Inter-Trochanteric Fractures Series – PART 2

Today is the part 2 of the Inter-Trochanteric Fracture series. Here we will show the significance of maintaining anterior calcar.

CASE 1

PRE OP X-RAY

Clinical Presentation:
– 87 years female.
– Fall in bathroom.
– Severe pain in right hip with inability to stand

Radiological investigation:
– X-Ray pelvis with both hips – Anteroposterior view

Diagnosis:
– Unstable intertrochanteric fractutre.

CASE 2

PRE OP X-RAY

Clinical Presentation:
– 75 years female.
– Slip and fall at home.
– Severe pain in left hip with inability to stand

Radiological investigation:
– X-Ray pelvis with both hips – Anteroposterior view

Diagnosis:
– Unstable intertrochanteric fracture.

Surgical Principles and Lacunae in Management

• Standard of management for unstable intertrochanteric fracture is proximal femoral nailing because of its superior biomechanical properties.
• Lacunae
  • Post operative and long term stability with acceptable outcome needs maintenance of anterior calcar in lateral radiograph.
  • It can be obtained by proper patient positioning and closed manipulation or minimally invasive technique (like using Homman lever through nail entry point incision as in case 2 )
  • Carry out open reduction if result is unsatisfactory.

Inter-Trochanteric Fractures Series – PART 1

From today, we’re starting the series of InterTrochanteric Fractures.
Today we’re talking about Significance of maintaining Medial Calcar in IT Fracture Management.

CASE 1

PRE OP X-RAY

Clinical Presentation:
– 80 years male.
– Slip and fall at home.
– Severe pain in left hip with inability to stand

Radiological investigation:
– X-Ray pelvis with both hips – Anteroposterior view

Diagnosis:
– Unstable intertrochanteric fractutre.

CASE 2

PRE OP X-RAY

Clinical Presentation:
– 84 years female.
– Fall in bathroom.
– Severe pain in right hip with inability to stand

Radiological investigation:
– X-Ray pelvis with both hips – Anteroposterior view

Diagnosis:
– Unstable intertrochanteric fractutre.

Surgical Principles and lacunae in Management

• Standard of management for unstable intertrochanteric fracture is proximal femoral nailing because of its superior biomechanical properties.
• Lacunae
  • Inability to obtain reduction with non maintenance of medial calcal is unacceptable.
  • It can be obtained by proper patient positioning and closed manipulation (increasing limb adduction in Case 1).
  • Carry out open reduction if result is unsatisfactory
  • Appropriate maintenance of medial calcar with centre-centre placement of spiral blade leads to proper directional controlled collapse on weight bearing and hence fracture union.
  • While poor reduction inturn leading to non centre-centre placement of spiral blade increases chances of fracture non union and blade cut-out rates.

Fracture Neck of Femur Series – PART II

This is part 2 of the Fracture neck of femur series- Understanding basics of screw fixation #NOF

We reduce and fix displaced NOF fractures under the age of 65

Except when
– Presence of significant co-morbidity or pre-existing disability
– True age or physiological age is 65 or older.
– Delayed presentation of displaced fracture (> 3 days).
– Pre-existing hip pathology

Under these exceptions, we would consider a Hemiarthroplasty or THR.

• 

• 

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Common Issues

• Screws biased towards anterior half of head
• Inferior screw too far from calcar
• Screws too short and not reaching sub-chondral bone or penetration of articular cartilage

• 

Reduction Method

• 

• The most successful method of addressing this multiplane displacement is to initially restore length.
• Applying increasing traction until the cortical break along the inferior neck of the proximal and distal segment are at the same vertical position.
• Once length has been achieved, internal rotation will appose the fractured surfaces while correcting anterior angulation.
• Reduction of this anterior angulation may be facilitated with manual pressure applied to the anterior femoral neck, combined with a lateral distractive force applied to the femoral shaft.
• Once the sagittal plane angulation has been corrected, adduction of the leg will generate tension within the abductor musculature, which will lock the reduction in place.

Three-screw pattern, each screw has specific mechanical function

• Inferior screw- along the inferior cortex in the anteroposterior projection and centrally on the lateral projection. This position will optimally resist inferior displacement and varus collapse while the femoral head is loaded in a standing position.
• Posterior screw is placed parallel to the first along the posterior cortex and centrally on the anteroposterior image. This pin will resist posterior displacement and anterior angulation while the patient is rising from a seated position.
• The final screw should be placed anteriorly on the lateral view and centrally on the anteroposterior view.

