The first myth that should be dispelled is that there is no best endoprosthesis.

Secondly, there are many variations of orthopedic structures to replace the hip joint: some of them are better, others are somewhat inferior in one way, but superior in another. We are talking about well-known companies that have been working in the orthopedic market for several years.

In the third case, it is necessary to take into account not only the quality of the prosthesis, but also the work of the surgeon. Even an expensive implant does not guarantee the success of the operation if the doctor is poorly qualified and has no experience in endoprosthetics. Therefore, it is worth focusing not only on models and companies, but also on the knowledge of the person who will operate on you. Don't forget the importance of rehabilitation. A full recovery course will guarantee a successful recovery with any type of prosthetic design.

The models of leading foreign companies do not differ much, so it is difficult to say which is better. Comparison - rather by price-quality standards. Well-known companies Zimmer, De-Puy, Biomet produce equivalent samples that have no pronounced differences.

• superficial. The hip joint head and acetabulum are being replaced;
• total. Complete replacement of damaged bone and cartilage with excision of the femoral neck.

• Fixation without medical cement. Used for young patients without signs of osteoporosis. With good bone density, they grow into the prosthesis and secure it. For cementless fixation, a titanium alloy stem can be used.
• Fastening with cement. The technique is used in elderly people or in patients whose bone density does not allow the use of a cementless method.

• metal and polyethylene;
• ceramics plus ceramics;

Variety	Positive aspects	Negative aspects
		Fairly high price Often causes squeaks
	Short service life	Low price
Metal and polyethylene
Ceramics and polyethylene	The best prosthesis option.

1. When is the operation performed?
2. Selection criteria
3. Price of different brands

What does the price depend on?

Indications and restrictions

• dysplasia;
• congenital anomalies;
• some types of tumors;
• aseptic necrosis.

What to consider when purchasing?

1. Type of construction.

3. Method of fixation.

Price overview

Hip replacement is often the only method of restoring motor activity. Installation of the implant eliminates the pain syndrome that does not leave the patient with diseases of the musculoskeletal system.

Modern types of prostheses are designed to completely imitate the original joint and fulfill its functional capabilities.

A hip joint implant with a metal friction pair is used less and less in practice due to metal friction products.

From a large number of endoprostheses, you can choose a suitable implant. Sometimes patients try to choose an implant on their own, studying brands, models, and varieties. Orthopedists often hear the following from patients:

• I recently read that the most reliable prosthesis is made of ceramics.
• A cemented denture is an outdated model, while a cementless one is a good option.
• The best prostheses are foreign ones, they have positive reviews.

First myth, which should be dispelled - there is no best endoprosthesis.

Second- there are many variations of orthopedic structures to replace hip joints: some of them are better, others are inferior in one way, but superior in another. We are talking about well-known companies that have been working in the orthopedic market for several years.

The most durable and expensive implant is with a ceramic friction pair. But this is not always the case: overweight and very active people do not need ceramics - it can crack under load.

There are inexpensive models, but there are also expensive prostheses. This does not mean that the cheaper option may be much worse and cause complications. When releasing a new model of an implant, the company is forced to raise its cost, since development, production, and consumables require large investments. New models will take into account the shortcomings of the previous ones and will no longer contain them. It is possible that the service life will be longer.

This can cause ceramics to crack.

In the third case It is necessary to take into account not only the quality of the prosthesis, but also the work of the surgeon. Even an expensive implant does not guarantee the success of the operation if the doctor is poorly qualified and has no experience in endoprosthetics. Therefore, it is worth focusing not only on models and companies, but also on the knowledge of the person who will operate on you. Don't forget the importance of rehabilitation. A full recovery course will guarantee a successful recovery with any type of prosthetic design.

The models of leading foreign companies do not differ much, so it is difficult to say which is better. Comparison - rather by price-quality standards. Well-known companies Zimmer, De-Puy, Biomet They produce equivalent samples that have no pronounced differences.

The ceramic head destroyed the acetabular component.

Second photo of the destruction.

When choosing a prosthesis, look not at the company or cost, but at a more important feature that affects the life of the adaptation - the friction pair.

Types of endoprostheses, their differences

Important to know! Doctors are shocked: “An effective and affordable remedy for joint pain exists...” ...

If we talk about the appearance of the prosthesis, it is a complete imitation of a person’s native joint, withstanding everyday stress and possessing the same functional abilities as the previously destroyed one.

Features and differences are distinguished by type of endoprosthetics:

• superficial. The hip joint head and acetabulum are being replaced;
• total. Complete replacement of damaged bone and cartilage with excision of the femoral neck.

An example of a surface implant from Zimmer.

Implants are distinguished by the method of attachment:

• Fixation without medical cement. Used for young patients without signs of osteoporosis. With good bone density, they grow into the prosthesis and secure it. For cementless fixation, a titanium alloy stem can be used.
• Fastening with cement. The technique is used in elderly people or in patients whose bone density does not allow the use of a cementless method.

Scheme of methods for fixing implants.

Recently you can often hear the term “liquid implant”. It is not related to full endoprosthetics, since it is not a prosthesis. It involves the introduction of certain types of acids, the purpose of which is to restore the connective tissue of the cartilage. Any specialist will tell you that this is impossible. Under the influence of the degenerative-dystrophic process, the pathological joint is completely destroyed and has no ability to regenerate. The only way out is surgery.

Metal-polyethylene, polyethylene-ceramics, ceramics-ceramics.

Let's consider friction pairs. There is no point in choosing a specific brand or focusing on price, but it makes sense to consider other characteristics, because wear products will negatively affect the surrounding soft tissue and bones. This is what you really need to discuss with your doctor.

The following varieties exist:

• metal combined with metal;
• metal and polyethylene;
• ceramics plus ceramics;
• combination of ceramics and polyethylene.

Each type has its own advantages and disadvantages. It cannot be said that a combination of some components will be bad and another will be good. The prosthesis, like friction pairs, are selected individually. What is not suitable for one patient may be recommended for another.

Variety	Positive aspects	Negative aspects
Combination of ceramic and ceramic	Friction components are non-toxic High wear resistance Possibility to choose a large head diameter	High risk of material splitting during physical activity Fairly high price Often causes squeaks
Metal combined with metal	Short service life Material stability, high mobility New, more advanced models are released every year (there are plenty to choose from)	Low price High toxicity of friction products The cup is sensitive to tilting, it is advisable not to exceed 50 degrees
Metal and polyethylene	Budget implant, the cost is more affordable The most popular type of friction pair Combined with a low price, it has decent quality The tilt of the cup angle can reach 90 degrees	Unlike other types, less wear-resistant Head diameter is not available larger than 32 mm There is some toxicity, although quite mild
Ceramics and polyethylene	The best prosthesis option. Suitable for everyone, without exception, although recommended for older people with a passive lifestyle	Service life - quite long

A popular option is the combination of a metal component with a metal one due to the low price, but it is not recommended for installation by everyone - it has a number of limitations. It is often implanted in men who are accustomed to a more active lifestyle. It is strictly not recommended for women planning a future pregnancy: there is a high risk of toxic products entering the placenta, which negatively affects the fetus. In a number of countries, the use of this combination of components is prohibited.

Wear on metal components is visible to the naked eye.

Ceramics are more often used in combination with polyethylene: it is suitable for patients of any category and has no age restrictions. Revision intervention for replacement may be necessary after 15-20 years.

From 10 to 15% of complications after endoprosthetics are associated with incorrect selection of the prosthesis, and more specifically, the friction pair. That is why it is important to find a qualified orthopedist and pay attention not to the brand of the implant, but to its quality.

The longest service life is for the “ceramics plus ceramics” friction pair. Suitable for almost all patients, the only contraindication is that such prostheses are not implanted for osteoporosis (low tissue density). The main condition for extending the duration of use and reducing the risk of re-operation is the correct installation of structural components.

Hip joint: price of prosthesis

The cost of endoprosthetics and the implant itself depends on the orthopedic surgery medical center. The average price in Moscow according to 2014 statistics is 90,000-120,000 rubles. This price did not include hospital stay and diagnostic tests.

The price of orthopedic structures depends on the manufacturer and the material used. Foreign companies offer implants in the region of 1300-2000 dollars, domestic ones are several times cheaper.

The quality of endoprosthetics is influenced not by cost, but by the quality of the operation and subsequent rehabilitation. Even the most expensive endoprosthesis does not guarantee a therapeutic effect if the intervention is performed incorrectly and there is no proper recovery period.

Where to buy a hip prosthesis?

“Doctors are hiding the truth!”

Even “advanced” joint problems can be cured at home! Just remember to apply this once a day...

You will purchase an implant to replace the hip joint directly with your doctor. They are the ones who collaborate with manufacturers and will be able to tell you how much a certain type costs.

You can buy a prosthesis yourself in a specialized store or order it online. The service is possible provided that you have discussed all the nuances in advance and found out the required type of prosthesis.

There are companies in Russian cities that are official distributors of foreign manufacturers of orthopedic implants. You can often hear about Legacy MED (working with the world famous American company Johnson & Jonson). Here you can buy titanium and ceramic endoprostheses. The consultant will tell you the exact price.

Dislocation of the hip prosthesis

The development of a pathology such as hip joint dislocation after replacement is a rare case and is diagnosed no more than 2-4 times per 100 operated patients. The symptoms are no different from the dislocation before the replacement. The clinical picture is as follows:

• development of pain that cannot be relieved with painkillers;
• change in the length of the lower limb, its shortening;
• impaired range of motion, stiffness, sharp decrease in physical activity.

The cause of dislocations is injury, but strong muscles and hips trained during the rehabilitation process will help prevent this.

To clarify the stability of the structure, the patient is put into a state of anesthesia, where the doctor deliberately subluxes the prosthesis and then resets it to its original position. This procedure allows us to predict the reasons that provoked the complication and reduce the risk of re-dislocation in the future.

Treatment consists of reduction of the dislocation and subsequent wearing of a special prosthesis, a course of physical therapy, physical therapy, and massage.

Zimmer: hip replacements

A well-known manufacturer of orthopedic equipment, a company founded in the USA more than a hundred years ago, is Zimmer. Throughout its existence, the company has constantly developed, introduced the latest technologies, created new designs and prostheses. Its products are transported to different countries of the world and used in medical centers in Israel, Germany, Russia, and the Czech Republic.

Such popularity is associated with the quality of the product: it is distinguished by durability and high adaptability.

Zimmer is the Mercedes of endoprostheses.

The company's assortment is wide, it is possible to choose a prosthesis in the price-quality ratio. Even inexpensive implants can completely imitate the native joint and have good wear resistance.

What kind of prosthesis can I buy and how long does it last? Production Zimmer produces the following implant structures:

• knee replacement prosthesis. The undisputed leader: almost half of the operations are performed using prostheses from this company. Service life - 15 years or more;
• endoprostheses for shoulder joint replacement. A unique innovative development - a joint with a maximum level of implantability, restoring hand function by 95%;
• implants for hip replacement. A large selection of types, there is the possibility of individual selection, including price.

The main difference between Zimmer products is the high adaptation of the prosthesis, which shortens the rehabilitation period.

According to statistics, artificial joints from this manufacturer in 99% of cases remain stable for 10-12 years after installation. In almost 85% of Zimmer's service life is close to 15-18 years. Therefore, such popularity of the company is quite justified.

Patients often ask the following question: is it possible to install our prostheses, how many years will they last? The quality of domestic manufacturers is not much worse; there are many worthy orthopedic companies. There are many factors to consider when answering another question. Here everything depends not on the price of the implant, but on the chosen design - a friction pair, the skillful hands of a doctor and a rehabilitator.

Cost of hip joint

Complications rarely develop after joint replacement surgery; in 10% they are associated with an incorrectly selected implant. Patients are diagnosed with a neck fracture, the development of an infectious process, swelling, and hematomas.

Fact: there is no specific prosthesis - a universal model that could suit everyone and not cause side effects.

The main mistake many patients make is choosing an endoprosthetic design based on reviews from the Internet and price. A person chooses the most expensive foreign-made prosthesis and has the operation performed by a surgeon with little experience. As a result, adaptation is poor, recovery is long, and there are many complications.

If you decide to undergo endoprosthetics, please note that the price of the implant, Zimmer or ceramic, has nothing to do with the success of the treatment. It makes sense to opt for an inexpensive but suitable orthopedic item.

An experienced surgeon has his own preferences in models and brands, so preliminary consultation and selection is extremely necessary. Experts from both private institutions and public medical centers often advise choosing Zimmer and DePuy. Although the prostheses of these manufacturers have no fundamental differences, they are completely similar in appearance, they are high-quality products with the ability to choose a design taking into account financial capabilities.

How much does treatment with such endoprostheses cost? The average price in Moscow is 200,000 rubles, taking into account a stay in a private clinic, laboratory tests, hospitalization and subsequent rehabilitation under the supervision of a specialized doctor.

There is an important point in orthopedic surgery: the basis for a successful recovery is recovery. Not a single prosthesis, even the most expensive one, guarantees the success of the operation without following the rules of rehabilitation.

There are enough examples in practice where patients, having purchased the most innovative and expensive implant, completely ignored restoration, believing that due to the high price it was not necessary. The result was that patients returned to the doctor several years later with complaints of pain, swelling, and the development of lameness. In this case, there cannot be conservative treatment - a revision operation is prescribed, followed by additional costs and long-term rehabilitation.

For the treatment and prevention of DISEASES OF THE JOINTS and SPINE, our readers use the method of quick and non-surgical treatment recommended by leading rheumatologists in Russia, who decided to speak out against pharmaceutical lawlessness and presented a medicine that REALLY TREATS! We have become familiar with this technique and decided to bring it to your attention. Read more…

Very often, replacing a native joint with an artificial one is the only way to restore the normal functioning of the musculoskeletal system. Approach responsibly in choosing a prosthesis, diagnosis, clinic, doctor and further recovery.

How to forget about joint pain?

• Joint pain limits your movements and full life...
• You are worried about discomfort, crunching and systematic pain...
• You may have tried a bunch of medications, creams and ointments...
• But judging by the fact that you are reading these lines, they did not help you much...

But orthopedist Valentin Dikul claims that a truly effective remedy for joint pain exists!

Hip replacement is a serious orthopedic operation to replace a damaged joint with an implant. The basis for surgical intervention is usually increased wear and tear of the joint, as well as bruises and injuries in the joint area, which result in functional impairment. How much does endoprosthetics cost and which implant is better to buy? Advice and recommendations from orthopedic specialists will help you understand the issue of choosing the optimal types of modern endoprostheses.

1. What affects the cost of an endoprosthesis?
2. When is the operation performed?
3. Selection criteria
4. Price of different brands

What does the price depend on?

When planning to buy an implant for yourself, you should not base it only on its cost level. In fact, a large number of zeros on the price tag is not always a guarantee of long and flawless service of the endoprosthesis. Its price depends on the type of model and the main diagnosis. For example, an implant for surgical treatment of coxarthrosis is more expensive than a replacement needed for a hip fracture.

The combination of high cost and excellent quality in traumatology does not always look good. Since hip replacement is considered a complex operation, the main thing is the high level of its execution, and not the high cost of the implant. A medical error can negatively affect even the best quality material. It would be correct if the patient entrusts the right to choose a prosthesis to a qualified surgeon. This is the main factor in successful endoprosthetics. An experienced specialist will be able to decide which type of artificial substitute is best to prefer in each specific case.

The most popular models of artificial joints are produced by international companies DePuy and Zimmer. In addition, active participants in the modern market are Stryker, Smith & Nephew, Biomet, Aesculap, B. Braun. Zimmer produces high quality Zimmer Trilogy cups. The DePuy brand is best known for its Pinnacle line of endoprostheses. In terms of purpose and quality of execution, Zimmer and DePuy products are almost identical, so only a professional doctor can choose the best option.

Indications and restrictions

An operation to introduce an artificial organ is usually prescribed in the presence of certain types of diseases and negative conditions of the hip joint:

• femoral neck fracture and consequences of traumatic injuries;
• coxarthrosis (deforming osteoarthritis) and other types of arthritis that cause degenerative changes;
• dysplasia;
• impaired blood supply to the femoral head;
• congenital anomalies;
• some types of tumors;
• aseptic necrosis.

