The Hip Operation – Steps Of Surgery
Approach And Exposure
The hip replacement may be done with various approaches to the hip joint. The patient is given appropriate anesthesia and positioned to access the hip joint. The surgeon makes an incision of about 8 inches over the hip joint. The length of incision varies with the type of approaches and can be shortened or extended. The surgeon decides the type of approach based on his expertise and preference. The incision reveals a layer of ligaments and muscles covering the joint. These are separated to have a better view of the part to be operated. This process makes these structures weak and it takes about six weeks to heal. Hence it is advised to take precations till the time the supporting structures heal well.
Preparation Of Femur And Acetabulum
The surgeon after accessing the hip joint, disengages the femoral and acetabular components. The head of the femur is cut through the neck to make place for the artificial head. The articular cartilage is removed and the acetabulum is reamed into hemispherical shape to receive the prosthetic acetabular component.
The Acetabular Component
To ensure that the person gets the right size of the artificial hip, a trial component is used. The trial version determines the accurate size which is then inserted into the reamed acetabulum. The cemented prosthesis are held in place by special epoxy type cement whereas in uncemented types of joints , the metal cups are held either by screws or by the accurate fit of the cup.
The Femoral Component
The femur shaft is prepared into exact size in order to hold the metallic femoral component. It is hollowed and shaped according to the artificial femoral head. In the cemented type, the hollow is a bit larger than the prosthesis to accommodate the epoxy cement used. The surgeon tests the mobility of the joint as well as the correct shape and size with the help of a trial component. The stem of the prosthesis is then inserted into the hollow created into the femur shaft. In the uncemented variety the femoral component is held by the perfect fit of the femoral insert. The leg may not be of same length before surgery. it may be shorter or longer than the other leg.
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