• 

• Traction is released, and gentle impaction along the axis of the pins is performed manually.
• Further screw tightening may be required to minimize postoperative collapse and resultant symptomatic hardware.
• Thread length should be chosen so that threads do not cross the fracture, allowing for postoperative impaction.
• Continuous fluoroscopy during internal and external rotation, in both anteroposterior and lateral projections, may aid in this assessment of containment of all of the screws within the femoral head

Pearls

• Strive for cortical support of implants in osteopenic bone, using the inferior and posterior cortices of the femoral neck.
• When the starting point of a guidewire is correct but angular change is necessary, the pilot hole may be expanded with a cannulated drill bit, which will allow angulation of the guidewire and improved positioning.
• When open reduction is required, a drill hole placed in the anterior neck serves as an excellent seating point for a pointed reduction clamp.
• While performing antegrade or retrograde nailing in the setting of an associated femoral neck fracture, generous overreaming of 1.5 to 2 mm will reduce the force necessary for nail insertion and, in turn, reduce the risk of femoral neck displacement

GPC Screws

• 7.3 mm Screws
• 2.8 mm Guide wires
• 16 mm/32 mm thread
• Titanium & Stainless steel (S.S. screws avoided due to need of MRI in future)
• Self-drilling & self-tapping

Total hip replacement allows you to perform daily activities again

Living with a worn or damaged hip joint can be painful and frustrating. It is possible that you find yourself doing fewer and fewer activities. Over time, even simple activities, such as walking a grocery store or getting up from a chair, can cause pain. However, you do not have to live like that. In many cases, an orthopedic surgeon can replace the hip joint that gives you problems. For most people, having a total hip replacement means returning to the movement without pain.

Indications for total hip replacement

The accepted indications for total hip replacement have changed and expanded over the years. An operation that was rather a salvage procedure for the elderly with low expectations, has evolved and has become the preferred surgery for a wide range of pathological conditions of the hip. The main indication for a Total Hip Prosthesis (THP) remains an advanced stage osteoarthritis. Currently, the population of the United States, which is increasingly older, suffers from an obesity epidemic (recent estimates show that a third of the US population is obese and with a body mass index greater than 30) and the The prevalence of primary osteoarthritis has increased significantly. When non-surgical treatment, such as losing weight, modifying activity amount, helping with cane and non-steroidal anti-inflammatory drugs, fail to relieve pain, total hip replacement offers a highly predictable treatment.

Total Hip Replacement

Historically, inflammatory arthritis, mainly due to rheumatoid disease, has been another common indication for THP. However, since the introduction several decades ago of anti-rheumatic drugs that modify the disease, the prevalence of advanced rheumatic destruction of the hip joint has decreased. Post-traumatic osteoarthritis secondary to fractures and / or dislocation of the acetabulum and proximal femur are still frequent indications for THP.

Osteonecrosis with segmental collapse of the head of the femur is a very frequent indication for total hip replacement. With the widespread use of corticosteroids for multiple medical conditions, the high rate of alcoholism in the general population and the increasing number of HIV patients taking highly active antiretroviral drugs, the incidence of osteonecrosis has increased in the United States and also in many other industrialized countries.

Displaced fractures of the neck of the femur in patients older than 60 years have become another frequent indication for THP. Several large retrospective studies, together with randomized clinical trials, have shown that THP provides a better functional outcome and fewer complications compared to traditional techniques of internal fixation or hemiarthroplasty for displaced fractures of the neck of the femur.

Less frequent indications for a THP are the primary or metastatic tumors of the hip joint and the after-effects of postinfectious arthritis.

Description

Total hip replacement is a surgery that involves replacing the hip joint with artificial elements. The head of the femur is replaced by a component known as the femoral stem, which has a part that is inserted into the medullary canal of the femur and a spherical joint that replaces the head of the femur. The femoral rods are metallic, generally made of biocompatible alloys, which does not generate rejection by the organism in which it is implanted. The acetabular is replaced with an element known as acetabular cup, which is located in the same area where the joint cavity is in the pelvis, screws or cement are used to keep the cavity in place. In general acetabular cups are manufactured with a special type of plastic called polyethylene of utra high molecular weight that provides great strength and allow a smooth gliding surface.

Realistic expectations

An important factor in the decision to undergo hip replacement surgery is to understand what the intervention can and cannot do. Hip replacement surgery allows patients to experience a drastic reduction in hip pain and provides a significant in their ability to perform activities of daily living.

After the surgery, the patient will be able to walk without limit, swim, play golf, drive, ride a bicycle, dance, among others.

