Replacement Arthroplasty
Features of an ideal replacement arthroplasty
- Patient
- Good range of movement
- Complete pain relief
- Implant
- Mechanical stability
- Low coefficient of friction
- Low wear
- Biocompatible
- Surgery
- Secure fixation to skeleton
- Revisable in event of component failure
Materials used for manufacturing hip joint prostheses
- Ultra high molecular weight polyethylene
- Cobalt-chromium-molybdenum alloys
- Cobalt-chromium alloys
- Ceramic
Surgical Options
- Total hip replacement
- Hip resurfacing
Complications
- Infection
- Minimised by pre-operative antibiotics
- Anti-microbial loaded cememnt
- Laminar airflow ventilation in operating room
- Thorough scrubbing, use of disposable gowns, changing gloves and good skin preparation
- Gentle handling of tissues, adequate haemostasis and good suturing techniques
- Optimisation of tissue oxygenation
- Component failure
- Dislocation
- Mechanical loosening
- Minimised by dry operative field with adequate haemostasis
- Pressurised cement (tighter fit)
- Cement restrictors
- Lavage systems
- Aseptic loosening
- Microfracture of components
- Leads to small particulate matter in joint
- Incites inflammatory reaction leading to cysts and loosening
- Metal sensitivity