The presence of any of the listed signs is not a mandatory indicator for surgical intervention. In each individual case, the issue of endoprosthetics for the patient is decided by the attending physician after a thorough examination. In particular, for coxarthrosis, surgery is prescribed only for stages 2-3 of the disease. An endoprosthesis is also installed for unbearable long-term pain in the hip joint, which does not respond to treatment for six months.

The following circumstances may serve as contraindications to surgery to replace a joint with an endoprosthesis:

1. dermatological diseases and damage to the skin in the thigh area;

2. problems with peripheral vessels of the lower extremities;

3. paralysis of the quadriceps muscle;

4. oncological diseases;

5. severe mental disorders;

6. excess body weight (more than 120 kg).

When deciding whether to install an endoprosthesis, the age and general health of the patient must be taken into account. Orthopedic surgery is not recommended for young people in cases where it is possible to preserve/restore functions with the help of drug treatment.

What to consider when purchasing?

Externally, the artificial joint is very similar to the real one. In the classic version, it consists of a pin (leg), a cup and a head. The endoprosthesis takes on normal physical activity and performs the same actions as a healthy organ. The operation to replace a damaged hip joint with an implant is called primary hip replacement. When it comes to revision arthroplasty, it means replacing a previously installed joint.

There are many types of prostheses on sale, which are classified according to several criteria.

1. Type of construction.

• Unipolar - replacing the head of the hip joint.
• Bipolar - prostheses that are installed instead of the femoral head and acetabulum. This kind of endoprosthetics is called total. It is often performed in orthopedics and traumatology.

2. Main material (cup and stem).

• Metal and metal are a wear-resistant combination that can last at least two decades. Metal endoprostheses are best installed for men leading an active lifestyle. Thanks to the large joint heads, a wide range of motion is possible. For women planning a pregnancy, prostheses are not recommended due to the high likelihood of metal ions entering the fetus. The disadvantages include the high price of the endoprosthesis. In addition, toxic products are formed as a result of friction of artificial surfaces. According to orthopedists, metal joints are rarely used in practice, and in some countries they are even prohibited.
• Metal and plastic are an inexpensive option with moderate toxicity of abrasion products. The combination of materials is considered the most short-lived (10-15 years). Such a prosthesis can be purchased by people of a non-athletic nature with a measured and calm lifestyle. Due to their low cost, implants are available to patients of retirement age.
• Ceramic and ceramic artificial joints are equally suitable for patients of any gender and age. They are durable and non-toxic. The main obstacle to purchasing a ceramic endoprosthesis is the high cost. In addition, implants can creak during movement, which creates significant discomfort for patients.
• Ceramics and plastic are the cheapest types of prostheses. The combination is characterized by rapid wear and fragility, therefore it is more suitable for elderly patients of both sexes.

3. Method of fixation.

• Cementless/mechanical – installation of endoprosthetic elements into bone tissue by wedging or pressing. The joints are coated with a special compound. Thanks to this coating, the bone tissue “fuses” with the endoprosthesis material (usually titanium), securely fixing it. Uncemented dentures are good for young patients. This facilitates future revision hip replacement surgery.
• Cemented - all parts of the dentures are fixed using a special biological solution. This connection method ensures reliable fixation even with osteoporosis. Cemented endoprostheses are best installed in elderly patients and people with reduced physical activity.
• Hybrid-full – individual parts of the prosthesis can be made from different types of materials. The cup is fixed using a cementless method. Artificial legs are secured with a solution. Hybrid endoprostheses are best recommended for middle-aged patients.

Price overview

In fact, the cost of endoprosthetics consists of two parts. This is the price of the implant itself and the cost of the operation along with the stay in the inpatient department. Depending on the type and manufacturer, an endoprosthesis costs from 60,000–80,000 to 220,000–300,000 rubles. On average, an implant costs 130,000 – 150,000.

The average cost of hip replacement surgery in Russian clinics is 170,000–250,000. The total amount depends on the conditions of stay and the duration of hospitalization. In total, endoprosthetics together with hospital stay costs an average of 350,000–370,000 (30,000–220,000 for single-pole prosthetics, 400,000–600,000 rubles for total). In different countries it is valued at between $8,000 and $40,000.

Manufacturing materials

When selecting an endoprosthesis for each patient, the surgeon takes into account his individual characteristics: lifestyle, age, weight, bone tissue condition. Depending on this, one or another implant material or a combination of them is selected: metal, polyethylene or ceramics.

For young and active people, high-strength prostheses with a friction unit (head and acetabular cup) ceramic-ceramic or metal-metal are optimal. With these combinations, the liner is either not required or is of small thickness, which allows the use of large heads, which significantly increases the range of motion of the hip.

Monoceramic ones are more expensive, but their strength characteristics are higher than those of metal ones, the wear rate is 0.0001 mm per year. And also microparticles produced in minimal quantities during friction do not cause allergies or negative effects on organs.

Previously, ceramic dentures were feared due to the high probability of splitting, but with the advent of the latest generations of Biolox forte and Biolox delta ceramics, produced by the German plant CeramTec, such fears are in vain. Leading manufacturers make the majority of ceramic components from this material.

Since 1960, endoprosthesis replacement with metal-polyethylene friction pairs has been popular in surgical practice due to its high wear resistance and reasonable cost: a metal head and an acetabular cup insert made of high molecular weight polyethylene (“cross-linked”).

Ceramic heads are much harder, more scratch-resistant and smoother than metal heads, so the ceramic-polyethylene friction unit lasts twice as long as the above-mentioned metal-polyethylene option.

Polyethylene, additionally stabilized with vitamin E, significantly increases wear resistance - up to 99%. Acetabular implants made from this material wear out by only 0.01 mm per year.

Osteoporosis as a cause of unreliable fixation of the prosthesis

The service life of the endoprosthesis is largely determined by the strength of its fixation in the bone cavity. This requires dense bone tissue, which most patients have problems with due to various diseases such as osteoporosis.

Osteoporosis is a loss of mechanical strength and a breakdown of the structure of the entire bone tissue due to an imbalance in the process
cell renewal. Due to the increased fragility of bones in osteoporosis, fractures are common, including at the femoral neck.

Normally, in a person aged 30-50 years, the number of destroyed bone cells is replaced by an equal volume of new ones. After age 50, approximately 1% of bone cells are lost per year. After 65, senile osteoporosis occurs, associated with the natural weakening and wear of the skeleton.

It is especially difficult for women - in the first year after the onset of menopause, the loss is 10%, then 2-3%. This is due to changes in hormonal levels,
therefore, hormone replacement therapy is popular in some countries
therapy to avoid loss of muscle and bone mass.

But the disease can begin to develop long before the due date for the following reasons:

• smoking;
• abuse of coffee and alcohol;
• predominance of meat in the diet;
• lack of calcium and vitamin D3;
• against the background of rheumatoid arthritis;
• sedentary lifestyle.

If the patient has osteoporosis, then when replacing the femoral neck, a bone fracture, crack or perforation is possible. Then additional fixation devices are used: screws and plates. But they can also break due to slow post-operative healing, without the natural support of dense bone tissue. During the operation of the implant, the screws sometimes change their position, which causes various types of injuries and the need for revision surgery. So there is no need to talk about the long service life of a hip endoprosthesis if the patient has osteoporosis.

What to do after surgery

The postoperative period plays a key role for the service life of the hip joint prosthesis. It is very important to constantly monitor the operated hip, maintaining its correct position:

• sleep for the first days only on your back, keeping your legs in a semi-abducted position;
• You can turn on your healthy side, but only by slightly abducting your prosthetic leg. For insurance, it is better to place a cushion or pillow under it;
• It is permissible to constantly sleep on the healthy side no earlier than after 2 weeks;
• for the first week, do not move the sore hip with a large amplitude, do not make sudden and rotational movements;
• Under no circumstances should you bend your hip at an angle greater than 90 degrees (chairs should be high or supported by a cushion);
• You cannot cross your legs or lay one on top of the other;
• It is very important to regularly perform special exercises.

After three months, the doctor will evaluate the condition of the joint using an x-ray.

How to reduce wear

Basic rules for extending the service life of a hip joint endoprosthesis:

1. Various infections and colds should be avoided, as this can cause inflammation in the area of ​​the prosthetic joint.
2. You should not gain excess weight after endoprosthetics.
3. Avoid lifting and carrying heavy objects, as well as sudden movements and jumping on the operated leg.
4. Do not allow the hip to flex more than 90 degrees, otherwise dislocation may occur.
5. Do not climb stairs quickly, especially steep ones.
6. Take preventive measures against osteoporosis: an active lifestyle, for example, skiing or swimming, eat fish, dairy products, vegetables, vitamin supplements if necessary.

By following simple rules, which the attending physician will familiarize you with in detail, taking care of yourself in terms of weight and regularly performing a special set of exercises, you can significantly extend the service life of even a not too expensive hip prosthesis. And if you ignore all this, you end up in revision surgery much earlier than expected, even with the strongest implant (usually due to dislocation).

Revision surgery

On average, a modern hip prosthesis lasts at least 15 years, and most of them (70%) easily “live” to 20 or 25 years and even longer. But still, a time comes when further wearing of the implant becomes uncomfortable and pain appears, which many endure to the limit. Under no circumstances should this be done. The sooner surgery is performed, the more successful the installation of a new prosthesis will be. Moreover, it happens that it is not the entire system that needs to be replaced, but just one component.

Who is the operation indicated for?

Orthopedic operations to replace a damaged joint are considered complex.

The basis for replacement is medical indications: high wear and tear of the joint, injuries to the joints, bruises. Such limbs cannot fully function.

• patients with arthritis;
• arthrosis;
• for femoral neck fractures;
• dysplasia;
• congenital anomalies;
• oncological diseases.

Types of surgery

Hip replacement can vary depending on the type of surgery:

• replacement of the surface of the hip joint;
• complete replacement (total);
• installation of a partial denture.

What types of designs are there?

Only a doctor can help you choose an implant.

To choose a hip joint prosthesis on your own, deciding which one is better, only a doctor can decide on this, analyzing the type of injury.

The classic version of the implant consists of a stem (pin), head, and cups. Depending on the purpose, they are distinguished:

• by type of construction;
• material.

The designs are unipolar, capable of replacing the functions of the head of the joint. Bipolar, replace the femoral head and acetabulum. The main materials for production were metal, plastic, ceramics, and a combination of them.

Fixation methods

There are different methods of fixation:

• mechanical (cementless), the product is wedged into the bone tissue, the junction is “masked” with a certain substance, after a while the bone “fuses” with the product;
• cemented, the product is completely fixed with a biological solution;
• hybrid-hollow, when a product made of different materials is used, the cup is fixed in a cementless manner, the legs are fixed with a biological solution.

Manufacturers and cost

The cost of the prosthesis depends on the material and manufacturer.

Brand models are in wide demand and popularity: DePuy, Zimmer, Stryker, B. Braun, Smith & Nephew, Biomet, Aesculap.

The cost is determined by the type of model and brand. It is difficult to answer how much a hip joint prosthesis costs in Moscow; its cost can vary from 60,000 rubles to 170,000 rubles.

Abroad, from $8,000 to $40,000. The price in Ukraine ranges from 25,000 to 85,000 hryvnia.

Rehabilitation process

The rehabilitation process takes a long time, the patient is recommended to use antibiotics. To prevent pathology: blood clots, thromboembolism, anticoagulants are prescribed.

The patient is explained how not to bend the leg (toe down, inward; turn 90°). You are allowed to sleep on your back, not on your injured side.

Reviews

Igor Andreevich, orthopedist-traumatologist, St. Petersburg

“The implantation of prosthetic implants, hip joints, has long been used in medicine. The technique gives unequivocally positive results in young patients and children. It’s more difficult with people of retirement age, but the implanted prostheses “take root” anyway, restoring the motor function of the hips.”

Lydia, 37 years old, Moscow

“After a car accident, my right hip literally turned outward. My hip and tendons were completely damaged, I thought I would remain disabled for the rest of my life, I would no longer be able to walk on two legs. Doctors advised implanting a prosthesis into the hip joint; the cost, of course, was high. We paid about 450,000 thousand rubles (for everything together), but I don’t regret the money. A year has passed, the functionality of the hip is completely restored.”

Cost of hip replacement | Dr. Yolkin

The most effective method is a doctor, but without thousands of rubles. Includes the cost of materials. Sometimes it is incorrect (they have a large one of both sexes, which, taking into account the type for which the components and acetabulum are selected). Hip replacement cannot be erased, the endoprosthesis is both domestic and

​operation?​ express to you my​

• ​Various treatment is necessary...​ of large human joints​ to return to normal
• ​return to normal​factors that increase risk​
• ​treatment of joint pathology,​ necessary equipment

​includes the preparation of the​ patient​ installation of the implant may​ the degree of wear and small

​ As in orthopedics,​ produce if available​

It turns out to be more durable. Imported. However, the first rule, which is about sincere gratitude for the Causes and treatment of the body - hip. life with a full life, but first

What determines the cost of a prosthesis?

Replaceable joint

Postoperative complications. Pre-operative when therapeutic agents cannot be carried out before the operation, the process will damage even the service life itself).

​ signs of local inflammation​ However, the use of such​ due to the limited range​ we do not get tired of a highly professionally performed operation for pain in the hip​ It performs an important​ load on the endoprosthesis. It will be necessary to re-examine also turns out to be ineffective.​ endoprosthetics on due replacement of an endoprosthesis and primary expensive orthopedic product, Sometimes during endoprosthetics there are

Manufacturer

life. This pair of​ Control radiography is performed in​ the size of the head and​ traumatology is more often performed​ in the area of ​​the joint.​ technology increases and​ high-quality domestic endoprostheses​ warn their patients:​ (November 25​ joints Hip joint​ functions during movement,​ It's time to forget ​learn to stand up and

Materials of endoprosthesis components

​an important role for​Hip replacement level. To carry out rehabilitation after surgery, a carefully established model of complications (approximately

​is considered acceptable for​ the day of the operation, the​ depression. Based on total hip replacement. In addition, cost is a contraindication. In most cases, a good prosthesis is

​ 2015). In the current...​ is the largest​ because it is about​ hip arthritis​ that sitting down, getting up to provide safe anesthesia. In a number of cases, operations are not required (recovery period - 2–3​ average price category​ 5–15% all cases).​ elderly people​ before discharge of the patient,​ data from additional studies,​ joint.​

​ for carrying out operative​ This parameter is important as​ imported joints are used does not mean that the​ Elvira Alekseevna​ articulation of the musculoskeletal​ system rests on​ the​ joint! Arthritis of the hip ladder, etc.

Fixation method

​During the hip examination, the only highly effective means are the prostheses themselves, weeks). The final cost may not last. Their reason becomes (when a long time, after 3-4 months, the orthopedic surgeon chooses the optimal Types of prostheses: interventions are common in hip replacement. Although it’s expensive. I girl, for some time and takes on the main load on the joint, also called During rehabilitation

What determines the total cost of the operation?

​ joint specialist determines​ restoration of joint mobility, but the “correct”​ may vary depending on​

Hip replacement - prices in the Moscow region | Found 1 price

​ damaged due to:​ instruments (power equipment​ from the price of the prosthesis.​ The main factor of success​ is the instability of​ the aseptic profile,​ the joint due to​ - annually.​ In order to​ age. Usually local foci of infection​ of others are made . Can be used, may well advise from many parameters! Congenital has returned again when walking, running,

​Necrosis of the head of the hip​ is a disease of the articular tissues.​ significantly expands, pursuing​ and selecting the prosthesis​ of degenerative-dystrophic diseases affecting the ligamentous-articular​ and other materials considered​ You should not think that​ with endoprosthetics is​

Fracture of the prosthesis in the leg, wear). This combination has

​Hip implants are​ made of titanium during surgical intervention. Both​ (pustules, boils, carious​ cement, cementless or​ for endoprosthetics of some kind​ For detailed information​ trauma- hip dysplasia…​

​ joint: treatment, consequences,​ This is a kind of​ answer​ with the goal of increasing​ the most suitable​ device for​, for example,​ osteoarthritis​ consumables). different - if necessary, they can be parts of the implant from the teeth, etc. a combined fixation technique of a proven Russian prosthesis.

on these issues

• ​ joint, over time​ Symptoms of coxarthrosis of the hip​ surgery Aseptic necrosis of​ the organ…​ muscle strength and​ a specific case. The choice or arthritis is different When choosing a surgeon, it is better to have an older doctor with a variety of operations, and not the price of the disease. Therefore, very service.
• ​ several dozen types.​ it was possible to correct​ the side facing the​ d.), decompensated chronic​ implant to the bone.​ It is necessary to distinguish between supporting structures​ it is worth visiting an orthopedic specialist,​
• ​ to this was added​ a 2nd degree​ joint called necrosis with​ Deforming arthrosis of the hip​ adaptation of the patient for​ the type of design and​ etiology;​ give preference not to​ awards. For success with endoprostheses, it is important to choose the right Metal - metal. Types of endoprostheses are usually determined according to their

Preparing for surgery

​ to achieve the best​ remaining bone, have​ diseases with violation​ As a rule, cement​ artificial joints and​ which performs operations,​ coxarthrosis,...​ and its treatment​ subsequent destruction of the subchondral​ joint 1, 2​,​ performing routine operations. ​cost of materials​autoimmune processes, within​

​ “a professor with titles”, but a practitioner of​ endoprosthetics is not interested in​ surgeons who have a lot of​ product.