With normal use and activity, the material between the head and the cavity of each implant in the hip replacement begins to wear out. Excessive activity or overweight can accelerate this normal wear and tear and make the hip replacement loosen and painful. Therefore, most surgeons do not advise high-impact activities such as running, jogging, jumping or other high-impact sports.

With the proper modification of activities, hip replacements can last for many years.

Prosthesis

Medical science has developed many types of hip prostheses. In general, they can be classified according to the way they are fixed to the patient’s bone and according to the material from which the head of the femur and the acetabular cup are made.

According to the corm form they are attached to the patient’s bone, there are cemented and uncemented prostheses. The cemented prostheses are attached to the patient’s bone by means of acrylic cement. At the time of surgery, it is inserted into polymethyl methacrylate bone cement. This hardens and forms a solid connection between the prosthesis and the femur. Without cement, the solid connection between the prosthesis and the femur depends on osseous ingrowth and osseointegration (as in the case of uncemented prostheses). The potential advantages of cement are the reduction of postoperative pain, since the prosthesis is fixed more firmly in the femur and the rate of long-term revision due to loosening of the prosthesis is reduced.

Depending on the type of material from which the head of the femoral stem and the acetabular cup are made, they can be metal-metal prostheses, if the head and acetabulum are metallic, polyethylene-cerimica, if the acetabulum is made of polyethylene and the head is of ceramic, and ceramica-ceramica, if both components are ceramic.

The decision of which type of prosthesis to use should be taken by the orthopedist specialist in joint replacements according to the characteristics of each patient.

Possible complications of surgery

Infection

Surface infection of the wound or deep infection around the prosthesis may occur. It could presented as a nosocomial infection (acquired in the hospital) or after medical discharge. It could happen even years later.

Minor wound infections are usually treated with antibiotics. More severe and deeper infections may require surgery to remove the prosthesis. Any infection in your body can spread to the replacement of your joint.

Blood clots

Blood clots in the veins of the leg or pelvis are the most common complication of hip replacement surgery. These clots can be life-threatening if they are released and travel to your lungs. Your orthopedic surgeon will design a prevention program that may include anticoagulant medications, supportive socks, inflatable leg covers, ankle exercises and early mobilization.

Dislocation

This occurs when the head comes out of the cavity. The risk of dislocation is greater in the first months after surgery while the tissues are healing. Dislocation is rare. If the head comes out of the cavity, a closed reduction can usually reposition it in place without the need for further surgery. In situations where the hip remains dislocated, additional surgery may be necessary.

For GPC Medical, the priority is your health and quality of your life

Orthopedic implants are the devices that are surgically inserted into the body and are intended to reinstate function by restoring or strengthening a damaged structure. Global Orthopedic Implants Market is booming internationally. The orthopedics market covers a wide range of medical devices, from bone cement and surgical power tools to joint replacement implants and prosthetic limbs, all of which aim to provide patients with increased mobility. Driven largely by the aging population and patients’ desire to maintain an active lifestyle, the global orthopedics market was valued at $52.7B in 2017. GlobalData expects this market will grow to $66.3B in 2023 at a steady Compound Annual Growth Rate (CAGR) of 3.9%.

GPC Orthopedic Implants & Instruments are globally reputed for their high quality, precision and durability. Our Orthopedic Surgery Instruments & Implants, in large quantities are regularly exported to many different countries including those in Europe. Meeting customized requirements of Orthopedic Surgery Instruments and Implants is our specialty. Most of our Orthopaedic Implants including spinal system, intramedullary interlocking nail, locking/non-locking bone plates & screws are US FDA 510(K) approved. GPC is the only Indian Company so far to have achieved this distinction in the field of Orthopaedic/Medical Equipment.

Our wide range of Orthopaedic Implants & Surgical Equipment includes Bone Screws, Plates, Intramedullary Nails, Maxillofacial Implants, Knee Implants, Hip Prosthesis, Spinal Implant System, Locking Plate System, External Fixators, Power Tools, General Orthopedic Instruments, Instruments Sets, Surgical Drills, Arthroscopy Instrumentation, etc. etc.

 

Scope of orthopedic Implants

GPC Medical Orthopedic Implants occupy a lion’s share in the international orthopedic implant market. Orthopedic implants are associated with the musculoskeletal system. For instance, to treat a backache orthopedic implants such as bone plates or bone screws are utilized in spinal fusion surgery. Fixation of damaged bone fragments as well as implant components is used for hip, knee and any other joint replacement. The material applied in orthopedic implants must be biocompatible to avert rejection by the body.

