髋关节替换概述

The hip joint is made up of a ball-and-socket. The socket is made of bone and cartilage, and the ball is the top of the thighbone, also known as the femoral head.

髋关节置换手术是一种用来替换损坏的球插座的操作，用新的和耐用的人工合成部件模仿球射击。

Sometimes, either the socket of the hip or the thighbone is injured or becomes diseased. This can result in pain, trouble with walking, or difficulty with everyday tasks. You may have already tried pain relief methods such as medications, physical therapy, supports, or braces. If the pain doesn’t subside, your doctor may recommend hip replacement surgery.

According to theAmerican Academy of Orthopaedic Surgeons(AAOS),大多数人有髋关节置换s are between ages 50 and 80. These surgeries are usually performed for arthritis of the hip. Arthritis is a disease that breaks down cartilage (the cushion between bones). Without cartilage, the bones rub against each other, which can cause severe pain.

A hip replacement may be used for three types of arthritis:

  • rheumatoid arthritis — an autoimmune disease that leads to joint inflammation
  • traumatic arthritis — damage to the joint caused by an injury
  • osteoarthritis — a degenerative form of arthritis that’s most common in older adults

医生通常会试图控制步行者或拐杖的使用，低影响运动计划以及非甾体类抗炎药（NSAID）（NSAID），例如布洛芬。如果这些措施失败，则最佳解决方案是髋关节更换。如果由于疼痛而无法入睡或舒适地坐着，或者关节炎限制了您的活动，则应考虑髋关节更换。

髋关节置换也可以用于其他健康状况。例如，如果肿瘤在髋关节中生长，有时会使用它们。髋关节置换也可以在紧急情况下使用，以固定髋关节或大腿的骨折。一种称为髋关节血管坏死的疾病通常需要总髋关节置换。

The replacement hip is made up of four components:

  • a metal socket
  • a liner to help the ball move easily within the socket
  • 金属或陶瓷球代替股头
  • a metal rod used to stabilize the thigh bone to which the ball is attached

There are different options of joint prosthesis. Most surgeons use uncemented joint prosthesis, which allows bone to grow into the prosthesis over time.

A cemented prosthesis, on the other hand, is attached to the hip with bone cement for quicker adhesion. While both options have similar success rates, they have differences in terms of recovery.

未元素的关节需要更长的时间才能连接到骨头，因此恢复时间更长。胶结版本虽然更快，但最好用于老年人或不那么活跃的人。

要考虑的另一个选择是肌肉保留的髋关节置换。与传统的髋关节手术不同，此手术可以节省肌肉，从而减少疼痛和恢复时间。

通常通过前或后进行肌肉隔离程序。前后的主要区别是切口的位置。前切口是在大腿上部的前部进行的，而后切口则在臀部的后部进行。

Educating yourself about hip replacement is crucial. Perhaps just as important is knowing how to choose the right surgeon for the job. Oftentimes, a general doctor will refer you to a surgeon. You might consider interviewing a few candidates on your own to find the right match. Consider asking:

  • how many hip replacements they have conducted
  • their overall success rate
  • if they are open to muscle sparing replacements
  • estimated recovery time
  • if they will be involved with your aftercare

除非您因事故而进行紧急髋关节置换，否则您的手术可能会提前几周安排。您的医生会敦促您花时间进入最佳的身体状况。

他们可能会建议你减肥。你所愿ll also need to stop taking any medications, including blood thinners. During this time, you may also want to rearrange your living space to minimize having to walk long distances or up and down stairs. For example, you might consider:

  • preparing meals in advance and freezing them
  • placing everyday items within arm’s reach to avoid overexertion

手术当天午夜后，您将无法吃或喝任何东西。髋关节手术是在医院手术室进行的。在手术桌上办理登机手续后，护士将带您进入一个准备手术的房间。您将脱下衣服，穿上医院的礼服，护士将在您的手，手腕或手臂上开始IV。IV使您可以在手术期间接受液体和药物。

When it’s time for your operation to begin, you will be taken into the operating room. There, you may be given a general anesthetic or a medicine that makes you sleep through the surgery so you don’t feel pain.

If your surgeon believes that you have other health issues that might make general anesthesia difficult or risky (such as heart or lung conditions), they may recommend a localized or regional anesthetic. This is a small amount of medication injected into your spine that makes everything below your waist numb. Some people who receive a localized or regional anesthetic are also given sedatives to help them remain calm during the surgery.

The procedure takes anywhere from one to three hours.

你所愿ll wake up in a recovery room. The staff will monitor your vital signs and give you medicine for your pain. When they are sure that you are stable, you will be transferred to a room in the hospital.

Your hospital stay will last three to five days. The day after the surgery, a physical therapist will help you get up and take a few steps. Some people go home immediately after discharge from the hospital, although they continue to work with a physical therapist on an outpatient basis. Other people choose to go to a rehabilitation facility or a skilled nursing facility to receive additional care and inpatient therapy services.

为您的康复做准备很重要，因此您可以更轻松地走动。例如，您可能会考虑：

  • having someone on hand to help you during the first few weeks of recovery
  • arranging for someone to drive you to and from therapy appointments

Full recovery from a hip joint replacement takes about three to six months. A cemented joint prosthesis has the longest recovery time.

髋关节置换率通常具有很高的成功率。实际上，AAOShas called the hip replacement “one of the most successful operations in all of medicine.” Most people who have the procedure report significantly less hip pain and a greater ability to perform daily activities.

The most common complication is dislocation of the new joint. This usually occurs in people who do not let themselves fully recover before resuming normal activities. It can also occur in people who do not follow instructions for caring for the hip after surgery. However, with newer prosthesis, hip dislocation is greatly reduced. Infections and blood clots are potential complications, but procedures can help prevent these from occurring.

髋关节持续了很多年，但是高影响的活动或肥胖可能会缩短其寿命。如果第一个开始恶化，则有些人必须获得第二个髋关节置换。但是，借助新的设计和材料，它们甚至可能持续数十年。