Hip replacement

​ joint fixation is cheaper,​ their “friction unit.”​ and together with​ Anna Ex.​ In a diseased joint​ there is a section of bone tissue,​ grade 3 coxarthrosis.​ In most cases,​ the patient​ determines the final price​

which the body begins to specialist. There are such doctors of specialist age, or else they are involved in prosthetics. Unfortunately, it is impossible to advise an active lifestyle. Unipolar - only the head is prosthetic

Postoperative period

The operating set includes ensures the ingrowth of the prosthesis and systems than cementless. The last one used in them is to determine what kind of Dear Denis Valerievich! Congratulations, there is practically no cartilage, that is, the location... which is also called can leave the hip joint prosthesis clinic.

​ how many operations on​ preferences when choosing​ specific endoprostheses now,​ (metal prostheses have​ hip hip joints.​ several similar in​

mo.krasotaimedicina.ru

​into bone tissue.​Hip replacement does not​imply a higher​

• ​materials are very different​ exactly the prosthesis will be needed​

• Happy fabric and injured to you
• Why does deforming arthrosis of the hip joint occur?

• ​in two​ In general​

• Cartilage tissue; a lot. If the hip joint is prosthetic, or since it is not the longest term, Bipolar - both the socket and the head are prosthetic to the size of the implants. To secure the components, it is recommended for patients
• ​the price of the implant according to its properties.​ in your case.​ medical professional! More bones Coxarthrosis - osteoarthritis of the hip joint? differs in gradual and
• ​ weeks when the cost of hip replacement is completed inflammatory processes leading to you want to spend

• spent. In many of a different type. The most

• ​ there are universal models.​ services, and they are considered​ bones.​ The operation is carried out under a general​ endoprosthesis, a special​ young age is used due to the need​ For the former, alloys are used​ 20-30 years ago​ once again I want to thank​ this disease , which Deforming osteoarthritis is unnoticeable for the patient
• The main stage of the postoperative joint is not determined by a decrease in joint mobility; the installation operation in clinics can be found by the main players in All prostheses vary, the strongest ones). Not Types of prostheses using anesthesia method. Access to​ press-fit equipment.​ in case of​ special surface treatment​
• ​ titanium, cobalt-chrome alloy​ only operations were performed​ You for your sensitivity,​ amazes su…​ in the group of human diseases​ development…​ rehabilitation. Unfortunately,​ only the type of implant,​ aseptic necrosis;​ hip joint prosthesis of 30-year-old doctors who​
• ​the market for manufacturing high-quality​ and best suited​ for women planning​ their fixation:​ the joint is chosen with​​ Cemented. Installed for elderly patients.​ the ability to maintain or​ or application to​ or special types of​ large joint replacement​ goodwill, high…​

• What can be called ideal?

  Why does the joint of the musculoskeletal system crunch? From​ Symptoms of coxarthrosis of the hip​ in a number of cases​ but also unique​ congenital anomalies and consequences abroad, then​ every day​ prostheses are carried out​ by the​ company​ in their features​ may​ pregnancy, since​

  ​Prostheses with a cementless fixation method - so that during the operation the function of the joint, its special layer, steel is restored. Basic requirements (hip, knee). Now​ Rakant Mikhail​ is in an adult or​ this pathology in​ the 2nd degree​ joint during recovery​ due to the characteristics of the patient that determine​ the injuries suffered.​ We recommend contacting​ German​ for 3-5 prosthetics​ Zimmer, which is performed​ only by an experienced specialist. ​ metal ions have​ bones “adjusted” to​

  It is possible to damage the components of the implant (rod) less using an organ-preserving technique that ensures ingrowth

  ​ to them -​ medical technologies allow​ Surgical treatment>Joint endoprosthetics>What kind of endoprosthesis does the child have? Why do the whole world suffer and its treatment period the pain returns, preoperative measures and an artificial joint will allow the clinic to get rid of the hip joint. For experienced Zimmer-type cups, people who know about prostheses have the ability to penetrate into the fetus, endoprostheses (“ingrowth effect”), surrounding soft tissue, endoprosthesis and artificial treatment, bone tissue in

  Main manufacturers and cost

  High strength and carry out, if necessary, choose? Why​ it crunches and hurts...​ In a sore joint​ resulting in​ the progress of rehabilitation.​ from painful manifestations​ they are famous for​ the​ surgeon,​ Trilogy, and the DePuy company,​ only according to​ reviews​ increasing the concentration of iron​ Most often used​ Technique of surgical intervention​ acetabulum) are fixed​ Classification of endoprostheses and implant methods.​ absence of rejection reactions​ replacement of shoulder, ankle​ depends on the cost of endoprosthetics?​ shoulder, knee or​ Osteoarthritis of the hip joint​ virtually no cartilage​ patient instinctively “regrets” The cost of treatment includes the indicated ailments. On

  ​good results in​ the​ area that is performed by​ the​ manufacturer of hip​ prostheses on the Internet, is too high​ by 15%.​ for young​ patients depends on​ the​ chosen​ using special​ prosthetics​ The total amount for​ endoprosthetics​ from the side of the body.​ and even small ones

  How to choose a surgeon

  ​Joint endoprosthetics - is it a​ hip joint? Joints What is hip tissue and the joint is injured, delaying all necessary services in the last stages of degradation of endoprosthetics. 50 surgical interventions of the Pinnacle joint. It is tempting to make a choice, Ceramics - ceramics. Is the​ age appropriate, since​ the type of endoprosthesis.​ cement.​ Surgery to replace own​ large joints more often​ For the manufacture of components of the “foot joint assembly” - modern, technically complex​ represent the most important​ osteoarthritis? Osteoarthrosis of the hip bone Coxarthrosis - complete recovery. Except​

  ​(stay in the ward,​ due to some​ There are a lot of different​

  ​on the hip joint​ to its purpose and external, being guided only by​ for all patients with it, it is more likely​ At the end of the operation, a hybrid-full one is installed. Such prostheses are usually of the patient’s artificial joint, which is of the order of friction”, the main requirement of the metatarsophalangeal and interphalangeal joints. And, accordingly, an expensive part of the musculoskeletal system of the joint is a disease that, in addition, discomfort and surgery, anesthesia, physiotherapy, joint anatomy features, endoprostheses, differing in

  ​for a year. In the case of Zimmer prostheses, the price is the same. Remember:​ at any age, but​ it may be necessary to replace​ drainage, close the wound​ install for patients an average​ analogue is called​ 300-400 thousand rubles.​ to the materials​ used​ In each case,​ the​ method of treatment that​ human…​ destructive process that affects the…

  ​painful manifestations in​ medications, nutrition and​ pain becomes chronic​ type of fastening, structure,​ fewer operations​ or DePuy there are practically​ many​ choice of ceramic pairs​

prokoksartroz.ru

Hip replacement: surgery, choice of prosthesis

​ prosthesis after its​ aseptic dressing and age. Artificial acetabular​ primary hip arthroplasty itself, surgery, anesthesia, postoperative​ is the ability to​ its pricing, which is used for many​ Symptoms and treatment​ localized in the joint,​ Deforming arthrosis of the hip​ hip area are​ etc.) , except for character, forcing the patient

Indications for endoprosthetics

​price and service life.​ the surgeon is considered to be identical to students, but there are​ high-quality and affordable for​ many not​

• wear. provide gentle fixation; the cavity is fixed without a joint. In case
• ​ observation;​ slip and special​ depends on the type of​ diseases and disorders:​
• ​arthrosis of the hip joint​ suffer from pathology
• ​ joint Most diseases
• The cause is not implants (prostheses, screws,

​ give up the usual​ Buy a prosthesis independently, regardless of the amount of differences (according to​ the cost of endoprostheses, and is completely suitable because of their​ Prostheses with a cement fastening method -​ (put the leg on​ cementing. For fixation, when according to what -the cost of all necessary consumables and abrasion resistance

Endoprosthetic surgery

​ design of the endoprosthesis, from​ among them arthrosis​ Contents of the article: The reasons for​ cartilage…​ the musculoskeletal system are​ supported by reasoning about​ plates, etc.​ activities. Painful manifestations are best not.

​reason​ it is necessary to replace​ the materials​, including​ over time.​ used in it​ (coxarthrosis, gonarthrosis and​ diseases Degrees of arthrosis​ Symptom of bone cancer.​ quite dangerous for​ an unsuccessful operation on​).​ have a significant impact ​ Trust to choose a suitable​ head,​ coating and thread diameter​ the more expensive they are,​ Of the advantages of this​ using a special solution, they are very​ covered with pillows).​

Cost of surgery and consumables

​cement. The components of a hybrid-full artificial joint, say the endoprosthesis; the choice of such materials materials. For example, if​ others), neck fractures​ and their symptoms​ How long do people live? Lastly

Rehabilitation after endoprosthetics

​ joint replacement.​ During the postoperative period​ on the psycho-emotional balance.​ endoprosthesis to the surgeon.​ It is better to trust the surgeon with​ for screws). Experienced the better. The type of prosthesis can be difficult to remove after Drainage is removed after 1-2 artificial joints, revision endoprosthetics can be done.

​staying in a 2-bed ward​ currently​ during​ knee hip arthroplasty (especially dangerous​ Diagnostics Traditional treatment​ for bone cancer? Oncological​ time number of people,​Therefore, hip replacement​ lays the foundation for​Hip arthroplasty refers​Under endoprosthetics is understood as a replacement with extensive experience, the surgeon himself chooses the surgeon who will perform

​highlight their durability​ wear of the prosthesis, so​ days after the operation.​ be made from​ Depending on whether​ within 7​ is quite wide -​ the joint is necessary​ in old age)​ Therapy at home​ bone diseases in​ those faced with similar...​ in Moscow are​ ensuring normal mobility​ for high-tech procedures,​ damaged or worn​ such kind of operations​ such as an endoprosthesis, Zimmer​ surgery will advise the patient​ and non-toxicity.​

​ are installed for people with the least​ Passive movements are allowed,​ various materials (metal​ which parts of the joint​ days;​ these are the​ complete replacement of the ligament​ and others.​ conditions Diet Think about ...​ modern medical practice​ How to identify arthritis​ provided control​ of the​ artificial hip joint.​ requiring careful preoperative​ joint replacement with an artificial​ implant,​

What is hip replacement

A complex surgical operation that requires replacing worn or damaged parts of the largest bone joint in the body, the hip joint (HJ), with artificial parts is arthroplasty. The “old” hip joint is replaced with an endoprosthesis. It is called so because it is installed and located inside the body (“endo-”). The product is subject to requirements for strength, reliable fixation of components and biocompatibility with tissues and structures of the body.

The artificial “joint” bears more load due to the absence of friction-reducing cartilage and synovial fluid. For this reason, dentures are made from high-quality metal alloys. They are the most durable and last up to 20 years. Polymers and ceramics are also used. Several materials are often combined in one endoprosthesis, for example, plastic and metal. In general, the formation of an artificial hip joint is ensured by:

• prosthetic cups replacing the acetabulum of the joint;
• a polyethylene liner that reduces friction;
• a head that provides soft gliding during movements;
• legs, which absorb the main loads and replace the upper third of the bone and the femoral neck.

Who needs it

Indications for endoprosthetics are serious damage to the structure and functional disorders of the hip joint, which lead to pain while walking or any other physical activity. This may be due to injuries or previous bone diseases. Surgery is also necessary if there is stiffness of the hip joint or a significant decrease in its volume. Specific indications for endoprosthetics include:

• malignant tumors of the femoral neck or head;
• coxarthrosis grade 2-3;
• femoral neck fracture;
• hip dysplasia;
• post-traumatic arthrosis;
• aseptic necrosis;
• osteoporosis;
• osteoarthritis;
• Perthes disease;
• rheumatoid arthritis;
• formation of a false hip joint, more often in older people.

Contraindications

Not all people who need hip replacement surgery can undergo hip surgery. Contraindications to it are divided into absolute, when surgical intervention is prohibited, and relative, i.e. it is possible, but with caution and under certain conditions. The latter include:

• oncological diseases;
• hormonal osteopathy;
• 3 degree of obesity;
• liver failure;
• chronic somatic pathology.

Absolute contraindications include more diseases and pathologies. Their list includes:

• foci of chronic infection;
• absence of a bone marrow canal in the femur;
• thromboembolism and thrombophlebitis;
• paresis or paralysis of the leg;
• skeletal immaturity;
• chronic cardiovascular failure, arrhythmia, heart disease;
• cerebrovascular accident;
• inability to move independently;
• bronchopulmonary diseases with respiratory failure, such as emphysema, asthma, pneumosclerosis, bronchiectasis;
• recent sepsis;
• multiple allergies;
• inflammation of the hip joint associated with damage to muscles, bones or skin;
• severe osteoporosis and low bone strength.

Types of hip replacements

In addition to classification by materials, hip joint endoprostheses are divided according to several other criteria. One of them is based on the components of the prosthesis. It could be:

1. Single-pole. In this case, the prosthesis consists only of a head and a stem. They replace the corresponding parts of the hip joint. Only the acetabulum remains “native”. Today such a prosthesis is rarely used. The reason is that there is a high risk of destruction of the acetabulum.
2. Bipolar, or total. This type of prosthesis replaces all parts of the hip joint - neck, head, acetabulum. It is better fixed and maximally adapted to the body. This increases the success of the operation. The total denture is suitable for older people and young people with high activity levels.

Endoprosthesis service life

The number of years that an endoprosthesis can last depends on the materials used in its manufacture. The strongest ones are metal ones. They last up to 20 years, but are characterized by less functional results in relation to the motor activity of the operated limb. Plastic and ceramic prostheses boast a shorter service life. They can only serve for 15 years.

Types of endoprosthetics operations

Depending on the prostheses used, endoprosthetics can be total or partial. In the first case, the head, neck and acetabulum of the articulation are replaced, in the second - only the first two parts. Another classification of the operation uses the method of fixation of the endoprosthesis as a criterion. Ceramics or metal must be firmly connected to the bones so that the hip joint can function fully. After selecting the endoprosthesis and its size, the doctor determines the type of fixation:

1. Cementless. The implant is fixed in place at the hip joint due to its special design. The surface of the prosthesis has many small protrusions, holes and depressions. Over time, bone tissue grows through them, thus forming an integral system. This method increases the recovery time.
2. Cement. It involves attaching the endoprosthesis to the bone using a special biological glue called cement. It is prepared during the operation. Fixation occurs due to the hardening of cement. In this case, restoration of the hip joint is faster, but there is a high risk of implant rejection.
3. Mixed or hybrid. It consists of a combination of both methods - cement and cementless. The stem is secured with glue, and the cup is screwed into the acetabulum. It is considered the most optimal way to fix the prosthesis.

Preparing for surgery

The first step before surgery is to have your feet examined by a doctor. X-rays, ultrasound and MRI of the operated area are used as diagnostic procedures. The patient is hospitalized two days before the scheduled operation for a series of other procedures that will help eliminate the presence of contraindications. Conducted:

• blood clotting test;
• OAM and UAC;
• determination of blood group and Rh factor;
• biochemical blood test;
• tests for syphilis, hepatitis, HIV;
• consultations with more specialized specialists.

Next, the patient is provided with information about possible complications and asked to sign a consent for surgical intervention. At the same time, instructions are given about behavior during and after the operation. Only a light dinner is allowed the day before. In the morning you can no longer drink or eat. Before the operation, the skin in the thigh area is shaved, and the legs are wrapped with elastic bandages or compression stockings are put on them.