Implant Potential

Orthopedic implants are manufactured to replace or support a missing or damaged bone or joint. These implants are intended to treat the deformities, stabilize body posture, and restore the normal skeletal function. The orthopedic implants market has witnessed a shift from conventional surgical procedures to the use of modern fixation and prosthetic devices. The demand for orthopedic implants has increased significantly, owing to rise in geriatric population that increases the risk of osteoporosis, osteoarthritis, technological innovations in the orthopedic implants, and other musculoskeletal disorders. GPC Medical knows how to keep up with technological demands and adapt via their innovation laboratories with experienced surgeons and engineers.

Orthopedic Implants Market Synopsis

Almost every orthopedic implant present in the market in the current scenario, come under the class III category, which is the most scientifically meticulous classification of medical devices. Individuals facing immobility issues due to terrible accidental or traumatizing cases have no other alternative but to opt for major joint replacement surgeries. This can eventually provoke a radical change in people’s quality of life by relieving pain and reviving their physical independence.

Key Segments

The global orthopedic implants market is segmented based on product, biomaterial, and geography. Based on product, it is classified as reconstructive joint replacements, spinal implants, dental implants, trauma & craniomaxillofacial, orthobiologics, and others. The reconstructive joint replacements market is further divided into the knee, hip, and extremities. Spinal implants are further categorized into spinal fusion devices, non-fusion devices/motion preservation devices, and invasive spinal bone stimulators. Dental implants are further bifurcated into root form dental implants and plate form dental implants. Trauma & Craniomaxillofacial are further categorized into screws, plates, staples, and others. Orthobiologics are further classified into allografts, bone graft substitutes, and cell-based matrices. Based on biomaterials, it is categorized into metallic, ceramic, polymeric, and natural biomaterials. Among biomaterials, the metallic segment occupied dominant share in 2016 and is expected to maintain this trend during the forecast period, owing to their exclusive load-bearing properties.

Factors Leveraging Market Share

Rising geriatric population susceptible to increased risk of osteoarthritis, osteoporosis, and obesity lowered bone density; increased body mass index and other musculoskeletal disorders are the vital factors driving the growth of the global orthopedic implants market. Furthermore, a significant rise in the number of sports-related injuries and road accidental cases are another contributors stimulating market growth. Besides, technological advancement, innovative procedures, and swiftly growing healthcare industry further incite the growth of the market.

Moreover, the launch of internal fixation devices and biodegradable implants holds the higher potential for future prospects of orthopedic implants. However, unfavorable reimbursement policies, rigid guidelines authorization procedures, the high cost of the treatment might hamper the market development.

Additionally, the risk associated with orthopedic implants including implants coming loose or breakage in the bone causing painful inflammation and infections together with the possibility of implant rejection could also serve major roadblock to market expansion.

Technological approach GPC Medical

The impact of the driving factors is expected to surpass the effect of restraints. Moreover, GPC Medical’s increase in R&D in orthopedic implants and the untapped emerging economies are expected to provide new innovative products to orthopedic implants market in the near future.

Future of Global Orthopedic Market

Moving into 2018, there are several areas to watch that GlobalData anticipates will affect the orthopedics markets. Patient-specific implants are expected to drive growth in the hip and knee markets, as is patient-specific instrumentation (PSI), a tool developed to improve accuracy in total knee arthroplasty procedures by customizing the surgical cutting blocks to the patient’s anatomy. Similarly in the vein of personalized healthcare, 3D printing in a variety of orthopedic markets, including spinal intrabodies, craniomaxillofacial implants, and prosthetic devices, will advance physicians’ ability to provide customized solutions to patients. GPC Medical Limited aims to absorb all these changes to make availability of the best quality implants based on these technologies.

A Futuristic Approach

GPC Medical believes in growth and advancement. This is why it keeps a futuristic approach with orthopedic implants. Minimally invasive and robotic surgical systems are a growing trend in orthopedic surgeries, and major orthopedic players, including Medtronic, Stryker, Smith & Nephew, and DePuy, are taking steps to ensure they remain competitive with their Mazor X, Mako, NAVIO, and PUREVUE systems, respectively. Lastly, a shift in the US towards value-based healthcare, including Medicare’s Comprehensive Care for Joint Replacement (CJR) model, will continue to impact both orthopedic manufacturers and physicians, as will the move towards outpatient procedures in ambulatory surgical centers (ASCs). GPC Medical Limited is not ready to stop at any point, as we keep adopting these technological advancements.

Why GPC Medical Limited?

GPC Medical Limited is the oldest orthopedic implants manufacturer and international supplier. Our technology labs remain busy in innovating and manufacturing Trauma Implants with modern technology machines viz. Sliding Head Turning Center, Multiple Axis VMC, CNC Wire Cutting, CNC Deep Hole Drilling, Mechanized sharpening & surface finishing machines.

