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Hip Replacement

Does your hip pain prevent you from performing and enjoying everyday activities?

There are a variety of conditions that can lead to hip joint deterioration resulting in pain, reduced range of motion, and decreased quality of life. The human hip is a ball-and-socket, in which the ball of the femur (thigh bone) fits into the socket of the pelvic bone. Like other free-moving joints, the hip contains a small amount of synovial fluid, which lubricates the joint whenever you move. It is held together with ligaments (straps of tough tissue), which help prevent the joint from dislocating. Full function of the hip joint depends on the successful coordination of many interrelated parts including bones, muscles, tendons, ligaments and nerves. When the cartilage in the hip joint is damaged or wears down, the bones begin to rub together, resulting in friction, pain, and even bone deterioration. Worn cartilage is typically associated with arthritis, or osteoarthritis, the most common type of arthritis leading to total hip replacement.

Osteoarthritis is just one of many forms of arthritis, which can result in individuals experiencing pain and limited activity level. Other forms of arthritis are avascular necrosis, inflammatory arthritis and traumatic arthritis. An orthopedic surgeon may recommend Total Hip Replacement because of arthritis, but a severe hip fracture or dislocation (often caused by a fall) may also require a Total Hip Replacement.

What is Total Hip Replacement?

The goal of total hip replacement surgery, also known as hip arthroplasty, is to replace the damaged bone and  cartilage with smooth metal and high-grade plastic or ceramic that recreate the surface of your hip joint. Both parts of the hip joint are removed and replaced. Usually, a high-density plastic cup replaces the hip socket, a metal or ceramic ball replaces the femoral head, and a metal stem is inserted to connect the ball with the bone shaft.

These new surfaces are designed to replicate the function and feeling of a healthy hip, while also preventing the pain caused by damaged bones rubbing together. Total hip replacement is one of the most successful treatments to restore hip function and stop pain.1

What is Full Function, Faster® Tissue Preserving Hip Replacement?

Full Fast Function, Faster® Total Hip Replacement is a protocol which has been designed to optimize patient recovery and regain normal function as soon as possible.
In recent years, hip replacement surgery has entered a new era. Where traditional hip replacement patients were hospitalized between 4 and 14 days, the designers of this concept have put a multidisciplinary team approach together to allow you to regain function and mobility as soon as possible, without the typical post-operative restrictions associated with traditional total hip replacement. A number of patients who have undergone this procedure are able to walk unassisted shortly after surgery.

As a result, you can expect to leave the hospital back home much sooner than compared to a traditional total hip replacement. You’ll be able to go home as soon as you think you are ready and as soon as your surgeon thinks you are ready. This could be the day of the surgery itself or the day after, without additional risk or discomfort compared to conventional hip replacement and without the typical restrictions, such as crossing your legs.2
The protocol combines multiple aspects of hip replacement treatment that have a proven contribution to accelerated rehab and function. These aspects are:

  • Patient preparation
  • Anesthesia
  • Portal Assisted Superior Approach
  • Rehabilitation

The pillars of the program focus on your health, more specifically:

Psychological

You know each step of your treatment, what to expect and what not to expect. You always have a call point in case of any doubt.

Functional

You will be discharged, knowing what you can do, what you can’t do and what you must do with your newly replaced knee.

Physiological

The program has been designed to minimize discomfort and side effects after the surgery.

Is the surgical approach important?

Surgeons perform total hip replacement surgery using various surgical approaches, taking into consideration their preferred surgical style, as well as what will be the best surgical technique for their patient. A surgical approach is the way the surgeon access your hip joint to perform the actual surgery and the simplest classification for approaches is based on the direction of the approach itself. The most common total hip approach is the Posterior approach. With this technique, surgeons have been trained to cut through several muscle structures, as well as short external rotator tendons, which are the main stabilizers of your hip joint.3

Whenever a muscle or tendon is cut, it generates pain and takes time to heal, preventing you to perform for a certain time after surgery regular activities and also forcing you to respect some indications to avoid certain movements which can increase risk of dislocation.

Since these aspects increase your recovery and hospitalization time, surgeons investigated new and improved methods to avoid large incisions and traumatizing muscle structures, with the final aim to improve recovery and patient function. The conventional surgical approaches have been modified to limit the amount of soft-tissue dissection and minimize damage to healthy surrounding structures. In hip surgery nowadays, the surgeon attempts to reach the operative area minimizing dissection and thus avoiding damage to soft tissue such as nerves, muscles, tendons and vessels Figure 1 & 2. This will ultimately reflect in less pain, less blood loss, quicker rehabilitation and higher stability. What is important to understand is that a more conservative hip approach does not necessarily mean a shorter skin cut, but it is more about protection and preservation of the soft tissues, muscles and surrounding structures, which will allow you to recover quickly.

Tissue Preserving Hip Approach

The portal assisted superior approach belongs to the new generation of approaches aiming to accelarate patient recovery and function, by limiting the muscles and tendons dissection during the surgery. The portal assisted superior approach is designed to precisely reconstruct the hip without cutting critical tendons and stretching or traumatizing muscles that are important to the hip function. Additionally, with the portal assisted superior approach there is no dislocation of the hip, minimizing trauma. The implant is built inside the body, so the hip is never twisted into unnatural position during surgery, a common element to many other hip procedures.

How does the Portal assisted superior approach contribute to function?

The surgical technique for portal assisted superior approach was developed to get patients back on their feet within days (possibly hours) instead of weeks. A number of patients who have undegore this surgery are able to walk unassisted the day after surgery. Because of the elimination of damage to important muscle and tissue structures, patients experience less pain, less blood loss and quicker recovery.4 Patients treated with this surgery typically have a shorter hospital stay and a minimized rehab in general. Additionally, it avoids the need for your doctor to impose restrictions on angular leg movements.5 In comparative research studies, it was observed that the 100% of patients treated with the portal assisted superior approach mobilized without restriction, while the conventional group mobilized with precaution for 4 weeks after surgery.

Also, the length of stay in the portal assisted superior approach group was significantly lower and the pain experienced after the procedure was also lower at 1-week, 1-month and 3-months postoperative follow than in the conventional group.6 Patients were also able to perform activities quicker, showing improvement in walking speed and climbing ability, likely related to less impairment of hip muscles.6-7 Patients were also able to effectively return to work and to achieve functional outcomes with a reduce need for drugs.4 When compared to national averages, patients treated with the portal assisted superior approach have stayed in the hospital for a shorter amount of time, been discharged to their home more often, and are less likely to return to the hospital for any complications within 30 days post- surgery.5 All without the typical post operative hip restrictions associated with traditional hip techniques.

You are part of the team!

Undergoing total hip replacement surgery is a major event during life. The team behind your treatment is committed to provide you with the best possible care available, to ensure that you can resume your active lifestyle as quickly as possible and you are fully satisfied with the outcome of the treatment. However, their efforts are not the only thing that matters!

You, as a patient, are an important active team member in the process of hip replacement. During your journey, you will receive a lot of important guidelines and instructions. You will need to strictly follow these guidelines and fully execute your physician’s instructions. These are key factors in achieving the goal of your hip replacement, being maximal function and satisfaction.

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