Progress of the operation

After transporting the patient to the operating room, I give him anesthesia - full anesthesia with controlled breathing or spinal anesthesia, which is less harmful and is therefore more often used. The hip replacement technique is as follows:

• after anesthesia, the doctor treats the surgical field with antiseptics;
• then he cuts through the skin and muscle, making an incision of about 20 cm;
• then the intra-articular capsule is opened and the femoral head is removed into the wound;
• Next comes its resection until the medullary canal is exposed;
• the bone is modeled taking into account the shape of the prosthesis, and it is fixed using the selected method;
• Using a drill, he processes the acetabulum to remove cartilage from it;
• the cup of the prosthesis is installed into the resulting funnel;
• after installation, all that remains is to match the prosthetic surfaces and strengthen them by suturing the incised wound;
• A drain is inserted into the wound and a bandage is applied.

Temperature after hip replacement

An increase in temperature may be observed for 2-3 weeks after surgery. This is considered normal. In most cases, the body tolerates elevated temperatures well. Only if your condition is very bad, you can take an antipyretic tablet. You should only tell your doctor if your temperature rises after a period of several weeks when it was normal.

Rehabilitation

Hip replacement surgery requires the start of rehabilitation within the first hours after its completion. Rehabilitation measures include physical therapy, breathing exercises and early activation in general. The leg should be at functional rest, but movement is simply necessary. You can’t get up only on the first day. Changing the position of the body in bed and performing slight bends in the knee joint may be allowed by the doctor. In the following days, the patient can begin to walk, but with crutches.

How long does it last

Rehabilitation within the clinic lasts about 2-3 weeks. At this time, the doctor monitors the wound healing process. Postoperative sutures are removed approximately 9-12 days. The drainage is removed as the discharge decreases and completely stops. For approximately 3 months, the patient must use walking support. Full walking is possible after 4-6 months. Rehabilitation after hip replacement lasts approximately this long.

Life after hip replacement

If a person is somatically healthy and has no concomitant diseases, then he is able to restore the functionality of his leg almost completely. The patient can not only walk, but also play sports. You cannot perform only exercises related to strength tension of the limbs. Complications after endoprosthetics are observed more often in older people or in cases of non-compliance with the postoperative regimen.

Disability after endoprosthetics

Not all cases of hip replacement result in disability. If the patient suffers from pain and cannot perform his work normally, then he can apply for registration. Recognition of a person as disabled is carried out on the basis of a medical and social examination. To do this, you need to go to the clinic at your place of residence and go through all the necessary specialists.

The basis for disability is often not the endoprosthetics itself, but the diseases that required the operation. Experts consider the severity of impaired motor functions. If, after surgery, reduced functionality in the hip joint remains, the patient is given disability group 2-3 for 1 year with the possibility of subsequent re-registration.

Cost of the operation

Almost all patients are interested in the question of how much a hip replacement costs. There are several programs by which this operation can be performed:

• free under the compulsory medical insurance policy (in this case, you may face a queue for 6-12 months in advance);
• paid in a private or public clinic;
• free of charge under the quota of high-tech medical care (here circumstances are necessary to provide benefits).

In addition to the price of the operation itself, the cost of the hip joint prosthesis is also important. It depends on the reason that led to the need for endoprosthetics. With coxarthrosis, the cost of the prosthesis will be higher than with a femoral neck fracture. The approximate cost of surgery to replace the hip joint and prosthesis is shown in the table:

Today, there are any manufacturers on the medical implants market - Russian, European, American, and Chinese. We work with leading manufacturers of endoprostheses, most often we use endoprostheses from ZIMMER (USA) and Smith & Nephew (USA). Questions like “isn’t the Swiss one better”, or “I heard that the American ones are worse than the English ones”, etc. don't make sense at all. No sane surgeon would install a bad prosthesis, and it seems they are no longer produced (bad prostheses). The main thing is that the installed prosthesis matches the specific patient with all his features and is installed correctly.

Almost all serious companies have a wide range of implants that differ in design, materials, and some other parameters. The important thing is that the optimal endoprosthesis can be selected for each patient - both for young active patients who will engage in permitted sports, and for the very elderly, when the bone quality is worse than the surgeon would like.

In recent years, in 99% of cases we use endoprostheses with cementless fixation to the bone; we use cementation only in cases where there are no other options (very severe osteoporosis is the main reason).

The main parameter that determines the survival rate of the endoprosthesis is the material of the friction pair. The most “tenacious” pair today is the “ceramics-ceramics” (delta-ceramics) pair. The wear of the rubbing surfaces in such prostheses is so small that it can not even be taken into account - a person simply will not have time to wear out such a joint in his entire life. A simpler option is “ceramics-polyethylene” and “metal-polyethylene” pairs. The wear rate ratio in the three listed options is approximately: 0.00001: 0.01: 0.1 mm/year. Thus, the most wear-resistant prostheses are indicated for young people, the “ceramics-polyethylene” pair - for middle-aged people, and the “metal-polyethylene” pair - for older people. In all cases, any high-quality endoprosthesis, provided it is properly installed and used wisely, will serve for at least 15-20 years. There are joints for very elderly patients with a femoral neck fracture - unipolar, as well as bipolar and joints with double mobility of the head. There are oncological endoprostheses for cases when large bone defects have to be replaced.

If a person had an endoprosthesis installed a long time ago and it has worn out, or some problem has occurred with the prosthesis or the surrounding bone, an operation is performed to replace it - i.e. revision endoprosthetics. In some cases, you can get by simply replacing one prosthesis (or components) with another, but often (especially after cement prosthetics) you have to do quite traumatic operations to remove the old prosthesis and bone cement, and replace it with a revision one, which is more complex and cumbersome. In any case, there are no insoluble technical problems today - endoprosthetics has become one of the most well-developed operations. Several years ago, we had the opportunity to obtain customized endoprosthetic components for complex cases with large bone loss. Such components are printed from titanium powder on a 3D printer using computed tomography data. Most often we are talking about fragments of the pelvis.

Several examples of modern endoprostheses we use can be seen below.

Here is an interesting example of bilateral endoprosthetics. To my great regret, I did not make a video of walking before the operation, but, take my word for it, it was still a gait. Below you can see the radiographs sequentially - before the operation - after the first operation - after the second operation. You don't need to be a radiologist to appreciate the difference.

And here is the video - a year after the first, and 6 months after the second operation:

Of course, not all patients manage to be rehabilitated in this way, however, if there is a desire)))

If the patient's condition or the development of joint disease indicates the need for surgery to replace them, an understanding of which manufacturer should be preferred is required. The history of operations of implants of various manufacturers is very rich. This allows us to talk about the effectiveness and quality of different brands.

Basic criteria for choosing endoprostheses

Among the criteria that need to be assessed first are:

• availability for total endoprosthetics;
• the degree of restoration of the natural function of the joint;
• load distribution;
• materials from which the implant is made;
• surface treatment method;
• bone reaction to the implant;

The Corail endoprosthesis is most often used for complex hip joints, where it best meets the requirements of surgery and further rehabilitation.

Why choose Corail

If the patient's condition or the development of joint disease indicates the need for endoprosthetics, an understanding of which manufacturer should be preferred is required. The history of Corail, which belongs to the Johnson and Johnson concern, began in the 1970s. In 1986, they created a version of the implant that practically did not require further correction. This is due to the excellent results that clinics received after operations. What exactly persuades specialists to install the Corail endoprosthesis?

• low probability of developing “stress shielding”, because the hydroxyapatite coating goes over a large surface;
• horizontal grooves of the prosthesis reduce the risk of stem subsidence;
• if minimally invasive access is required, the design is ideal;
• long-term mechanical stability is ensured by the geometry of the leg, which comes in the form of a double wedge;
• Vertical grooves of the implant allow for rotational stability.

Experts found that the Corail endoprosthesis retained its properties in 97.7% of patients 10 years after surgery. Almost 100% rate was recorded 5 years after surgery.

Implants of this system are often offered free of charge to patients who have received a treatment quota. For those who pay for the operation themselves, the fact that it is affordable is important. There is no need to replace it often, which allows you to save even more.

Rehabilitation occurs quite quickly, which means a return to work function is possible in a short time. This is also a serious argument in favor of choosing models from this manufacturer.

The device of the endoprosthesis leg

The manufacturers of the implant tried to take into account all the features of implanting an artificial element into the human musculoskeletal system. It is difficult to find another manufacturer that offers a wide range of leg sizes like Corail. This allows the orthopedist to choose a model that is suitable for a particular patient, taking into account the structural features of his femur.

To increase the stability of the leg, a version with a calcar platform is created for each size. As a result, the risk of soft tissue entrapment is reduced.

In the Corail system, the 12/14 Morse taper at the stem fits perfectly with femoral heads with diameters of 32, 28 and 22.225 mm. They can be made of cobalt chromium or aluminum ceramics. Preference is given to ceramics by specialists for the following reasons:

• harder than metal;
• less susceptible to damage;
• can be better adapted to the joint, as a finer grind is provided;
• The head remains smooth, even with minor scratches. As a result, polyethylene wear is reduced by almost 70%.

The system also includes legs from the registered Fjord brand, which are cemented in cobalt chromium. Their shape creates conditions for the stress inside the cement mantle to be minimal. But most often, cementless models are chosen for total hip replacement.

The patented implant production technology makes it possible to create the size of its surface irregularities at the level of 3–5 microns. It is comparable in size to the trabeculae of bone. Due to this, reliable secondary fixation is created.

Preoperative planning

Those who are about to undergo joint replacement surgery are interested in how the process of preparing for it will take place. A wide range of ready-made templates allows you to start selecting from an X-ray image. In general, preparation for endoprosthetics looks like this:

• take x-rays in lateral and direct projections;
• by application, the size of the implant, neck length and other parameters are selected;
• it is checked how the filling of the metaphysis in the femur will occur;
• The dimensions of the leg are approved to adapt the template.

The orthopedist takes into account that there should be a gap of 1 mm between the cortical bone and the distal part of the stem of the artificial element. For correct resection, the angle of inclination is assumed to be 45 degrees. In this case, the resection itself is carried out 1 cm above the location of the lesser trochanter. During the operation, a minimal amount of cancellous bone is removed. This is necessary in order to:

• preserve bone mass;
• ensure better connection between the implant and bone;
• increase stability.

Why can’t you order an endoprosthesis yourself?

On the orthopedic goods market there are offers for the sale of the Corail system. Even if they are not fake, you cannot buy a Corail endoprosthesis yourself for the following reasons:

• only a doctor can correctly select a leg for surgery;
• in the process of preparing for surgery, the orthopedist will give recommendations on grinding the implant so that the patient can move as comfortably as possible;
• dubious sellers do not provide a guarantee for the product;
• An artificial joint is purchased along with a set of tools for their preparation, the choice of which must also be made by the doctor.

There is a high risk that the money will be spent and the goods will not arrive at all. This is especially true for online orders, the number of which has increased sharply in recent years.

Rehabilitation process after installing Corail

After surgery, patient observation in the intensive care unit is rarely required. Usually he is transferred directly to a regular ward under the supervision of medical staff. The next stages of recovery are:

• dressing, removal of urinary catheter, drainage;
• taking an x-ray to determine the quality of the endoprosthesis installation;
• performing verticalization with increasing load;
• within 8–14 days, drug treatment is carried out in the form of injections, bandaging and training in walking on different types of surfaces;
• development of recommendations on workload at home and at work;
• control using radiographs at certain intervals of the quality of the installation of the prosthesis.

If doctors have recommended a joint replacement, you should not be afraid of such an operation. Modern technologies make it possible to ensure that the patient’s quality of life does not decrease. The models that the Corail endoprosthesis has allow you to quickly select the option that suits a particular patient. You will have to return to a repeat operation after many years, which makes it possible to carefully plan it.

Hip replacement is often the only method of restoring motor activity. Installation of the implant eliminates the pain syndrome that does not leave the patient with diseases of the musculoskeletal system.

Modern types of prostheses are designed to completely imitate the original joint and fulfill its functional capabilities.

From a large number of endoprostheses, you can choose a suitable implant. Sometimes patients try to choose an implant on their own, studying brands, models, and varieties. Orthopedists often hear the following from patients:

• I recently read that the most reliable prosthesis is made of ceramics.
• A cemented denture is an outdated model, while a cementless one is a good option.
• The best prostheses are foreign ones, they have positive reviews.

The first myth that should be dispelled is that there is no best endoprosthesis.

Secondly, there are many variations of orthopedic structures to replace the hip joint: some of them are better, others are somewhat inferior in one way, but superior in another. We are talking about well-known companies that have been working in the orthopedic market for several years.

There are inexpensive models, but there are also expensive prostheses. This does not mean that the cheaper option may be much worse and cause complications. When releasing a new model of an implant, the company is forced to raise its cost, since development, production, and consumables require large investments. New models will take into account the shortcomings of the previous ones and will no longer contain them. It is possible that the service life will be longer.

In the third case, it is necessary to take into account not only the quality of the prosthesis, but also the work of the surgeon. Even an expensive implant does not guarantee the success of the operation if the doctor is poorly qualified and has no experience in endoprosthetics. Therefore, it is worth focusing not only on models and companies, but also on the knowledge of the person who will operate on you. Don't forget the importance of rehabilitation. A full recovery course will guarantee a successful recovery with any type of prosthetic design.

The models of leading foreign companies do not differ much, so it is difficult to say which is better. Comparison - rather by price-quality standards. Well-known companies Zimmer, De-Puy, Biomet produce equivalent samples that have no pronounced differences.

When choosing a prosthesis, look not at the company or cost, but at a more important feature that affects the life of the adaptation - the friction pair.

Types of endoprostheses, their differences

If we talk about the appearance of the prosthesis, it is a complete imitation of a person’s native joint, withstanding everyday stress and possessing the same functional abilities as the previously destroyed one.

Features and differences are distinguished by type of endoprosthetics:

• superficial. The hip joint head and acetabulum are being replaced;
• total. Complete replacement of damaged bone and cartilage with excision of the femoral neck.

Implants are distinguished by the method of attachment:

• Fixation without medical cement. Used for young patients without signs of osteoporosis. With good bone density, they grow into the prosthesis and secure it. For cementless fixation, a titanium alloy stem can be used.
• Fastening with cement. The technique is used in elderly people or in patients whose bone density does not allow the use of a cementless method.

Recently you can often hear the term “liquid implant”. It is not related to full endoprosthetics, since it is not a prosthesis. It involves the introduction of certain types of acids, the purpose of which is to restore the connective tissue of the cartilage. Any specialist will tell you that this is impossible. Under the influence of the degenerative-dystrophic process, the pathological joint is completely destroyed and has no ability to regenerate. The only way out is surgery.

Let's consider friction pairs. There is no point in choosing a specific brand or focusing on price, but it makes sense to consider other characteristics, because wear products will negatively affect the surrounding soft tissue and bones. This is what you really need to discuss with your doctor.

The following varieties exist:

• metal combined with metal;
• metal and polyethylene;
• ceramics plus ceramics;
• combination of ceramics and polyethylene.

Each type has its own advantages and disadvantages. It cannot be said that a combination of some components will be bad and another will be good. The prosthesis, like friction pairs, are selected individually. What is not suitable for one patient may be recommended for another.

Variety	Positive aspects	Negative aspects
Combination of ceramic and ceramic	Friction components are non-toxic High wear resistance Possibility to choose a large head diameter	High risk of material splitting during physical activity Fairly high price Often causes squeaks
Metal combined with metal	Short service life Material stability, high mobility New, more advanced models are released every year (there are plenty to choose from)	Low price High toxicity of friction products The cup is sensitive to tilting, it is advisable not to exceed 50 degrees
Metal and polyethylene	Budget implant, the cost is more affordable The most popular type of friction pair Combined with a low price, it has decent quality The tilt of the cup angle can reach 90 degrees	Unlike other types, less wear-resistant Head diameter is not available larger than 32 mm There is some toxicity, although quite mild
Ceramics and polyethylene	The best prosthesis option. Suitable for everyone, without exception, although recommended for older people with a passive lifestyle	Service life - quite long

A popular option is the combination of a metal component with a metal one due to the low price, but it is not recommended for installation by everyone - it has a number of limitations. It is often implanted in men who are accustomed to a more active lifestyle. It is strictly not recommended for women planning a future pregnancy: there is a high risk of toxic products entering the placenta, which negatively affects the fetus. In a number of countries, the use of this combination of components is prohibited.