Apart from our wonderful market acceptance along with the biggest manufacturing portfolio of over a thousand products in growing a worldwide market, we have built relationships based on trust and reliability. We follow internationally standardized protocols with precision throughout the manufacturing and innovating process.

GPC Medical Futuristic Facilities

GPC Medical Limited Manufactures Orthopedic Implants and Instruments product ranges which are packed in packages manufacture from the extraordinary material which is best and suited for orthopedic implants manufacturing process. Further, implants and instruments are marked with Cat Numbers, Batch Numbers and complete description with computer laser marking techniques. GPC medical remains conscious about its internationally renowned reputation and stringent compliance of international standards.

GPC Medical Ltd. – US FDA 510(k) Approved Orthopedic Implants

 

The Causes, Diagnosis and Treatment of Hip Arthritis

Hip arthritis is the common type of disease which causes joint inflammation which leads to severe pain and swelling in the hip joint. This type of arthritis is also termed as Osteoarthritis.

Hip arthritis usually affects people over fifty years of age and is more widespread in people who are obese. There is also a hereditary inclination of this state, meaning hip arthritis tends to run in families. There are also some other reasons which result in budding hip arthritis include distressing injuries to the hip and fractures to the hip bone.

Causes of Hip Arthritis

The causes of hip arthritis are not identified. Following are the factors that may cause injury of the hip joint, old age, and being fat. Apart from these are also some more reasons which contribute to hip arthritis:

• The hips joints may not have been shaped correctly.
• There are some hereditary defects in the cartilage.
• The patient may be overweight.

Signs of Hip Arthritis

Hip arthritis heads to increase as the situation worsens. The symptoms of hip arthritis do not always rise within the span of time. The people often report with sometimes good reports and sometimes bad as the change of weather takes place. The most popular hip arthritis symptoms are as follows:

• Soreness with actions.
• Restricted motion.
• Inflexibility of the hip joint.
• Walking lamely.
• Ache in the hip, thigh, and knee.

Hip Arthritis Treatment

The treatment of hip arthritis begins with mainly essential steps and steps forward to the more complicated which includes surgery. Surely not all therapies are suitable for every sufferer so one should have a detailed conversation with ones physician to decide which options are suitable for the particular case of hip arthritis.

Loss of Weight
This is probably the most significant therapy which in not at all popular among folks. The low weight causes the hip joint to carry out the tasks in a less painful manner.

Exercising
Learning new exercises proves to be useful in relieving the arthritis pain.

Use of Sticks or Walker
The usage of a simple wooden cane stick or a walker can decrease the pain in the hip joint.

Physical Therapy
Fortifying the muscles that surrounds the hip joint may prove helpful to reduce the weigh down the burden on the hip joint.

Anti-Inflammatory Drugs
Anti-inflammatory drugs are proved really helpful to treat ache and swelling.

Medications for Joints
The supplements for joints seems to be harmless and are effectual for cure of hip arthritis.

Reinstatement Surgery
In this method the cartilage of the hip joint is detached and a plate or soft artificial plastic is embedded in the hip joint.

Resurfacing Surgery
Some patients who don’t want to go for hip replacement surgery often go for the resurfacing treatment because it is more cost effective.

Hip Replacement Aftercare

The recovery time for each individual varies as it usually depends on the person’s weight, age and other factors. The diet plays an important role in the revival of hip joint. One should opt for healthy foods that can lead the wounds to heal at a faster rate.

References:

Hip Arthroplasty Implants

Orthopedic Surgery: A Comprehensive Overview

Steps by Step Guide of Hip Replacement Surgery

Hip Implants: Know Them Before You Get Them

FAQs Related to Hip Implants

Hip Surgery – Providing Relief to your Hip Pain

Hip Joint Replacement Surgery – An Analysis

 

Orthopedic Surgery: A Comprehensive Overview

The surgery about musculoskeletal system in human bodies is referred to as orthopedic surgery. The surgeons can use surgical and non-surgical methods to treat problems related to joints, bones, muscles, nerves, and ligaments in the human body. The kind of treatment which is adopted varies from person to person. The orthopedic surgeons are capable of resolving problems involving injuries, spine disorders, degenerative diseases, sports injuries, tumors, hip and knee reconstructions and infections of various kinds. However, going to a surgeon doesn’t qualify one for a surgery straight away. Most of the times the patient is treated using various non-invasive techniques and medicines only.

