing the head of the thigh (femur) bone and inserting a thin metal rod inside it. This metal rod acts as an anchor for the artificial ball-like prosthesis attached to the top of the stem, replacing the femoral head. A cup (or metal liner) is then inserted in the acetabulum (socket) of the hip joint which normally requires 2-3 screws to be fixed into place. Then another prosthesis made of metal, plastic or ceramic is placed as a support. The ball is then fitted into the cup which creates a new joint.
These are the more common types of artificial implants used for hip replacement:
Fixed Bearing Hip Implants – This is one of the most common type of hip replacement implant which is named such as it replaces the femoral head and the acetabulum lining in the hip bone. The only difference in these types of artificial hip implants is the variety of materials that these are available in. These come in metal, plastic, ceramic, polyethylene, etc. and these may also differ in terms of the method of anchoring used in fixing the implant in place. These are mostly fixed in place using medical adhesive (cement fixation) or cement-less fixation which works by using the natural bone growth process. It can also be a combination of the two fixation methods as well.
A total hybrid hip replacement implant uses one component which needs to be fixed on to the bone without the aid of medical adhesive (surgical cement). The other component (ball or socket) needs to be inserted using cementing method. Both are known to be efficiently stable and last a long term.
Although the majority of the total hip replacement implants are of the fixed-implant design there are a few advanced mobile-bearing hip implant designs which are fitted directly into the acetabulum and work as smoothly as the natural hip does. The implant is fixed onto the femoral (thigh bone) head and the acetabular portion fits snugly into the acetabulum cavity. The fixed femoral implant is already connected with the acetabular socket implant and the loose-fitted liner inside allows for natural hip movement. The implant is made from strong materials and provides immense range of movement.
These are fixed in place using a special acrylic polymer (poly-methyl-meth-acrylite PMMA) between the implant and the remaining surface of the bone.
For a strong bond the surgical cement must connect firmly with the bone to fix the inserted artificial femoral head in place properly. The artificial bone cement acts simply as a filler to cover the gap between the prosthesis and the bone. The advanced cement fixation techniques allows for injecting the cement into the tiny honeycomb structure of the bone and thus help is become stronger in bonding power.
Advanced surgical techniques have now rendered the use of bone cement for artificial hip replacement implant fixation almost useless in most cases. These innovative hip prosthesis implant designs allow for cement-less fixation to the femoral head and the acetabulum. However, these mostly tend to be comparatively larger in size as well.
These are specially-textured to have a porous outer surface which allows the naturally growing bone to grow integrating the implant with it. Although these require a comparatively longer recovery period they are considered to be stronger and more durable then the cement fixation hip implants.
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