Ceramics are more often used in combination with polyethylene: it is suitable for patients of any category and has no age restrictions. Revision intervention for replacement may be necessary after 15-20 years.

From 10 to 15% of complications after endoprosthetics are associated with incorrect selection of the prosthesis, and more specifically, the friction pair. That is why it is important to find a qualified orthopedist and pay attention not to the brand of the implant, but to its quality.

The longest service life is for the “ceramics plus ceramics” friction pair. Suitable for almost all patients, the only contraindication is that such prostheses are not implanted for osteoporosis (low tissue density). The main condition for extending the duration of use and reducing the risk of re-operation is the correct installation of structural components.

Hip joint: price of prosthesis

The cost of endoprosthetics and the implant itself depends on the orthopedic surgery medical center. The average price in Moscow according to 2014 statistics is 90,000-120,000 rubles. This price did not include hospital stay and diagnostic tests.

More details

The price of orthopedic structures depends on the manufacturer and the material used. Foreign companies offer implants in the region of 1300-2000 dollars, domestic ones are several times cheaper.

The quality of endoprosthetics is influenced not by cost, but by the quality of the operation and subsequent rehabilitation. Even the most expensive endoprosthesis does not guarantee a therapeutic effect if the intervention is performed incorrectly and there is no proper recovery period.

Where to buy a hip prosthesis?

You will purchase an implant to replace the hip joint directly with your doctor. They are the ones who collaborate with manufacturers and will be able to tell you how much a certain type costs.

You can buy a prosthesis yourself in a specialized store or order it online. The service is possible provided that you have discussed all the nuances in advance and found out the required type of prosthesis.

There are companies in Russian cities that are official distributors of foreign manufacturers of orthopedic implants. You can often hear about Legacy MED (working with the world famous American company Johnson & Johnson). Here you can buy titanium and ceramic endoprostheses. The consultant will tell you the exact price.

Dislocation of the hip prosthesis

The development of a pathology such as hip joint dislocation after replacement is a rare case and is diagnosed no more than 2-4 times per 100 operated patients. The symptoms are no different from the dislocation before the replacement. The clinical picture is as follows:

• development of pain that cannot be relieved with painkillers;
• change in the length of the lower limb, its shortening;
• impaired range of motion, stiffness, sharp decrease in physical activity.

To clarify the stability of the structure, the patient is put into a state of anesthesia, where the doctor deliberately subluxes the prosthesis and then resets it to its original position. This procedure allows us to predict the reasons that provoked the complication and reduce the risk of re-dislocation in the future.

Treatment consists of reduction of the dislocation and subsequent wearing of a special prosthesis, a course of physical therapy, physical therapy, and massage.

Zimmer: hip replacements

A well-known manufacturer of orthopedic equipment, a company founded in the USA more than a hundred years ago, is Zimmer. Throughout its existence, the company has constantly developed, introduced the latest technologies, created new designs and prostheses. Its products are transported to different countries of the world and used in medical centers in Israel, Germany, Russia, and the Czech Republic.

Such popularity is associated with the quality of the product: it is distinguished by durability and high adaptability.

The company's assortment is wide, it is possible to choose a prosthesis in the price-quality ratio. Even inexpensive implants can completely imitate the native joint and have good wear resistance.

What kind of prosthesis can I buy and how long does it last? Production Zimmer produces the following implant structures:

• knee replacement prosthesis. The undisputed leader: almost half of the operations are performed using prostheses from this company. Service life - 15 years or more;
• endoprostheses for shoulder joint replacement. A unique innovative development - a joint with a maximum level of implantability, restoring hand function by 95%;
• implants for hip replacement. A large selection of types, there is the possibility of individual selection, including price.

The main difference between Zimmer products is the high adaptation of the prosthesis, which shortens the rehabilitation period.

According to statistics, artificial joints from this manufacturer in 99% of cases remain stable for 10-12 years after installation. In almost 85% of Zimmer's service life is close to 15-18 years. Therefore, such popularity of the company is quite justified.

Patients often ask the following question: is it possible to install our prostheses, how many years will they last? The quality of domestic manufacturers is not much worse; there are many worthy orthopedic companies. There are many factors to consider when answering another question. Here everything depends not on the price of the implant, but on the chosen design - a friction pair, the skillful hands of a doctor and a rehabilitator.

Cost of hip joint

Complications rarely develop after joint replacement surgery; in 10% they are associated with an incorrectly selected implant. Patients are diagnosed with a neck fracture, the development of an infectious process, swelling, and hematomas.

Fact: there is no specific prosthesis - a universal model that could suit everyone and not cause side effects.

The main mistake many patients make is choosing an endoprosthetic design based on reviews from the Internet and price. A person chooses the most expensive foreign-made prosthesis and has the operation performed by a surgeon with little experience. As a result, adaptation is poor, recovery is long, and there are many complications.

If you decide to undergo endoprosthetics, please note that the price of the implant, Zimmer or ceramic, has nothing to do with the success of the treatment. It makes sense to opt for an inexpensive but suitable orthopedic item.

An experienced surgeon has his own preferences in models and brands, so preliminary consultation and selection is extremely necessary. Experts from both private institutions and public medical centers often advise choosing Zimmer and DePuy. Although the prostheses of these manufacturers have no fundamental differences, they are completely similar in appearance, they are high-quality products with the ability to choose a design taking into account financial capabilities.

Treatment of joints Read more >>

How much does treatment with such endoprostheses cost? The average price in Moscow is 200,000 rubles, taking into account a stay in a private clinic, laboratory tests, hospitalization and subsequent rehabilitation under the supervision of a specialized doctor.

There is an important point in orthopedic surgery: the basis for a successful recovery is recovery. Not a single prosthesis, even the most expensive one, guarantees the success of the operation without following the rules of rehabilitation.

There are enough examples in practice where patients, having purchased the most innovative and expensive implant, completely ignored restoration, believing that due to the high price it was not necessary. The result was that patients returned to the doctor several years later with complaints of pain, swelling, and the development of lameness. In this case, there cannot be conservative treatment - a revision operation is prescribed, followed by additional costs and long-term rehabilitation.

Very often, replacing a native joint with an artificial one is the only way to restore the normal functioning of the musculoskeletal system. Approach responsibly in choosing a prosthesis, diagnosis, clinic, doctor and further recovery.

Endoprosthetics of the hip joint is a surgical operation that is performed when there is a pronounced disruption of its functioning: in case of injuries, as well as when it is highly worn. Who needs hip replacement surgery? How much does this operation cost? How does this surgery occur? We will consider all these questions below.

• Indications for hip replacement surgery
• • Myth One: Hip surgery should only be done as a last resort.
  • Myth two: for a full recovery you just need to have this operation
  • Myth three: the endoprosthesis quickly fails
• • Hip replacement
  • Partial endoprosthetics
  • Total or complete prosthetics
  • Types of prostheses

• Contraindications for surgery
• How to live further after prosthetics?

Indications for hip replacement surgery

Hip arthroplasty or joint replacement surgery is usually performed for conditions and pathologies such as:

• aseptic necrosis of the bone head of the femur;
• fracture of the femoral neck;
• osteoarthritis of the hip joint;
• consequences of traumatic injuries;
• hip dysplasia.

All of the diseases described above are not yet a mandatory indication for surgery: in each individual case, this issue is resolved after a thorough examination and examination of the patient by a doctor.

As for arthrosis of the hip joint, surgical intervention is usually performed at advanced stages of the disease (at stages 2-3 of the disease), as well as for severe and persistent pain in the joint, even at rest, with relief from painkillers They can no longer cope.

Myths about hip replacement

There are popular misconceptions about hip replacement surgery, due to which most patients have a negative attitude towards surgical interventions or evaluate them not entirely correctly. Will try to dispel these myths.

Myth One: Hip surgery should only be done as a last resort.

Most people who suffer from coxarthrosis or arthrosis of the hip joint postpone prosthetics until the last moment, intending to do it only in the event that they are no longer able to walk completely. In reality, this is not the best tactic. By delaying a visit to the doctor, this person will absolutely in vain continue to experience pain in the joint, which it would be entirely possible to prevent by having an operation earlier.

In addition, if a patient with this disease is not in a hurry to undergo hip replacement surgery (which has been required for a long time), then by delaying it only aggravates the course of the disease. At this time, the disease continues to negatively affect the patient’s health and only begins to intensify every day, thereby lengthening the time of recovery and return to a full life.

Myth two: for a full recovery you just need to have this operation

In reality this is absolutely not the case. Coxarthrosis or another disease for which this operation needs to be performed is a pathology not only of the hip bone, but also of the entire joint and even, in general, of the body.

Due to the fact that a person spares the affected leg and uses the joint ligaments less of it, the hip muscles atrophy, weaken, and bone tissue density decreases (that is, osteoporosis appears).

Therefore, for a complete recovery, an integrated approach is required, when after the operation there follows a properly chosen program of rehabilitation, physiotherapy, physical therapy and other methods of treatment that can help a person quickly get back on his feet and feel healthy again.

Myth three: the endoprosthesis quickly fails

This also does not always correspond to reality. Since hip replacement is a fairly complex operation, all prostheses are manufactured with maximum performance and durability in mind.

Prostheses are made of high-quality metal, ceramics or plastic, due to which the operating time of the endoprosthesis is more than 25 years, and if everything is normal, then only after this time has passed is a repeat operation to replace the prosthesis. And in older people, due to this long operating time of the prosthesis, there is often no need for repeated surgical intervention.

Types of endoprosthetics

Today, there are three types of hip replacement surgeries:

• replacement of hip joint surfaces;
• installation of a total or complete endoprosthesis;
• installation of a partial endoprosthesis.

Hip replacement

With this type of operation, the surgical impact directly on the joint is minimal (unlike other methods). The cartilaginous layer is removed from the acetabulum of the hip bone, and an artificial articular bed is placed in its place.

As for the hip bone, its head is ground in a special way, then a special cap made of high-quality material is put on it. Due to these changes, the bony surfaces of the joint change to artificial ones, and the sliding between these parts becomes as close as possible to the ideal state.

Partial endoprosthetics

This surgical intervention affects more tissue, but the operation is also performed at more severe stages of the disease, when the process of replacing joint surfaces is no longer quite reliable.

With this type of surgical intervention, the bone head of the femur is no longer ground down, but is completely removed. In addition, the bone neck of the femur is also partially removed, and instead of the removed tissue, an artificial articular bed is placed, as well as an artificial bone head of the femur with a ceramic or metal surface of the joint. A special pin is inserted into the body of the bone, and due to this the structure has excellent strength.

Total or complete prosthetics

Total hip replacement is the most radical operation of all of the above, but at the same time the most effective. Its meaning is that during it a complete replacement of the hip joint takes place. The remnants of cartilaginous tissue are removed from the pelvic bone, and a new - metal or ceramic - joint bed is placed in its place.

The second part of the artificial prosthesis consists of a high-strength iron pin, which is made of stainless steel, titanium or other metals, and a joint head, which can also be made of high-quality ceramics or metal. A metal pin is inserted into the hip bone and fixed there, ensuring the stability and reliability of the entire structure, and the head of the endoprosthesis is fixed directly to it.

Types of prostheses

Since all people are different, with different builds and sizes, all the elements of this artificial prosthesis - the joint bed, the head of the joint, the pin - are selected individually for each person separately.

There are more than 200 different components of this endoprosthesis. Their choice is made by the surgeon during the examination of the person and preparation of him for this surgical intervention.

In addition, dentures are made from various materials:

• ceramics;
• metal;
• high quality polyethylene;
• plastic.

Taking into account what kind of person, with what lifestyle, and at what age the prosthetic operation is performed, these materials can be combined with each other in different combinations.

Thus, for an elderly person who has little physical activity on his leg, endoprostheses can be installed, where one articular part - for example, the joint bed - is made of plastic, and the second is made of ceramics. This combination makes it possible to significantly increase the service life of the prosthesis.

But when the operation is performed on a young patient whose physical loads on the joints have been (and will be in the future) quite large, the strategy for choosing an endoprosthesis will be completely different. This person, as a rule, is fitted with a prosthesis where both surfaces of the joint are made of metal, or both elements are made of ceramic. These hip replacements are more rigid, but at the same time they can last longer, even under very significant physical activity.

The cost of hip joint replacement consists of two components: the price of the prosthesis itself and the price of the operation simultaneously with treatment in an inpatient setting.

The cost of a prosthesis may differ depending on the type of disease: thus, a prosthesis for the surgical treatment of coxarthrosis may be more expensive than an endoprosthesis, which is necessary, for example, for femoral neck fractures and other diseases.

In general, the cost of a joint endoprosthesis can vary between 45-130 thousand rubles and more (approximately in Moscow at the beginning of 2016). The price of the operation itself along with hospital treatment, rehabilitation process, etc. can range from 40 thousand rubles. for a fairly simple unipolar hip replacement, up to 450 thousand rubles. and more for complete prosthetics.

That is, the price of an all-inclusive operation (we are considering total prosthetics) can be from 50,000 to 500,000 rubles - during this surgical treatment in hospitals and clinics in Moscow.

When you don’t really trust Russian specialists, you can perform this surgical operation in medical institutions of other countries - in Germany (18-25 thousand euros), Israel (16-21 thousand euros) or Turkey (11-16 thousand euros) ). But before performing this operation, you need to consult an experienced and competent orthopedic doctor, and sometimes more than one.

The duration of the operation is usually 40 minutes. up to 4 hours. Taking into account what specific endoprosthetics is performed - partial or total - the duration of the procedure may also vary. The operation takes place both under spinal anesthesia and under full anesthesia.

So that a person can begin to fully use the joint as quickly as possible, very light physical therapy exercises for the joint begin already 2-3 days after surgery, which over time complicate and increase the load on the sore leg. Most often, the person will be able to sit on the bed the very next day after the operation.

As a rule, 10-12 days after prosthetics are performed, if everything happened without complications, the person is discharged from the hospital. By this time, he can already get out of bed and carefully begin to walk, and can also climb stairs with the help of crutches.

Contraindications for surgery

When a hip replacement is needed, certain underlying medical conditions may make surgery impossible. We are talking about people who suffer from diabetes, Parkinson's disease, or have experienced a heart attack or stroke. Problems with the cardiovascular system can also lead to significant complications after a joint replacement is performed.

Surgery can also be problematic in cases of pronounced muscle weakness in a person. It is necessary to take into account contraindications, since if they are present, the risk of dislocation or damage to the artificial joint increases. If the health of a person's body can be defined as poor, and the chances of various complications occurring are quite high, then there is a possibility that the operation will not be successfully performed.

How long a prosthesis will last will depend on many factors. The most common complication is loosening or displacement of the endoprosthesis. Moreover, there is a slight difference in the length of the legs.

Blood clots are likely to appear in the blood vessels. In order to prevent the occurrence of this complication, treatment is carried out with anticoagulants. The treatment complex includes the use of special stockings, exercises for the lower leg, and periodic leg lifting.

Infectious complications can also appear after surgery. To reduce this risk, antibacterial therapy is performed. Infection from other foci of the chronic inflammatory process is likely.

Patients who do not follow the doctor's advice and place more stress on the hip joint may increase the risk of implant fracture or dislocation. This risk increases in overweight patients. To prevent complications, you need to monitor your own weight and avoid heavy loads.

In some cases, the bone that is next to the joint is destroyed. This happens as a result of the body's reaction to contact with a foreign body. It is likely that elements of the prosthesis will need to be replaced or it will have to be removed due to a person’s allergic reactions to a foreign body, improper cementing, or improper installation of the prosthesis.

How to live further after prosthetics?

Naturally, discharge from the clinic does not mean that the treatment and rehabilitation period ends. The attending surgeon develops a complex of rehabilitation treatment for the patient, which consists of several stages, during which the patient learns to walk again and use a new joint, learn to move and restore previous loads.

Moreover, the return to normal life, for a patient with a full load, most often occurs after a few months - provided that he follows all the doctor’s advice. In certain cases, including when the patient is elderly, the time for full restoration of joint function can last up to 6 months.

Hip prosthesis: how to choose the best one

Hip replacement is often the only method of restoring motor activity. Installation of the implant eliminates the pain syndrome that does not leave the patient with diseases of the musculoskeletal system.

Modern types of prostheses are designed to completely imitate the original joint and fulfill its functional capabilities.

