Total hip arthroplasty is one of the most successful and effective surgical operations.

The term arthritis is used to describe the wear and tear of articular cartilage. The hip joint consists of the femur bone ending in the head which articulates with a cavity in the pelvis, called the acetabulum. These two surfaces are covered by soft tissue, called cartilage, which helps to absorb shocks and the smooth and painless functioning of the joint. When the cartilage wears down and the bones come into contact we talk about hip arthritis. Due to the wear of the cartilage, friction and limitation of movement are caused, bony protrusions (osteophytes) are created and finally the patient is in pain. The causes of arthritis are varied: idiopathic, age, increased weight, osteonecrosis, an old trauma-fracture, autoimmune diseases e.g. rheumatoid arthritis or other inflammatory arthritis;

Arthritis is an irreversible condition and conservative treatment can only slow down the progression or temporarily improve the patients’ quality of life.

Treatment of osteoarthritis of the hip

The treatment of osteoarthritis of the hip is about reducing pain and improving the mobility of the joint. Initially, the treatment is conservative: medication (paracetamol or Non-Steroidal Anti-Inflammatory), ice therapy, strengthening exercises, physiotherapy or injection of substances into the joint. When the symptoms progress and the patient’s daily quality of life “deteriorates”, surgery is the only solution. Surgical treatment involves fitting an artificial joint to replace the worn one (prosthesis). The operation is called total hip arthroplasty.

During the operation, the orthopedist removes the damaged areas and replaces them with artificial parts that ensure the painless and correct functioning of the joint. The surgeon “cuts”, based on previous calculations, the upper part of the femur (femoral head), which shows cartilage wear, and removes it. Then with special rasps he creates a tunnel inside the femur and places the femoral prosthesis. He does the same in the cavity of the pelvis, i.e. in the acetabulum, so that the new prosthesis fits perfectly there as well.

What are the indications for hip replacement?

The main symptom is pain focused in the groin area. The joint becomes stiff, dysfunctional in rotational movements (difficulty putting on shoes or socks), and often accompanied by lameness and instability. Gradually problems are caused in the knee, the spine or the other hip. THE total hip arthroplasty done for:

1. pain, lameness or unsteadiness.
2. to protect the other joints.
3. to improve the quality of life.

On X-ray there is a significant reduction of the “space” between the femoral head and the acetabulum, cysts or osteophytes.

Advantages of the minimally invasive ASI method

1. Smaller incision, better aesthetic result.
2. Special anterior access that does not injure the underlying tissues (muscles, tendons).
3. Precise placement of prostheses under fluoroscopic control.
4. Relatively bloodless operation – usually no transfusion required.
5. Reduced postoperative pain.
6. It allows precise control of the length of the leg so as to exclude the risk of unevenness.
7. Shorter hospital stay (1-2 days), quick mobilization and loading of the hip.

The aim of the surgery is the correct (anatomical) stable positioning of the prosthesis and the exact reproduction of the biomechanics of the hip and the “balancing of the soft tissues”.

Complications, although rare in experienced surgical teams, after a total hip arthroplasty are (0.5-2%):

  • Infection
  • Dislocation
  • Injury to nerves or blood vessels
  • Deep vein thrombosis
  • Inequality
  • Periprosthetic fracture

in conclusion

Patient benefits after hip replacement are:

  • Elimination or significant reduction of pain.
  • Improving the quality of life.
  • Return to normal daily activities and low-intensity sports.
  • Sleep without pain.
  • Improvement in leg strength as a result of returning to more normal levels of activity.