Surgery And Risks Involved

Most of the doctors who enter the field of orthopedic surgery chose one of the following fields of specialization:

• Arthroscopy
• Joint Replacement
• Musculoskeletal Oncology
• Pediatric
• Rehabilitation
• Reconstructive Surgery
• Spine
• Sports Medicine
• Trauma and Fractures

While most of the procedures that are performed come without any possible risk but the ones that involve a surgery do come with certain limitations like any surgical procedure does. Some of the common risks involved with orthopedic surgeries involve:

Anesthesia: The type of anesthesia that is given depends on the type of surgery which is being performed. There are a lot of different types of anesthesia ranging from local to general and the risks of anesthesia vary with the type which is being selected.

Infections: Most of the surgical procedures especially the invasive ones will require good post-operation care. This is to avoid infections of any sort from developing in the body. Most of these infections are easy to manage, and some might require further surgeries to handle as well. The risk of infections is higher in surgeries that involve hip or joint replacement procedures.

Blood clot: A blood clot can form anywhere in a vein after surgery. If it is in the veins, the clot is fairly risk free. However, if it travels to the lungs, it can cause severe breathing issues and would require prompt medical care. Doctors make use of blood thinners and other medicines to eliminate the risks of blood clots in bodies.

Choosing The Right Orthopedic Surgeon

When choosing an orthopedic surgeon, it is important to make sure of a few things first.

• The doctor should have specialized in the area your problem is related to.
• All the necessary equipment and medications should be available for the procedure
• You have a clear idea of the procedure and how it will be performed. Ask all the necessary questions before-hand. Discuss with your doctor the different types of anesthesia and how one is different from the other.

If it is a surgery that your condition requires, make sure that not only the surgery but your post-operation care is up-to-the-mark as well. There are a lot of new techniques being introduced every other day which eliminate the chances for surgery. Make sure you have discussed and researched about them all before you decide on a surgical procedure with your orthopedic surgeon.

GPC Medical Ltd. – US FDA 510(k) Approved Orthopedic Implants

Steps by Step Guide of Hip Replacement Surgery

Hips are an integral human body part and have their own significance. The wear and tear of hip joint affects its working and results in intense pain called hip arthritis. Hip replace surgery is performed to relieve hip pain and improve hip functionality. Femoral head of the hip bone is removed and replaced with an artificial one. The bone is cut during the surgery to place this ball shaped prosthetic femur head inside that later becomes the new socket of pelvis.

Steps of a Hip Replacement Surgery

After the diagnosis of hip arthritis, orthopedic physicians determine the area of surgery and the process vary as per the patient’s condition. However, these are the common steps of every hip replacement surgery and the process is considered as the most effective solution of arthritis.

Checkup and Anesthesia: Doctors note down blood pressure, heart beat, blood group, and body temperature before starting the surgery. General or regional anesthesia is given to block sensation.

Removal of Damage Cartilage: Surgeons make 10 inches incision to remove the damaged cartilage. During incision, skin and muscles are cut down to expose the bone. They remove damaged cartilage and take out the upper part of femur bone present in the hip socket. Femur bone is the actual part where the issue resides due to the bone-on-bone contact. The socket in the pelvis is also called acetabulum and surgeons use a saw to cut the arthritis femoral head.

Preparation of Acetabelum: After the removal of arthritic ball, surgeons prepare the acetabelum with the help of a tool reamer and scrap the unnecessary skin and cartilage to a make place for acetabular cup.

Placement of Acetabular Component: The cup is placed into the reshaped socket and placed tightly in the pelvis. For the perfect fit, the pelvis socket is made smaller than the acetabular component and it adheres with special perforated cement in order to give space for the bone growth.

Preparation of Femur: The next step is the preparation of femur bone in which surgeons insert prosthetic femoral stem in the femur bone. The stem is designed to hold the ball perfectly and shaped like a narrow tapered metal shaft so it excellently plays the role of femoral head.

Insertion of Final Ball into the Socket: A temporary ball is placed in the top of the stem to move the acetabulum cup and make sure that the joint can move easily. On getting satisfactory results from the temporary ball, permanent ball is inserted and doctors take the help of X-ray machine to check the size and position of the ball.

Skin Stitching:  Stitching the skin is the last step of hip surgery. The muscles and the part of skin is precisely stitched and bandaged. Wedge willow is placed to between the legs to keep them apart from each other.

Usually, the patient has to spend a week in the hospital and doctors advise him/her about the range of motion precaution and weight bearing precautions to prevent any fatal issue later.