From a large number of endoprostheses, you can choose a suitable implant. Sometimes patients try to choose an implant on their own, studying brands, models, and varieties. Orthopedists often hear the following from patients:

• I recently read that the most reliable prosthesis is made of ceramics.
• A cemented denture is an outdated model, while a cementless one is a good option.
• The best prostheses are foreign ones, they have positive reviews.

The first myth that should be dispelled is that there is no best endoprosthesis.

Secondly, there are many variations of orthopedic structures to replace the hip joint: some of them are better, others are somewhat inferior in one way, but superior in another. We are talking about well-known companies that have been working in the orthopedic market for several years.

There are inexpensive models, but there are also expensive prostheses. This does not mean that the cheaper option may be much worse and cause complications. When releasing a new model of an implant, the company is forced to raise its cost, since development, production, and consumables require large investments. New models will take into account the shortcomings of the previous ones and will no longer contain them. It is possible that the service life will be longer.

In the third case, it is necessary to take into account not only the quality of the prosthesis, but also the work of the surgeon. Even an expensive implant does not guarantee the success of the operation if the doctor is poorly qualified and has no experience in endoprosthetics. Therefore, it is worth focusing not only on models and companies, but also on the knowledge of the person who will operate on you. Don't forget the importance of rehabilitation. A full recovery course will guarantee a successful recovery with any type of prosthetic design.

The models of leading foreign companies do not differ much, so it is difficult to say which is better. Comparison - rather by price-quality standards. Well-known companies Zimmer, De-Puy, Biomet produce equivalent samples that have no pronounced differences.

When choosing a prosthesis, look not at the company or cost, but at a more important feature that affects the life of the adaptation - the friction pair.

Types of endoprostheses, their differences

If we talk about the appearance of the prosthesis, it is a complete imitation of a person’s native joint, withstanding everyday stress and possessing the same functional abilities as the previously destroyed one.

Features and differences are distinguished by type of endoprosthetics:

• superficial. The hip joint head and acetabulum are being replaced;
• total. Complete replacement of damaged bone and cartilage with excision of the femoral neck.

Implants are distinguished by the method of attachment:

• Fixation without medical cement. Used for young patients without signs of osteoporosis. With good bone density, they grow into the prosthesis and secure it. For cementless fixation, a titanium alloy stem can be used.
• Fastening with cement. The technique is used in elderly people or in patients whose bone density does not allow the use of a cementless method.

Recently you can often hear the term “liquid implant”. It is not related to full endoprosthetics, since it is not a prosthesis. It involves the introduction of certain types of acids, the purpose of which is to restore the connective tissue of the cartilage. Any specialist will tell you that this is impossible. Under the influence of the degenerative-dystrophic process, the pathological joint is completely destroyed and has no ability to regenerate. The only way out is surgery.

Let's consider friction pairs. There is no point in choosing a specific brand or focusing on price, but it makes sense to consider other characteristics, because wear products will negatively affect the surrounding soft tissue and bones. This is what you really need to discuss with your doctor.

The following varieties exist:

• metal combined with metal;
• metal and polyethylene;
• ceramics plus ceramics;
• combination of ceramics and polyethylene.

Each type has its own advantages and disadvantages. It cannot be said that a combination of some components will be bad and another will be good. The prosthesis, like friction pairs, are selected individually. What is not suitable for one patient may be recommended for another.

Variety	Positive aspects	Negative aspects
Combination of ceramic and ceramic	Friction components are non-toxic High wear resistance Possibility to choose a large head diameter	High risk of material splitting during physical activity Fairly high price Often causes squeaks
Metal combined with metal	Short service life Material stability, high mobility New, more advanced models are released every year (there are plenty to choose from)	Low price High toxicity of friction products The cup is sensitive to tilting, it is advisable not to exceed 50 degrees
Metal and polyethylene	Budget implant, the cost is more affordable The most popular type of friction pair Combined with a low price, it has decent quality The tilt of the cup angle can reach 90 degrees	Unlike other types, less wear-resistant Head diameter is not available larger than 32 mm There is some toxicity, although quite mild
Ceramics and polyethylene	The best prosthesis option. Suitable for everyone, without exception, although recommended for older people with a passive lifestyle	Service life - quite long

A popular option is the combination of a metal component with a metal one due to the low price, but it is not recommended for installation by everyone - it has a number of limitations. It is often implanted in men who are accustomed to a more active lifestyle. It is strictly not recommended for women planning a future pregnancy: there is a high risk of toxic products entering the placenta, which negatively affects the fetus. In a number of countries, the use of this combination of components is prohibited.

Ceramics are more often used in combination with polyethylene: it is suitable for patients of any category and has no age restrictions. Revision intervention for replacement may be necessary after 15-20 years.

From 10 to 15% of complications after endoprosthetics are associated with incorrect selection of the prosthesis, and more specifically, the friction pair. That is why it is important to find a qualified orthopedist and pay attention not to the brand of the implant, but to its quality.

The longest service life is for the “ceramics plus ceramics” friction pair. Suitable for almost all patients, the only contraindication is that such prostheses are not implanted for osteoporosis (low tissue density). The main condition for extending the duration of use and reducing the risk of re-operation is the correct installation of structural components.

Hip joint: price of prosthesis

The cost of endoprosthetics and the implant itself depends on the orthopedic surgery medical center. The average price in Moscow according to 2014 statistics is 90,000-120,000 rubles. This price did not include hospital stay and diagnostic tests.

More details

The price of orthopedic structures depends on the manufacturer and the material used. Foreign companies offer implants in the region of 1300-2000 dollars, domestic ones are several times cheaper.

The quality of endoprosthetics is influenced not by cost, but by the quality of the operation and subsequent rehabilitation. Even the most expensive endoprosthesis does not guarantee a therapeutic effect if the intervention is performed incorrectly and there is no proper recovery period.

Where to buy a hip prosthesis?

You will purchase an implant to replace the hip joint directly with your doctor. They are the ones who collaborate with manufacturers and will be able to tell you how much a certain type costs.

You can buy a prosthesis yourself in a specialized store or order it online. The service is possible provided that you have discussed all the nuances in advance and found out the required type of prosthesis.

There are companies in Russian cities that are official distributors of foreign manufacturers of orthopedic implants. You can often hear about Legacy MED (working with the world famous American company Johnson & Johnson). Here you can buy titanium and ceramic endoprostheses. The consultant will tell you the exact price.

Dislocation of the hip prosthesis

The development of a pathology such as hip joint dislocation after replacement is a rare case and is diagnosed no more than 2-4 times per 100 operated patients. The symptoms are no different from the dislocation before the replacement. The clinical picture is as follows:

• development of pain that cannot be relieved with painkillers;
• change in the length of the lower limb, its shortening;
• impaired range of motion, stiffness, sharp decrease in physical activity.

To clarify the stability of the structure, the patient is put into a state of anesthesia, where the doctor deliberately subluxes the prosthesis and then resets it to its original position. This procedure allows us to predict the reasons that provoked the complication and reduce the risk of re-dislocation in the future.

Treatment consists of reduction of the dislocation and subsequent wearing of a special prosthesis, a course of physical therapy, physical therapy, and massage.

Zimmer: hip replacements

A well-known manufacturer of orthopedic equipment, a company founded in the USA more than a hundred years ago, is Zimmer. Throughout its existence, the company has constantly developed, introduced the latest technologies, created new designs and prostheses. Its products are transported to different countries of the world and used in medical centers in Israel, Germany, Russia, and the Czech Republic.

Such popularity is associated with the quality of the product: it is distinguished by durability and high adaptability.

The company's assortment is wide, it is possible to choose a prosthesis in the price-quality ratio. Even inexpensive implants can completely imitate the native joint and have good wear resistance.

What kind of prosthesis can I buy and how long does it last? Production Zimmer produces the following implant structures:

• knee replacement prosthesis. The undisputed leader: almost half of the operations are performed using prostheses from this company. Service life - 15 years or more;
• endoprostheses for shoulder joint replacement. A unique innovative development - a joint with a maximum level of implantability, restoring hand function by 95%;
• implants for hip replacement. A large selection of types, there is the possibility of individual selection, including price.

The main difference between Zimmer products is the high adaptation of the prosthesis, which shortens the rehabilitation period.

According to statistics, artificial joints from this manufacturer in 99% of cases remain stable for 10-12 years after installation. In almost 85% of Zimmer's service life is close to 15-18 years. Therefore, such popularity of the company is quite justified.

Patients often ask the following question: is it possible to install our prostheses, how many years will they last? The quality of domestic manufacturers is not much worse; there are many worthy orthopedic companies. There are many factors to consider when answering another question. Here everything depends not on the price of the implant, but on the chosen design - a friction pair, the skillful hands of a doctor and a rehabilitator.

Cost of hip joint

Complications rarely develop after joint replacement surgery; in 10% they are associated with an incorrectly selected implant. Patients are diagnosed with a neck fracture, the development of an infectious process, swelling, and hematomas.

Fact: there is no specific prosthesis - a universal model that could suit everyone and not cause side effects.

The main mistake many patients make is choosing an endoprosthetic design based on reviews from the Internet and price. A person chooses the most expensive foreign-made prosthesis and has the operation performed by a surgeon with little experience. As a result, adaptation is poor, recovery is long, and there are many complications.

If you decide to undergo endoprosthetics, please note that the price of the implant, Zimmer or ceramic, has nothing to do with the success of the treatment. It makes sense to opt for an inexpensive but suitable orthopedic item.

An experienced surgeon has his own preferences in models and brands, so preliminary consultation and selection is extremely necessary. Experts from both private institutions and public medical centers often advise choosing Zimmer and DePuy. Although the prostheses of these manufacturers have no fundamental differences, they are completely similar in appearance, they are high-quality products with the ability to choose a design taking into account financial capabilities.

Treatment of joints Read more >>

How much does treatment with such endoprostheses cost? The average price in Moscow is 200,000 rubles, taking into account a stay in a private clinic, laboratory tests, hospitalization and subsequent rehabilitation under the supervision of a specialized doctor.

There is an important point in orthopedic surgery: the basis for a successful recovery is recovery. Not a single prosthesis, even the most expensive one, guarantees the success of the operation without following the rules of rehabilitation.

There are enough examples in practice where patients, having purchased the most innovative and expensive implant, completely ignored restoration, believing that due to the high price it was not necessary. The result was that patients returned to the doctor several years later with complaints of pain, swelling, and the development of lameness. In this case, there cannot be conservative treatment - a revision operation is prescribed, followed by additional costs and long-term rehabilitation.

Very often, replacing a native joint with an artificial one is the only way to restore the normal functioning of the musculoskeletal system. Approach responsibly in choosing a prosthesis, diagnosis, clinic, doctor and further recovery.

Hip replacement is a serious orthopedic operation to replace a damaged joint with an implant. The basis for surgical intervention is usually increased wear and tear of the joint, as well as bruises and injuries in the joint area, which result in functional impairment. How much does endoprosthetics cost and which implant is better to buy? Advice and recommendations from orthopedic specialists will help you understand the issue of choosing the optimal types of modern endoprostheses.

1. What affects the cost of an endoprosthesis?
2. When is the operation performed?
3. Selection criteria
4. Price of different brands

What does the price depend on?

When planning to buy an implant for yourself, you should not base it only on its cost level. In fact, a large number of zeros on the price tag is not always a guarantee of long and flawless service of the endoprosthesis. Its price depends on the type of model and the main diagnosis. For example, an implant for surgical treatment of coxarthrosis is more expensive than a replacement needed for a hip fracture.

The combination of high cost and excellent quality in traumatology does not always look good. Since hip replacement is considered a complex operation, the main thing is the high level of its execution, and not the high cost of the implant. A medical error can negatively affect even the best quality material. It would be correct if the patient entrusts the right to choose a prosthesis to a qualified surgeon. This is the main factor in successful endoprosthetics. An experienced specialist will be able to decide which type of artificial substitute is best to prefer in each specific case.

The most popular models of artificial joints are produced by international companies DePuy and Zimmer. In addition, active participants in the modern market are Stryker, Smith & Nephew, Biomet, Aesculap, B. Braun. Zimmer produces high quality Zimmer Trilogy cups. The DePuy brand is best known for its Pinnacle line of endoprostheses. In terms of purpose and quality of execution, Zimmer and DePuy products are almost identical, so only a professional doctor can choose the best option.

Indications and restrictions

An operation to introduce an artificial organ is usually prescribed in the presence of certain types of diseases and negative conditions of the hip joint:

• femoral neck fracture and consequences of traumatic injuries;
• coxarthrosis (deforming osteoarthritis) and other types of arthritis that cause degenerative changes;
• dysplasia;
• impaired blood supply to the femoral head;
• congenital anomalies;
• some types of tumors;
• aseptic necrosis.

The presence of any of the listed signs is not a mandatory indicator for surgical intervention. In each individual case, the issue of endoprosthetics for the patient is decided by the attending physician after a thorough examination. In particular, for coxarthrosis, surgery is prescribed only for stages 2-3 of the disease. An endoprosthesis is also installed for unbearable long-term pain in the hip joint, which does not respond to treatment for six months.

The following circumstances may serve as contraindications to surgery to replace a joint with an endoprosthesis:

1. dermatological diseases and damage to the skin in the thigh area;

2. problems with peripheral vessels of the lower extremities;

3. paralysis of the quadriceps muscle;

4. oncological diseases;

5. severe mental disorders;

6. excess body weight (more than 120 kg).

When deciding whether to install an endoprosthesis, the age and general health of the patient must be taken into account. Orthopedic surgery is not recommended for young people in cases where it is possible to preserve/restore functions with the help of drug treatment.

What to consider when purchasing?

Externally, the artificial joint is very similar to the real one. In the classic version, it consists of a pin (leg), a cup and a head. The endoprosthesis takes on normal physical activity and performs the same actions as a healthy organ. The operation to replace a damaged hip joint with an implant is called primary hip replacement. When it comes to revision arthroplasty, it means replacing a previously installed joint.

There are many types of prostheses on sale, which are classified according to several criteria.

1. Type of construction.

• Unipolar - replacing the head of the hip joint.
• Bipolar - prostheses that are installed instead of the femoral head and acetabulum. This kind of endoprosthetics is called total. It is often performed in orthopedics and traumatology.

2. Main material (cup and stem).

• Metal and metal are a wear-resistant combination that can last at least two decades. Metal endoprostheses are best installed for men leading an active lifestyle. Thanks to the large joint heads, a wide range of motion is possible. For women planning a pregnancy, prostheses are not recommended due to the high likelihood of metal ions entering the fetus. The disadvantages include the high price of the endoprosthesis. In addition, toxic products are formed as a result of friction of artificial surfaces. According to orthopedists, metal joints are rarely used in practice, and in some countries they are even prohibited.
• Metal and plastic are an inexpensive option with moderate toxicity of abrasion products. The combination of materials is considered the most short-lived (10-15 years). Such a prosthesis can be purchased by people of a non-athletic nature with a measured and calm lifestyle. Due to their low cost, implants are available to patients of retirement age.
• Ceramic and ceramic artificial joints are equally suitable for patients of any gender and age. They are durable and non-toxic. The main obstacle to purchasing a ceramic endoprosthesis is the high cost. In addition, implants can creak during movement, which creates significant discomfort for patients.
• Ceramics and plastic are the cheapest types of prostheses. The combination is characterized by rapid wear and fragility, therefore it is more suitable for elderly patients of both sexes.

3. Method of fixation.

• Cementless/mechanical – installation of endoprosthetic elements into bone tissue by wedging or pressing. The joints are coated with a special compound. Thanks to this coating, the bone tissue “fuses” with the endoprosthesis material (usually titanium), securely fixing it. Uncemented dentures are good for young patients. This facilitates future revision hip replacement surgery.
• Cemented - all parts of the dentures are fixed using a special biological solution. This connection method ensures reliable fixation even with osteoporosis. Cemented endoprostheses are best installed in elderly patients and people with reduced physical activity.
• Hybrid-full – individual parts of the prosthesis can be made from different types of materials. The cup is fixed using a cementless method. Artificial legs are secured with a solution. Hybrid endoprostheses are best recommended for middle-aged patients.

Price overview

In fact, the cost of endoprosthetics consists of two parts. This is the price of the implant itself and the cost of the operation along with the stay in the inpatient department. Depending on the type and manufacturer, an endoprosthesis costs from 60,000–80,000 to 220,000–300,000 rubles. On average, an implant costs 130,000 – 150,000.

