engleski

Current trends in total hip replacement

Total hip replacement (THR) has been proven to decrease a patient's pain and improve function and quality of life. Today, in the world the number of THR is estimated to 900, 000 yearly. According to Croatian Arthroplasty Register, about 3100 hip arthroplasties were performed in 2005. From the economical point of view, the costs of THR in Croatia were 13 million Euros in 2005. With THR, prosthetic socket is pressed into the pelvis ; the end of the femur is amputated, a metal shank is inserted into the femur, and the shank holds a ball which mates with the socket. Several improvements have been made in THR during the last decade: hip implants are made of a ceramic material rather than polyethylene ; metal-on-metal implants are also gaining popularity. There is still no standard in using cementless implants or implants with bone cement. An alternative to THR is hip surface replacement (HSR). With HSR, the end of the femur is not amputated ; the outer surface of the femoral ball is replaced with a cylindrical metal cap. About 90, 000 resurfacings have been performed world-wide yearly. The latest developments in THR are several competing Minimally Invasive Surgery (MIS) approaches, which could result in far less soft tissue damage and a quicker recovery. Computer assisted surgery is said to better navigate prosthetic implantation. One should be aware of the influence of the industry in introducing new methods, techniques and/or devices. Still, current improvements in hip designs, surgical techniques, fixation methods, prophylactic therapies, preadmission education, and rehabilitation have contributed to improved patient outcomes. In the work the basic principles, the Croatian experience, and results in THR are discussed.

hip replacement

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