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Total Hip Arthroplasty (THA)

If hip joint osteoarthrosis occurs it often leads to pain which appears in stress situations but also during rest. This pain often limits the quality of life. At some point cartilage-conserving methods are not longer possible ( e.g. injection treatment, arthroscopy ) in this case a total hip arthrosplasty should come in mind (Figure 1)

Figure 1: Typical arthrosis with the lost of cartilage and the joint space . Post-op picture after a hip endoprosthesis

Currently, there are different operational procedures in order to replace both sides of the joint, to get pain free and to increase the quality of life.

Since several years the hip endoprosthesis is an established procedure when dealt with proceeded hip osteoarthrosis. Whether cemented or uncemented, both kinds of prosthesis are implanted successfully. There is an expectation on 15-20 years of durability until a revision surgery gets necessary.

In recent years, alternative treatment methods have developed, so that osteoarthrosis can be treatened with more bone conserving implants. They can be implanted through a minimally invasive anterior or antero-lateral access (key hole technique). Thereby the post-op mobilization can be done much faster.

Bone conserving implants are called short stem hip prosthesis which require less bone resection than the normal endoprosthesis. Furthermore these prosthesis enable, within future revison surgeries, an implantation of the normal endoprosthesis so that they can be called a “prosthesis before the prosthesis” (Figure 2).

Figure 2: Hip Endoprosthesis Options in case of Osteoarthrosis (Hip Osteoarthrosiss, two Short Stem Hip Prosthesis)

An HemiCap Implantation was discouraged in the last couple of years because neurological problems, tumour-like growth, metallosis and hypersensitivity, caused by strong abrasion of the metal on metal articulation, occurred. Therefore, it is recommended that affected patients carry out an metallosis serum concentration inspection and further inspections in order to prevent complications. At our center we carry out these kind of screening-inspections.

After the procedure the patients are allowed to mobilize their joint during full load and are released into a follow-up treatment.