Hip Treatments – Joint Clinic Paarl

Total Hip Replacement

Saltlicker — Fri, 30 Oct 2020 09:48:31 +0000

Total Hip replacement surgery, also called total hip arthroplasty, involves removing a diseased hip joint and replacing it with an artificial joint, called a prosthesis. Hip prostheses consist of a ball component, made of metal or ceramic, and a socket, which has an insert or liner made of plastic, ceramic or metal. The implants used in hip replacement are biocompatible — meaning they’re designed to be accepted by your body — and they’re made to resist corrosion, degradation and wear.

Total hip replacement surgery is typically used for people with hip joint damage from arthritis or an injury. Followed by rehabilitation, hip replacement can relieve pain and restore range of motion and function of your hip joint. Multiple types of hip replacement approaches and types of hip prostheses are available. Depending on the type and severity of your condition a partial, total or a hip resurfacing can be done. The prosthesis can be fixed with or without cement. The cup is sometimes fixed with screws into the acetabulum. All modern prostheses are modular and a head made of metal or ceramic and with sizes from 28-58mm in diameter is placed onto the the stem. A polyethylene (plastic) liner is placed between the head and the cup. Modern improved highly crosslinked polyethylene liners that are now used results in reduced wear on the bearing and a better longevity for the prosthesis.

Hip Arthroscopy

Daan Botes — Thu, 22 Oct 2020 12:26:09 +0000

Hip arthroscopy refers to the viewing of the interior of the acetabulo-femoral (hip) joint through an arthroscope and the treatment of hip pathology through a minimally invasive approach. This technique is sometimes used to help in the treatment of various joint disorders and has gained popularity because of the small incisions used and shorter recovery times when compared with conventional surgical techniques (sometimes referred to as “open surgery”).

This procedure is relatively new and due to the fact that the demand for this procedure is low in this geographical region, Dr Botes made the decision to help make a diagnosis and then refer the patient to a colleague who does perform hip arthroscopy on a regular basis.

Hemi replacement of the hip

Daan Botes — Wed, 29 Jan 2020 13:36:52 +0000

A hemiarthroplasty is an operation that is used most commonly to treat a fractured hip. The operation is similar to a total hip replacement, but it involves only half of the hip. Hemi means half, and arthroplasty means joint replacement. The hemiarthroplasty replaces only the ball portion of the hip joint, not the socket portion. In a total hip replacement, the socket is also replaced.

Hip Resurfacing

Saltlicker — Mon, 27 Jan 2020 09:49:46 +0000

Hip resurfacing is a bone conserving alternative to conventional total hip replacement (THR). Unlike traditional hip replacement, hip resurfacing doesn’t replace the “ball” of the hip with a metal or ceramic ball. Instead, the damaged hip ball is reshaped and capped with a metal prosthesis. The damaged hip socket also is fitted with a metal prosthesis — similar to what is used in a conventional hip replacement.

With newer materials, the artificial joint implants used for total hip replacement are lasting longer and may last for decades, although long-term data aren’t yet available for newer implants. This isn’t an issue for older people who receive a hip replacement late in life. But hip resurfacing might be a better choice for younger people because the procedure leaves more bone intact, which can make it easier to perform a total hip replacement if needed later.

Revision Hip Surgery

Saltlicker — Sun, 26 Jan 2020 09:50:47 +0000

Hip revision surgery is performed to repair an artificial hip joint (prosthesis) that has been damaged over time due to an infection, or due to normal wear and tear of the prosthetic hip. Revision surgery helps to correct the problem so the hip can function normally again.

The use of artificial hip implants is extremely effective in improving hip joints that are damaged by injury or some form of arthritis. Artificial joints, including hip joints, do not last forever. The typical life of an artificial hip joint is 10-15 years, depending on the patient’s daily use of the joint. Patients with artificial hip joints are typically over the age of 55 and have developed severe arthritis in the hip. After a period of normal wear and tear of the hip joint, the prosthesis does not fit as securely and is not as effective. In these cases, hip revision surgery may be recommended by your doctor.

Revision surgery may also be recommended if an infection has developed in the tissue surrounding the joint. If infected, the muscle, tendon and ligament tissues in the hip joint will become weakened and damaged. The infection will also damage the hip bone.

Abductor Tendon Tear Repair

Daan Botes — Sat, 25 Jan 2020 17:52:02 +0000

Treatment options:

Nonoperative management

Physical therapy
Nonsteroidal anti-inflammatory drugs
Activity modification with assistive walking devices.

Surgical alternatives

Endoscopic or open direct soft-tissue repair
Suture anchor repair
Bone tunnel repair
Graft jacket reconstruction
Gluteus maximus muscle transfer.

Indications for surgery

Absolute indications
Magnetic resonance imaging (MRI) evidence of gluteus medius and/or complete abductor complex avulsion

Relative indications
Pain and disability for >6 months despite conservative therapy (including nonsteroidal anti-inflammatory drugs [NSAIDs] and physical therapy)
MRI evidence of gluteus medius or gluteus minimus tendinitis and/or a partial tear.

Custom hip replacement

Daan Botes — Fri, 24 Jan 2020 15:11:26 +0000

Traditional hip replacement prostheses only allow a fairly narrow range of shapes and sizes. Even small changes in hip geometry can have large effects on the function of the hip joint
New types of hip replacement are now available that allow a far wider range of sizes and lengths. New pre-operative 3-D imaging software can allow precise pre-operative planning of size, shape, angle and length.

For patients whose hips fall too far outside the normal range or who have severe deformity, new custom made prostheses, designed specifically for the individual patient, can now match precisely the required geometries. We use a local prosthesis designer and manufacturer in Cape Town, Professor George Vicatos to assist us with the procedure.

Periprosthetic fractures of the hip

Daan Botes — Tue, 21 Jan 2020 13:38:46 +0000

A periprosthetic hip fracture is a broken bone that happens around or very close to the implants (metal and plastic) of a hip replacement. This broken bone can happen during the surgery to replace the hip or from a fall or other trauma. The fracture typically occurs in the thighbone around the metal stem. The bone around the hip socket can also break but this is less common.