Hip replacement surgery necessarily involves changes in life everyday. The ' expert in Orthopedics and Traumatology in Turin , Dr.. Matteo Bruzzone, tells us how and what impact this intervention on the patient's quality of life
1) Those undergoing more often the intervention of surgery?
The intervention of the hip prosthesis can be subjected patients, both female and male, ranging in age between 25 to 90 years. The young patient may require this type of intervention for early disabling outcomes of congenital malformations, such as congenital dysplasia, diseases of the growth plates, necrosis of the femoral head or trauma at a young age that has altered the anatomy of the joint.
As for older patients, these are undergoing arthroplasty for osteoarthritis or even by way of emergency for femoral neck fractures. Usually the average age of a patient "standard" subjected to this type of surgery, 55 to 75 years. Regarding sex, I would say that the distribution is rather uniform.
2) How long does the postoperative course of surgery?
For the postoperative hip replacement recovery schedules vary by age and general condition of the patient, the cause that led to the prosthetic and the quality and tonotrofismo periarticular (buttock muscles, quadriceps).
The recovery of gait occurs already in the 24-48 hours following surgery, if there is no complications in the immediate post-operative are verified, such as vascular or nervous deficiency, bleeding, periprosthetic fractures, dislocation of the system (in any case less than 1 % of cases). The resumption of ambulation occurs progressively over the following weeks. Usually a good deambulatoria autonomy, initially assisted by walker or crutches, there is already after 10-15 days, for any surgical access used (postero-lateral or mini-invasive front). In 90% of cases, 30 days after surgery, the patient is autonomous in the movements or personal hygiene. The guide is granted from 6 to 8 weeks after surgery.
The medium- and long-term risks are the infection (certainly the most feared complication, fortunately rare), the dislocation of the system (associated with incongruous movements that the patient is educated to avoid), periprosthetic fracture (associated with falls) and implant loosening (which can usually occur at 25 - 30 years after surgery in 3-5% of cases).
3) You can return to sports after surgery for hip replacement?
After the intervention of the hip prosthesis long walks can be performed, while the race activity would be excessively intensive and traumatic to the plant, which could lead to an early consumption of the contact surfaces.
The bicycle and swimming are granted, without prejudice to the necessity of subjecting the joint to trauma and extreme movements, however easily avoidable.
The effort and duration of the activity must be related to the degree of training, always avoiding sovramassimali efforts that could lead to an incongruous use of neo-articulation. Tennis and skiing at mild pace other sports are granted to a holder of hip implants, as well as golf. Avoid sports with jumps and / or physical contact, such as soccer, basketball, volleyball. Some martial arts and yoga are granted with restrictions.
4) How important is the intervention of hip implants in everyday life?
First of all, the hip replacement is an operation that can significantly improve the quality of life of patients who have indication.
The life after hip prosthesis is absolutely normal in daily activities, notwithstanding the need to avoid the movements which involve excessive hip flexion, especially if associated to an excessive internal rotation of the leg, or rotate the knee and the foot inwardly, in the case of a surgical access postero-lateral. In the case of an earlier access, the limitations concerning the excessive hip extension (bring back the leg), especially if associated with a limb external rotation (ie rotation of the knee or foot outwards).
The work does not undergo substantial variations, especially for predominantly sedentary activities, but also for work at higher physical impact, which require prolonged standing or walking or repeated joint movements (such as hip flessoestensioni, ascend and descend from floors to different height or vehicles). The modern facilities are in fact manufactured to withstand millions of movements of this kind and very high axial loads. It is advisable however to avoid the repeated lifting of heavy loads which may excessively stress the prosthesis.
sex life too, undergo a substantial modification: in this regard, the patient's request, comes an information brochure on the granted positions or to avoid.
5) for the patient Advice operated hip prosthesis
Regarding the signs for the patient operated hip prosthesis, observing the rules described above, it is able to minimize the possibility of complications, such as dislocation and premature wear of the plant. Maintain good musculature it is also essential to allow the prosthesis to work better. In this regard, a good daily walk of 30-40 minutes is enough.
You should always remember that keeping activities and sports appreciated by the patient is crucial to his well-being, and is among the objectives of prosthetic surgery. Good personal hygiene is essential to minimize the chance of encountering a late infection of the prosthesis.
The glycemic control in diabetic patients and timely treatment with antibiotics for any infections in other locations (for example, dental and urinary) is essential in patients prosthesized. The prosthesis is in fact a real "magnet" for bacteria that may be present in the blood, which should be readily eliminated before they can adhere to the implant.
Not to be underestimated are also the periodic checks, clinical and radiographic: like a car, in fact, the prosthesis should be checked every 2 years by orthopedists, to highlight in advance any problems yet silent and prevent their deterioration.