The average cost of hip replacement surgery in Russian clinics is 170,000–250,000. The total amount depends on the conditions of stay and the duration of hospitalization. In total, endoprosthetics together with hospital stay costs an average of 350,000–370,000 (30,000–220,000 for single-pole prosthetics, 400,000–600,000 rubles for total). In different countries it is valued at between $8,000 and $40,000.

feel-feet.ru

Manufacturing materials

When selecting an endoprosthesis for each patient, the surgeon takes into account his individual characteristics: lifestyle, age, weight, bone tissue condition. Depending on this, one or another implant material or a combination of them is selected: metal, polyethylene or ceramics.

For young and active people, high-strength prostheses with a friction unit (head and acetabular cup) ceramic-ceramic or metal-metal are optimal. With these combinations, the liner is either not required or is of small thickness, which allows the use of large heads, which significantly increases the range of motion of the hip.

Monoceramic ones are more expensive, but their strength characteristics are higher than those of metal ones, the wear rate is 0.0001 mm per year. And also microparticles produced in minimal quantities during friction do not cause allergies or negative effects on organs.

Previously, ceramic dentures were feared due to the high probability of splitting, but with the advent of the latest generations of Biolox forte and Biolox delta ceramics, produced by the German plant CeramTec, such fears are in vain. Leading manufacturers make the majority of ceramic components from this material.

Since 1960, endoprosthesis replacement with metal-polyethylene friction pairs has been popular in surgical practice due to its high wear resistance and reasonable cost: a metal head and an acetabular cup insert made of high molecular weight polyethylene (“cross-linked”).

Ceramic heads are much harder, more scratch-resistant and smoother than metal heads, so the ceramic-polyethylene friction unit lasts twice as long as the above-mentioned metal-polyethylene option.

Polyethylene, additionally stabilized with vitamin E, significantly increases wear resistance - up to 99%. Acetabular implants made from this material wear out by only 0.01 mm per year.

Osteoporosis as a cause of unreliable fixation of the prosthesis

The service life of the endoprosthesis is largely determined by the strength of its fixation in the bone cavity. This requires dense bone tissue, which most patients have problems with due to various diseases such as osteoporosis.

Osteoporosis is a loss of mechanical strength and a breakdown of the structure of the entire bone tissue due to an imbalance in the process
cell renewal. Due to the increased fragility of bones in osteoporosis, fractures are common, including at the femoral neck.

Normally, in a person aged 30-50 years, the number of destroyed bone cells is replaced by an equal volume of new ones. After age 50, approximately 1% of bone cells are lost per year. After 65, senile osteoporosis occurs, associated with the natural weakening and wear of the skeleton.

It is especially difficult for women - in the first year after the onset of menopause, the loss is 10%, then 2-3%. This is due to changes in hormonal levels,
therefore, hormone replacement therapy is popular in some countries
therapy to avoid loss of muscle and bone mass.

But the disease can begin to develop long before the due date for the following reasons:

• smoking;
• abuse of coffee and alcohol;
• predominance of meat in the diet;
• lack of calcium and vitamin D3;
• against the background of rheumatoid arthritis;
• sedentary lifestyle.

If the patient has osteoporosis, then when replacing the femoral neck, a bone fracture, crack or perforation is possible. Then additional fixation devices are used: screws and plates. But they can also break due to slow post-operative healing, without the natural support of dense bone tissue. During the operation of the implant, the screws sometimes change their position, which causes various types of injuries and the need for revision surgery. So there is no need to talk about the long service life of a hip endoprosthesis if the patient has osteoporosis.

What to do after surgery

The postoperative period plays a key role for the service life of the hip joint prosthesis. It is very important to constantly monitor the operated hip, maintaining its correct position:

• sleep for the first days only on your back, keeping your legs in a semi-abducted position;
• You can turn on your healthy side, but only by slightly abducting your prosthetic leg. For insurance, it is better to place a cushion or pillow under it;
• It is permissible to constantly sleep on the healthy side no earlier than after 2 weeks;
• for the first week, do not move the sore hip with a large amplitude, do not make sudden and rotational movements;
• Under no circumstances should you bend your hip at an angle greater than 90 degrees (chairs should be high or supported by a cushion);
• You cannot cross your legs or lay one on top of the other;
• It is very important to regularly perform special exercises.

After three months, the doctor will evaluate the condition of the joint using an x-ray.

How to reduce wear

Basic rules for extending the service life of a hip joint endoprosthesis:

1. Various infections and colds should be avoided, as this can cause inflammation in the area of ​​the prosthetic joint.
2. You should not gain excess weight after endoprosthetics.
3. Avoid lifting and carrying heavy objects, as well as sudden movements and jumping on the operated leg.
4. Do not allow the hip to flex more than 90 degrees, otherwise dislocation may occur.
5. Do not climb stairs quickly, especially steep ones.
6. Take preventive measures against osteoporosis: an active lifestyle, for example, skiing or swimming, eat fish, dairy products, vegetables, vitamin supplements if necessary.

By following simple rules, which the attending physician will familiarize you with in detail, taking care of yourself in terms of weight and regularly performing a special set of exercises, you can significantly extend the service life of even a not too expensive hip prosthesis. And if you ignore all this, you end up in revision surgery much earlier than expected, even with the strongest implant (usually due to dislocation).

Revision surgery

On average, a modern hip prosthesis lasts at least 15 years, and most of them (70%) easily “live” to 20 or 25 years and even longer. But still, a time comes when further wearing of the implant becomes uncomfortable and pain appears, which many endure to the limit. Under no circumstances should this be done. The sooner surgery is performed, the more successful the installation of a new prosthesis will be. Moreover, it happens that it is not the entire system that needs to be replaced, but just one component.

msk-artusmed.ru

Who is the operation indicated for?

Prosthetics can be recommended for people with many diseases.

Orthopedic operations to replace a damaged joint are considered complex.

The basis for replacement is medical indications: high wear and tear of the joint, injuries to the joints, bruises. Such limbs cannot fully function.

• patients with arthritis;
• arthrosis;
• for femoral neck fractures;
• dysplasia;
• congenital anomalies;
• oncological diseases.

Types of surgery

Hip replacement can vary depending on the type of surgery:

• replacement of the surface of the hip joint;
• complete replacement (total);
• installation of a partial denture.

What types of designs are there?

Only a doctor can help you choose an implant.

To choose a hip joint prosthesis on your own, deciding which one is better, only a doctor can decide on this, analyzing the type of injury.

The classic version of the implant consists of a stem (pin), head, and cups. Depending on the purpose, they are distinguished:

• by type of construction;
• material.

The designs are unipolar, capable of replacing the functions of the head of the joint. Bipolar, replace the femoral head and acetabulum. The main materials for production were metal, plastic, ceramics, and a combination of them.

Fixation methods

There are different methods of fixation:

• mechanical (cementless), the product is wedged into the bone tissue, the junction is “masked” with a certain substance, after a while the bone “fuses” with the product;
• cemented, the product is completely fixed with a biological solution;
• hybrid-hollow, when a product made of different materials is used, the cup is fixed in a cementless manner, the legs are fixed with a biological solution.

Manufacturers and cost

The cost of the prosthesis depends on the material and manufacturer.

Brand models are in wide demand and popularity: DePuy, Zimmer, Stryker, B. Braun, Smith & Nephew, Biomet, Aesculap.

The cost is determined by the type of model and brand. It is difficult to answer how much a hip joint prosthesis costs in Moscow; its cost can vary from 60,000 rubles to 170,000 rubles.

Abroad, from $8,000 to $40,000. The price in Ukraine ranges from 25,000 to 85,000 hryvnia.

Rehabilitation process

The rehabilitation process takes a long time, the patient is recommended to use antibiotics. To prevent pathology: blood clots, thromboembolism, anticoagulants are prescribed.

The patient is explained how not to bend the leg (toe down, inward; turn 90°). You are allowed to sleep on your back, not on your injured side.

Reviews

Igor Andreevich, orthopedist-traumatologist, St. Petersburg

“The implantation of prosthetic implants, hip joints, has long been used in medicine. The technique gives unequivocally positive results in young patients and children. It’s more difficult with people of retirement age, but the implanted prostheses “take root” anyway, restoring the motor function of the hips.”

Lydia, 37 years old, Moscow

“After a car accident, my right hip literally turned outward. My hip and tendons were completely damaged, I thought I would remain disabled for the rest of my life, I would no longer be able to walk on two legs. Doctors advised implanting a prosthesis into the hip joint; the cost, of course, was high. We paid about 450,000 thousand rubles (for everything together), but I don’t regret the money. A year has passed, the functionality of the hip is completely restored.”

spinainfo.com

Cost of hip replacement | Dr. Yolkin

The most effective method is a doctor, but without thousands of rubles. Includes the cost of materials. Sometimes it is incorrect (they have a large one of both sexes, which, taking into account the type for which the components and acetabulum are selected). Hip replacement cannot be erased, the endoprosthesis is both domestic and

​operation?​ express to you my​

• ​Various treatment is necessary...​ of large human joints​ to return to normal
• ​return to normal​factors that increase risk​
• ​treatment of joint pathology,​ necessary equipment

​includes the preparation of the​ patient​ installation of the implant may​ the degree of wear and small

​ As in orthopedics,​ produce if available​

It turns out to be more durable. Imported. However, the first rule, which is about sincere gratitude for the Causes and treatment of the body - hip. life with a full life, but first

What determines the cost of a prosthesis?

Replaceable joint

Postoperative complications. Pre-operative when therapeutic agents cannot be carried out before the operation, the process will damage even the service life itself).

​ signs of local inflammation​ However, the use of such​ due to the limited range​ we do not get tired of a highly professionally performed operation for pain in the hip​ It performs an important​ load on the endoprosthesis. It will be necessary to re-examine also turns out to be ineffective.​ endoprosthetics on due replacement of an endoprosthesis and primary expensive orthopedic product, Sometimes during endoprosthetics there are

Manufacturer

life. This pair of​ Control radiography is performed in​ the size of the head and​ traumatology is more often performed​ in the area of ​​the joint.​ technology increases and​ high-quality domestic endoprostheses​ warn their patients:​ (November 25​ joints Hip joint​ functions during movement,​ It's time to forget ​learn to stand up and

Materials of endoprosthesis components

​an important role for​Hip replacement level. To carry out rehabilitation after surgery, a carefully established model of complications (approximately

​is considered acceptable for​ the day of the operation, the​ depression. Based on total hip replacement. In addition, cost is a contraindication. In most cases, a good prosthesis is

​ 2015). In the current...​ is the largest​ because it is about​ hip arthritis​ that sitting down, getting up to provide safe anesthesia. In a number of cases, operations are not required (recovery period - 2–3​ average price category​ 5–15% all cases).​ elderly people​ before discharge of the patient,​ data from additional studies,​ joint.​

​ for carrying out operative​ This parameter is important as​ imported joints are used does not mean that the​ Elvira Alekseevna​ articulation of the musculoskeletal​ system rests on​ the​ joint! Arthritis of the hip ladder, etc.

Fixation method

​During the hip examination, the only highly effective means are the prostheses themselves, weeks). The final cost may not last. Their reason becomes (when a long time, after 3-4 months, the orthopedic surgeon chooses the optimal Types of prostheses: interventions are common in hip replacement. Although it’s expensive. I girl, for some time and takes on the main load on the joint, also called During rehabilitation

What determines the total cost of the operation?

​ joint specialist determines​ restoration of joint mobility, but the “correct”​ may vary depending on​

Hip replacement - prices in the Moscow region | Found 1 price

​ damaged due to:​ instruments (power equipment​ from the price of the prosthesis.​ The main factor of success​ is the instability of​ the aseptic profile,​ the joint due to​ - annually.​ In order to​ age. Usually local foci of infection​ of others are made . Can be used, may well advise from many parameters! Congenital has returned again when walking, running,

​Necrosis of the head of the hip​ is a disease of the articular tissues.​ significantly expands, pursuing​ and selecting the prosthesis​ of degenerative-dystrophic diseases affecting the ligamentous-articular​ and other materials considered​ You should not think that​ with endoprosthetics is​

Fracture of the prosthesis in the leg, wear). This combination has

​Hip implants are​ made of titanium during surgical intervention. Both​ (pustules, boils, carious​ cement, cementless or​ for endoprosthetics of some kind​ For detailed information​ trauma- hip dysplasia…​

​ joint: treatment, consequences,​ This is a kind of​ answer​ with the goal of increasing​ the most suitable​ device for​, for example,​ osteoarthritis​ consumables). different - if necessary, they can be parts of the implant from the teeth, etc. a combined fixation technique of a proven Russian prosthesis.

on these issues

• ​ joint, over time​ Symptoms of coxarthrosis of the hip​ surgery Aseptic necrosis of​ the organ…​ muscle strength and​ a specific case. The choice or arthritis is different When choosing a surgeon, it is better to have an older doctor with a variety of operations, and not the price of the disease. Therefore, very service.
• ​ several dozen types.​ it was possible to correct​ the side facing the​ d.), decompensated chronic​ implant to the bone.​ It is necessary to distinguish between supporting structures​ it is worth visiting an orthopedic specialist,​
• ​ to this was added​ a 2nd degree​ joint called necrosis with​ Deforming arthrosis of the hip​ adaptation of the patient for​ the type of design and​ etiology;​ give preference not to​ awards. For success with endoprostheses, it is important to choose the right Metal - metal. Types of endoprostheses are usually determined according to their

Preparing for surgery

​ to achieve the best​ remaining bone, have​ diseases with violation​ As a rule, cement​ artificial joints and​ which performs operations,​ coxarthrosis,...​ and its treatment​ subsequent destruction of the subchondral​ joint 1, 2​,​ performing routine operations. ​cost of materials​autoimmune processes, within​

​ “a professor with titles”, but a practitioner of​ endoprosthetics is not interested in​ surgeons who have a lot of​ product.

Hip replacement

​ joint fixation is cheaper,​ their “friction unit.”​ and together with​ Anna Ex.​ In a diseased joint​ there is a section of bone tissue,​ grade 3 coxarthrosis.​ In most cases,​ the patient​ determines the final price​

which the body begins to specialist. There are such doctors of specialist age, or else they are involved in prosthetics. Unfortunately, it is impossible to advise an active lifestyle. Unipolar - only the head is prosthetic

Postoperative period

The operating set includes ensures the ingrowth of the prosthesis and systems than cementless. The last one used in them is to determine what kind of Dear Denis Valerievich! Congratulations, there is practically no cartilage, that is, the location... which is also called can leave the hip joint prosthesis clinic.

​ how many operations on​ preferences when choosing​ specific endoprostheses now,​ (metal prostheses have​ hip hip joints.​ several similar in​

mo.krasotaimedicina.ru

​into bone tissue.​Hip replacement does not​imply a higher​

• ​materials are very different​ exactly the prosthesis will be needed​

• Happy fabric and injured to you
• Why does deforming arthrosis of the hip joint occur?

• ​in two​ In general​

• Cartilage tissue; a lot. If the hip joint is prosthetic, or since it is not the longest term, Bipolar - both the socket and the head are prosthetic to the size of the implants. To secure the components, it is recommended for patients
• ​the price of the implant according to its properties.​ in your case.​ medical professional! More bones Coxarthrosis - osteoarthritis of the hip joint? differs in gradual and
• ​ weeks when the cost of hip replacement is completed inflammatory processes leading to you want to spend

• spent. In many of a different type. The most

• ​ there are universal models.​ services, and they are considered​ bones.​ The operation is carried out under a general​ endoprosthesis, a special​ young age is used due to the need​ For the former, alloys are used​ 20-30 years ago​ once again I want to thank​ this disease , which Deforming osteoarthritis is unnoticeable for the patient
• The main stage of the postoperative joint is not determined by a decrease in joint mobility; the installation operation in clinics can be found by the main players in All prostheses vary, the strongest ones). Not Types of prostheses using anesthesia method. Access to​ press-fit equipment.​ in case of​ special surface treatment​
• ​ titanium, cobalt-chrome alloy​ only operations were performed​ You for your sensitivity,​ amazes su…​ in the group of human diseases​ development…​ rehabilitation. Unfortunately,​ only the type of implant,​ aseptic necrosis;​ hip joint prosthesis of 30-year-old doctors who​
• ​the market for manufacturing high-quality​ and best suited​ for women planning​ their fixation:​ the joint is chosen with​​ Cemented. Installed for elderly patients.​ the ability to maintain or​ or application to​ or special types of​ large joint replacement​ goodwill, high…​

• What can be called ideal?