Related Posts:

Hip Implants: Know Them Before You Get Them

FAQs Related to Hip Implants

Hip Surgery – Providing Relief to your Hip Pain

Hip Joint Replacement Surgery – An Analysis

Whаt Yоu Shоuld Knоw About Orthopedic Prосеdurеѕ

Hip Implants: Know Them Before You Get Them

Hip implant surgery is important if a part or the whole hip becomes damaged after an injury or a disease or wear downs after a disease related to joint. To have the person return to normal life and get some relief from the excruciating pain, replacing the affected part becomes of pivotal importance. The hip joint is replaced with an artificial joint or implant.

Types Of Hip Implants

Depending on the severity of the condition, the doctors can opt for either one of the following types of hip implants:

• Complete hip implant where the joint is removed and a ball is inserted. The socket is then attached by roughing a part of the bone to create the necessary space. The ball and the socket are then cemented using various techniques and materials. In some cases, the cement is not used and the bone is roughened in a special way instead that would allow it to grow on the parts of the implants.
• Partial hip implant where only a certain part of the joint is removed.
• Hip resurfacing is used for younger patients or to improve mobility which is affected by arthritis. It replaces the socket and resurfaces the head of the femur instead of removing it.

Total Hip Replacement

The Design Of The Hip Implant

There are different types of materials being used for hip implants to make them more efficient. The design, however, pretty much remains to be the same. The design of the hip implant makes use of:

• A metal stem which is inserted into the femur. It can also be used to keep the implants in place.
• A ball which acts like the moveable joint and gives the hip its mobility
• A socket which is attached to the pelvis which connects the ball to the stem
• The bearing which gives the ball a smooth surface it can rotate on. It is the part where the ball and the socket rub together. The purpose is to give Hip its:
  – Mobility
  – Flexibility
  – Range-of-motion
  – Performance
  – Durability

Materials Used For Hip Implants

Combinations of different equipment are now being used to make the designs of the hip implants more efficient. The most common ones being:

• A metal ball which is attached to a plastic socket. This metal and plastic approach is the most widely used
• Plastic socket with a ball made of ceramic or in some cases ceramic ball used in combination with a ceramic socket. The latter is more common for patients who lead a fairly active life or a still young.
• A metal ball with a metal socket. This one is used for young active patients

The hip implant makes use of a major surgery, and it is important to discuss all the possible alternatives with your doctor before coming to a conclusion. A lot of health, age and lifestyle factors will come into play when it comes to deciding the type of implant and the material which is used for the implant.

Source: https://www.indianorthopaedic.com/implants/arthroplasty/hip.html

Whаt Yоu Shоuld Knоw About Orthopedic Prосеdurеѕ

Orthореdіс surgery mainly rеvоlvеѕ around thе diagnosis, рrе-ореrаtіоn, роѕt ореrаtіоn and trеаtmеnt оf аll thе diseases thаt аffесt thе musculoskeletal ѕуѕtеm. It іѕ a vеrу brоаd field and there аrе ѕеvеrаl рrосеdurеѕ that уоu should bе аwаrе оf.  Although there аrе probably hundreds оf dіffеrеnt рrосеdurеѕ thеу perform on a daily basis, thе following are the mоrе соmmоn оrthореdіс ѕurgеrіеѕ seen wіthіn the practice:

Total Joint Replacement

Tоtаl jоіnt replacement includes rеmоvіng thе dаmаgеd joint соmрlеtеlу аnd rерlасіng іt wіth аn аrtіfісіаl joint. Cеrtаіn раrtѕ of аn аrthrіtіс jоіnt соuld аlѕо bе rерlасеd wіth thіѕ surgical рrосеdurе.

Tоtаl Knee Replacement

Knee rерlасеmеnt-tурісаllу реrfоrmеd in cases оf ѕеvеrе аrthrіtіѕ, thе cartilage of thе knее jоіnt is rерlасеd during this procedure wіth mеtаl аnd plastic implants. Oссаѕіоnаllу, thе аrtіfісіаl rерlасеmеnt hаѕ tо bе аnсhоrеd wіth a tуре оf bone сеmеnt that аllоwѕ thе further grоwth оf normal bоnе tіѕѕuе.

Tоtаl Hip Rерlасеmеnt

Rеmоvіng thе ball аnd socket аnd inserting nеw bаll and socket jоіnt that аllоwѕ better movement. Tоtаl hip replacement procedures аrе plenty depending on thе tуре оf mаtеrіаl uѕеd аnd how thе іmрlаnt is designed tо wоrk. Sоmе аrе mаdе out оf metal аnd оthеrѕ аrе ceramic. Thе tуре оf mаtеrіаl used іѕ dеtеrmіnеd bу orthopedic dосtоrѕ аnd dереndѕ on a number of vаrіаblеѕ.

