Total Hip Replacement (THR) for fractures around the hip is a surgical procedure performed to treat severe fractures that involve the hip joint. These fractures are typically the result of trauma, such as a fall or a car accident. Further, these fractures can cause significant pain, instability, and loss of function. THR is considered when the fracture is severe and cannot be adequately treated with other methods, such as casting or internal fixation.
The hip joint is a ball-and-socket joint formed by the femoral head (the ball) and the acetabulum (the socket) of the pelvis. During a THR procedure, the damaged or fractured parts of the hip joint are removed and replaced with artificial components made of metal, ceramic, or plastic. The main goal of the surgery is to relieve pain, improve joint function, and restore mobility for the patient.
The procedure begins with the patient being placed under general anaesthesia or spinal anaesthesia, which ensures that they are unconscious or numb from the waist down during the surgery. Once the anaesthesia has taken effect, an incision is made over the hip joint to expose the fractured bones and the damaged joint.
The next step involves carefully removing the fractured fragments and preparing the bone surfaces for the artificial components. The femoral head is removed, and a metal stem is inserted into the centre of the femur. This stem provides stability and serves as an anchor for the new artificial ball. The damaged acetabulum is then reshaped and lined with a metal cup, which acts as the new socket.
The artificial ball, usually made of metal or ceramic, is attached to the metal stem, creating the new femoral head. The metal cup is then securely placed into the acetabulum. The ball and socket components are carefully aligned to ensure proper joint function and stability. In some cases, a plastic liner is placed between the metal ball and socket to allow for smooth movement and reduce friction.
Once the new components are in place, the surgeon tests the range of motion and stability of the hip joint. The incision is then closed, typically with sutures or staples, and a sterile dressing is applied to the wound. The patient is closely monitored in the recovery room before being transferred to a hospital room for postoperative care.
After the surgery, the patient will undergo a period of rehabilitation and physical therapy to regain strength, flexibility, and mobility in the hip joint. The physical therapist will guide the patient through exercises and movements to gradually increase their range of motion and improve their ability to walk and perform daily activities.
While THR for fractures around the hip is generally a safe and effective procedure, it carries some risks, including infection, blood clots, dislocation of the new joint, nerve injury, and implant failure. However, with proper surgical technique, postoperative care, and rehabilitation, the majority of patients experience significant pain relief and improved joint function, allowing them to return to an active and fulfilling life.