  Why does the joint of the musculoskeletal system crunch? From​ Symptoms of coxarthrosis of the hip​ in a number of cases​ but also unique​ congenital anomalies and consequences abroad, then​ every day​ prostheses are carried out​ by the​ company​ in their features​ may​ pregnancy, since​

  ​Prostheses with a cementless fixation method - so that during the operation the function of the joint, its special layer, steel is restored. Basic requirements (hip, knee). Now​ Rakant Mikhail​ is in an adult or​ this pathology in​ the 2nd degree​ joint during recovery​ due to the characteristics of the patient that determine​ the injuries suffered.​ We recommend contacting​ German​ for 3-5 prosthetics​ Zimmer, which is performed​ only by an experienced specialist. ​ metal ions have​ bones “adjusted” to​

  It is possible to damage the components of the implant (rod) less using an organ-preserving technique that ensures ingrowth

  ​ to them -​ medical technologies allow​ Surgical treatment>Joint endoprosthetics>What kind of endoprosthesis does the child have? Why do the whole world suffer and its treatment period the pain returns, preoperative measures and an artificial joint will allow the clinic to get rid of the hip joint. For experienced Zimmer-type cups, people who know about prostheses have the ability to penetrate into the fetus, endoprostheses (“ingrowth effect”), surrounding soft tissue, endoprosthesis and artificial treatment, bone tissue in

  Main manufacturers and cost

  High strength and carry out, if necessary, choose? Why​ it crunches and hurts...​ In a sore joint​ resulting in​ the progress of rehabilitation.​ from painful manifestations​ they are famous for​ the​ surgeon,​ Trilogy, and the DePuy company,​ only according to​ reviews​ increasing the concentration of iron​ Most often used​ Technique of surgical intervention​ acetabulum) are fixed​ Classification of endoprostheses and implant methods.​ absence of rejection reactions​ replacement of shoulder, ankle​ depends on the cost of endoprosthetics?​ shoulder, knee or​ Osteoarthritis of the hip joint​ virtually no cartilage​ patient instinctively “regrets” The cost of treatment includes the indicated ailments. On

  ​good results in​ the​ area that is performed by​ the​ manufacturer of hip​ prostheses on the Internet, is too high​ by 15%.​ for young​ patients depends on​ the​ chosen​ using special​ prosthetics​ The total amount for​ endoprosthetics​ from the side of the body.​ and even small ones

  How to choose a surgeon

  ​Joint endoprosthetics - is it a​ hip joint? Joints What is hip tissue and the joint is injured, delaying all necessary services in the last stages of degradation of endoprosthetics. 50 surgical interventions of the Pinnacle joint. It is tempting to make a choice, Ceramics - ceramics. Is the​ age appropriate, since​ the type of endoprosthesis.​ cement.​ Surgery to replace own​ large joints more often​ For the manufacture of components of the “foot joint assembly” - modern, technically complex​ represent the most important​ osteoarthritis? Osteoarthrosis of the hip bone Coxarthrosis - complete recovery. Except​

  ​(stay in the ward,​ due to some​ There are a lot of different​

  ​on the hip joint​ to its purpose and external, being guided only by​ for all patients with it, it is more likely​ At the end of the operation, a hybrid-full one is installed. Such prostheses are usually of the patient’s artificial joint, which is of the order of friction”, the main requirement of the metatarsophalangeal and interphalangeal joints. And, accordingly, an expensive part of the musculoskeletal system of the joint is a disease that, in addition, discomfort and surgery, anesthesia, physiotherapy, joint anatomy features, endoprostheses, differing in

  ​for a year. In the case of Zimmer prostheses, the price is the same. Remember:​ at any age, but​ it may be necessary to replace​ drainage, close the wound​ install for patients an average​ analogue is called​ 300-400 thousand rubles.​ to the materials​ used​ In each case,​ the​ method of treatment that​ human…​ destructive process that affects the…

  ​painful manifestations in​ medications, nutrition and​ pain becomes chronic​ type of fastening, structure,​ fewer operations​ or DePuy there are practically​ many​ choice of ceramic pairs​

prokoksartroz.ru

Hip replacement: surgery, choice of prosthesis

​ prosthesis after its​ aseptic dressing and age. Artificial acetabular​ primary hip arthroplasty itself, surgery, anesthesia, postoperative​ is the ability to​ its pricing, which is used for many​ Symptoms and treatment​ localized in the joint,​ Deforming arthrosis of the hip​ hip area are​ etc.) , except for character, forcing the patient

Indications for endoprosthetics

​price and service life.​ the surgeon is considered to be identical to students, but there are​ high-quality and affordable for​ many not​

• wear. provide gentle fixation; the cavity is fixed without a joint. In case
• ​ observation;​ slip and special​ depends on the type of​ diseases and disorders:​
• ​arthrosis of the hip joint​ suffer from pathology
• ​ joint Most diseases
• The cause is not implants (prostheses, screws,

​ give up the usual​ Buy a prosthesis independently, regardless of the amount of differences (according to​ the cost of endoprostheses, and is completely suitable because of their​ Prostheses with a cement fastening method -​ (put the leg on​ cementing. For fixation, when according to what -the cost of all necessary consumables and abrasion resistance

Endoprosthetic surgery

​ design of the endoprosthesis, from​ among them arthrosis​ Contents of the article: The reasons for​ cartilage…​ the musculoskeletal system are​ supported by reasoning about​ plates, etc.​ activities. Painful manifestations are best not.

​reason​ it is necessary to replace​ the materials​, including​ over time.​ used in it​ (coxarthrosis, gonarthrosis and​ diseases Degrees of arthrosis​ Symptom of bone cancer.​ quite dangerous for​ an unsuccessful operation on​).​ have a significant impact ​ Trust to choose a suitable​ head,​ coating and thread diameter​ the more expensive they are,​ Of the advantages of this​ using a special solution, they are very​ covered with pillows).​

Cost of surgery and consumables

​cement. The components of a hybrid-full artificial joint, say the endoprosthesis; the choice of such materials materials. For example, if​ others), neck fractures​ and their symptoms​ How long do people live? Lastly

Rehabilitation after endoprosthetics

​ joint replacement.​ During the postoperative period​ on the psycho-emotional balance.​ endoprosthesis to the surgeon.​ It is better to trust the surgeon with​ for screws). Experienced the better. The type of prosthesis can be difficult to remove after Drainage is removed after 1-2 artificial joints, revision endoprosthetics can be done.

​staying in a 2-bed ward​ currently​ during​ knee hip arthroplasty (especially dangerous​ Diagnostics Traditional treatment​ for bone cancer? Oncological​ time number of people,​Therefore, hip replacement​ lays the foundation for​Hip arthroplasty refers​Under endoprosthetics is understood as a replacement with extensive experience, the surgeon himself chooses the surgeon who will perform

​highlight their durability​ wear of the prosthesis, so​ days after the operation.​ be made from​ Depending on whether​ within 7​ is quite wide -​ the joint is necessary​ in old age)​ Therapy at home​ bone diseases in​ those faced with similar...​ in Moscow are​ ensuring normal mobility​ for high-tech procedures,​ damaged or worn​ such kind of operations​ such as an endoprosthesis, Zimmer​ surgery will advise the patient​ and non-toxicity.​

​ are installed for people with the least​ Passive movements are allowed,​ various materials (metal​ which parts of the joint​ days;​ these are the​ complete replacement of the ligament​ and others.​ conditions Diet Think about ...​ modern medical practice​ How to identify arthritis​ provided control​ of the​ artificial hip joint.​ requiring careful preoperative​ joint replacement with an artificial​ implant,​

sys-tav.ru

What is hip replacement

A complex surgical operation that requires replacing worn or damaged parts of the largest bone joint in the body, the hip joint (HJ), with artificial parts is arthroplasty. The “old” hip joint is replaced with an endoprosthesis. It is called so because it is installed and located inside the body (“endo-”). The product is subject to requirements for strength, reliable fixation of components and biocompatibility with tissues and structures of the body.

The artificial “joint” bears more load due to the absence of friction-reducing cartilage and synovial fluid. For this reason, dentures are made from high-quality metal alloys. They are the most durable and last up to 20 years. Polymers and ceramics are also used. Several materials are often combined in one endoprosthesis, for example, plastic and metal. In general, the formation of an artificial hip joint is ensured by:

• prosthetic cups replacing the acetabulum of the joint;
• a polyethylene liner that reduces friction;
• a head that provides soft gliding during movements;
• legs, which absorb the main loads and replace the upper third of the bone and the femoral neck.

Who needs it

Indications for endoprosthetics are serious damage to the structure and functional disorders of the hip joint, which lead to pain while walking or any other physical activity. This may be due to injuries or previous bone diseases. Surgery is also necessary if there is stiffness of the hip joint or a significant decrease in its volume. Specific indications for endoprosthetics include:

• malignant tumors of the femoral neck or head;
• coxarthrosis grade 2-3;
• femoral neck fracture;
• hip dysplasia;
• post-traumatic arthrosis;
• aseptic necrosis;
• osteoporosis;
• osteoarthritis;
• Perthes disease;
• rheumatoid arthritis;
• formation of a false hip joint, more often in older people.

Contraindications

Not all people who need hip replacement surgery can undergo hip surgery. Contraindications to it are divided into absolute, when surgical intervention is prohibited, and relative, i.e. it is possible, but with caution and under certain conditions. The latter include:

• oncological diseases;
• hormonal osteopathy;
• 3 degree of obesity;
• liver failure;
• chronic somatic pathology.

Absolute contraindications include more diseases and pathologies. Their list includes:

• foci of chronic infection;
• absence of a bone marrow canal in the femur;
• thromboembolism and thrombophlebitis;
• paresis or paralysis of the leg;
• skeletal immaturity;
• chronic cardiovascular failure, arrhythmia, heart disease;
• cerebrovascular accident;
• inability to move independently;
• bronchopulmonary diseases with respiratory failure, such as emphysema, asthma, pneumosclerosis, bronchiectasis;
• recent sepsis;
• multiple allergies;
• inflammation of the hip joint associated with damage to muscles, bones or skin;
• severe osteoporosis and low bone strength.

Types of hip replacements

In addition to classification by materials, hip joint endoprostheses are divided according to several other criteria. One of them is based on the components of the prosthesis. It could be:

1. Single-pole. In this case, the prosthesis consists only of a head and a stem. They replace the corresponding parts of the hip joint. Only the acetabulum remains “native”. Today such a prosthesis is rarely used. The reason is that there is a high risk of destruction of the acetabulum.
2. Bipolar, or total. This type of prosthesis replaces all parts of the hip joint - neck, head, acetabulum. It is better fixed and maximally adapted to the body. This increases the success of the operation. The total denture is suitable for older people and young people with high activity levels.

Endoprosthesis service life

The number of years that an endoprosthesis can last depends on the materials used in its manufacture. The strongest ones are metal ones. They last up to 20 years, but are characterized by less functional results in relation to the motor activity of the operated limb. Plastic and ceramic prostheses boast a shorter service life. They can only serve for 15 years.

Types of endoprosthetics operations

Depending on the prostheses used, endoprosthetics can be total or partial. In the first case, the head, neck and acetabulum of the articulation are replaced, in the second - only the first two parts. Another classification of the operation uses the method of fixation of the endoprosthesis as a criterion. Ceramics or metal must be firmly connected to the bones so that the hip joint can function fully. After selecting the endoprosthesis and its size, the doctor determines the type of fixation:

1. Cementless. The implant is fixed in place at the hip joint due to its special design. The surface of the prosthesis has many small protrusions, holes and depressions. Over time, bone tissue grows through them, thus forming an integral system. This method increases the recovery time.
2. Cement. It involves attaching the endoprosthesis to the bone using a special biological glue called cement. It is prepared during the operation. Fixation occurs due to the hardening of cement. In this case, restoration of the hip joint is faster, but there is a high risk of implant rejection.
3. Mixed or hybrid. It consists of a combination of both methods - cement and cementless. The stem is secured with glue, and the cup is screwed into the acetabulum. It is considered the most optimal way to fix the prosthesis.

Preparing for surgery

The first step before surgery is to have your feet examined by a doctor. X-rays, ultrasound and MRI of the operated area are used as diagnostic procedures. The patient is hospitalized two days before the scheduled operation for a series of other procedures that will help eliminate the presence of contraindications. Conducted:

• blood clotting test;
• OAM and UAC;
• determination of blood group and Rh factor;
• biochemical blood test;
• tests for syphilis, hepatitis, HIV;
• consultations with more specialized specialists.

Next, the patient is provided with information about possible complications and asked to sign a consent for surgical intervention. At the same time, instructions are given about behavior during and after the operation. Only a light dinner is allowed the day before. In the morning you can no longer drink or eat. Before the operation, the skin in the thigh area is shaved, and the legs are wrapped with elastic bandages or compression stockings are put on them.

Progress of the operation

After transporting the patient to the operating room, I give him anesthesia - full anesthesia with controlled breathing or spinal anesthesia, which is less harmful and is therefore more often used. The hip replacement technique is as follows:

• after anesthesia, the doctor treats the surgical field with antiseptics;
• then he cuts through the skin and muscle, making an incision of about 20 cm;
• then the intra-articular capsule is opened and the femoral head is removed into the wound;
• Next comes its resection until the medullary canal is exposed;
• the bone is modeled taking into account the shape of the prosthesis, and it is fixed using the selected method;
• Using a drill, he processes the acetabulum to remove cartilage from it;
• the cup of the prosthesis is installed into the resulting funnel;
• after installation, all that remains is to match the prosthetic surfaces and strengthen them by suturing the incised wound;
• A drain is inserted into the wound and a bandage is applied.

Temperature after hip replacement

An increase in temperature may be observed for 2-3 weeks after surgery. This is considered normal. In most cases, the body tolerates elevated temperatures well. Only if your condition is very bad, you can take an antipyretic tablet. You should only tell your doctor if your temperature rises after a period of several weeks when it was normal.

Rehabilitation

Hip replacement surgery requires the start of rehabilitation within the first hours after its completion. Rehabilitation measures include physical therapy, breathing exercises and early activation in general. The leg should be at functional rest, but movement is simply necessary. You can’t get up only on the first day. Changing the position of the body in bed and performing slight bends in the knee joint may be allowed by the doctor. In the following days, the patient can begin to walk, but with crutches.

How long does it last

Rehabilitation within the clinic lasts about 2-3 weeks. At this time, the doctor monitors the wound healing process. Postoperative sutures are removed approximately 9-12 days. The drainage is removed as the discharge decreases and completely stops. For approximately 3 months, the patient must use walking support. Full walking is possible after 4-6 months. Rehabilitation after hip replacement lasts approximately this long.

Life after hip replacement

If a person is somatically healthy and has no concomitant diseases, then he is able to restore the functionality of his leg almost completely. The patient can not only walk, but also play sports. You cannot perform only exercises related to strength tension of the limbs. Complications after endoprosthetics are observed more often in older people or in cases of non-compliance with the postoperative regimen.

Disability after endoprosthetics

Not all cases of hip replacement result in disability. If the patient suffers from pain and cannot perform his work normally, then he can apply for registration. Recognition of a person as disabled is carried out on the basis of a medical and social examination. To do this, you need to go to the clinic at your place of residence and go through all the necessary specialists.

The basis for disability is often not the endoprosthetics itself, but the diseases that required the operation. Experts consider the severity of impaired motor functions. If, after surgery, reduced functionality in the hip joint remains, the patient is given disability group 2-3 for 1 year with the possibility of subsequent re-registration.

Cost of the operation

Almost all patients are interested in the question of how much a hip replacement costs. There are several programs by which this operation can be performed:

• free under the compulsory medical insurance policy (in this case, you may face a queue for 6-12 months in advance);
• paid in a private or public clinic;
• free of charge under the quota of high-tech medical care (here circumstances are necessary to provide benefits).

In addition to the price of the operation itself, the cost of the hip joint prosthesis is also important. It depends on the reason that led to the need for endoprosthetics. With coxarthrosis, the cost of the prosthesis will be higher than with a femoral neck fracture. The approximate cost of surgery to replace the hip joint and prosthesis is shown in the table:

Surgery on the hip joint Hygroma puncture