Tоtаl Shоuldеr rерlасеmеnt

Thіѕ іѕ a оrthореdіс ѕurgеrу procedure thаt іnvоlvеѕ replacement оf the dаmаgеd bone аnd саrtіlаgе wіth рlаѕtіс and оthеr material – much lіkе thе hip rерlасеmеnt procedure. Thе rаngе of motion іѕ grеаtlу improved аftеr this ѕurgеrу. Shоuldеr rерlасеmеnt-ѕіmіlаr tо the hір jоіnt rерlасеmеnt with  itѕ main gоаl  tо improve mobility аnd funсtіоn.

Rоtаtоr Cuff Rераіr

Rоtаtоr сuff іѕ whаt keeps уоur ѕhоuldеr аnсhоrеd аnd in place. It іѕ also responsible fоr shoulder mоvеmеnt. Any dаmаgе, tear оr other disease саuѕеѕ movement іmраіrmеnt and lоtѕ оf раіn. Surgеrу hеlрѕ іmрrоvе mоvеmеnt, rеduсе pain аnd improve ѕtrеngth.

Rоtаtоr cuff rераіr-thе rotator сuff kеерѕ уоur ѕhоuldеr аnсhоrеd and facilitates mоvеmеnt. Whеn it tеаrѕ, іt causes tremendous раіn, еѕресіаllу upon аttеmрtіng to reach uрwаrd or оvеrhеаd. Thіѕ рrосеdurе іnvоlvеѕ rеmоvіng dеbrіѕ аnd bоnе ѕрurѕ frоm the іnjurу and rеаttасhіng thе edges оf thе tendon tоgеthеr.

Arthrоѕсоріс Surgеrу

Arthrоѕсору – thіѕ procedure uѕеѕ аn arthroscope, whісh is a tubе with a lеnѕ аnd a lіght ѕоurсе аttасhеd. Whеn uѕеd соrrесtlу, thе surgeon саn see thе аffесtеd area whіlе реrfоrmіng a ѕurgісаl procedure. Arthrоѕсоріс рrосеdurеѕ are uѕuаllу dоnе for ѕhоuldеr and knее surgeries but саn be uѕеd fоr other ѕurgеrіеѕ.

Spine Surgery

Sріnе ѕurgеrу соuld bе a сhоісе whеn bасk pain іѕ persistent аnd unbearable mаkіng dаіlу tаѕkѕ іmроѕѕіblе. Sріnе ѕurgеrу іѕ соnѕіdеrеd only whеn trаdіtіоnаl mеdісіnе and thеrару does nоt hеlр. Lаmіnесtоmу, dіѕkесtоmу, fuѕіоn, аnd spinal decompressions аrе some of thе most соmmоn ѕріnаl ѕurgеrу рrосеdurеѕ. Amоng thе lesser іnvаѕіvе рrосеdurеѕ, thеrе іѕ Kурhорlаѕtу. The ultimate goal is to іmрrоvе funсtіоn аnd еlіmіnаtе pain.

Anklе ѕurgеrу

Thе аnklеѕ аnd wrіѕtѕ саn hаrbоr рrоblеmѕ ѕuсh аѕ arthritis, іnjurіеѕ, fractures, and ѕрrаіnѕ. Overusing these jоіntѕ саn аlѕо саuѕе соmрlісаtіоnѕ, whісh mіght rеԛuіrе ѕurgеrу when more соnѕеrvаtіvе trеаtmеntѕ fail.  Anklе rерlасеmеnt can also considered оnlу when other соnvеntіоnаl mеthоdѕ fail оr hаvе bad оutсоmеѕ.

ACL Rесоnѕtruсtіоn

ACL іѕ thе anterior сruсіаtе lіgаmеnt. It іѕ thе major ѕtаbіlіzіng ligament оf thе knее. Reconstruction саn bе реrfоrmеd when this ligament ruрturеѕ. Thе anterior cruciate lіgаmеnt acts as a stabilizing lіgаmеnt fоr thе knее. Whеn іt ruptures, уоu mіght hear or fееl a ‘рор,’ and your knee mіght gіvе out, ultіmаtеlу causing a fаll. If left untrеаtеd, dаmаgе tо thе jоіnt can оссur оvеr tіmе, leading tо osteoarthritis. Surgеrу іѕ not always indicated wіth a torn ACL, but whеn it is, a grаft іѕ uѕеd to rерlасе the tоrn lіgаmеnt. Phуѕісаl thеrару аnd rеhаbіlіtаtіоn іѕ gеnеrаllу rеԛuіrеd and can be a ѕоmеwhаt lengthy process.