total hip replacement


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Related to total hip replacement: Total hip arthroplasty

replacement

 [re-plās´ment]
joint replacement arthroplasty.
total hip replacement total hip arthroplasty.
total joint replacement total joint arthroplasty.

total hip replacement

a surgical procedure to correct a hip joint damaged by degenerative disease, often arthritis. The head of the femur and the acetabulum are replaced with metal components. The acetabulum is plastic-coated to avoid metal-to-metal articulating surfaces. See also total hip arthroplasty, total joint replacement.

total hip replacement

Orthopedics Surgery that replaces the femoral head and its articular surface with a mechanical surrogate Indications Advanced osteoarthritis and rheumatoid arthritis with disabling pain Complications Loosening of 1 or more of the synthetic components, dislocation, femoral head fracture, DVT, nerve damage and, rarely, infection

to·tal hip re·place·ment

(THR) (tō'tăl hip rě-plās'mĕnt)
Surgical procedure to remove the damaged or diseased joint completely and replace it with a man-made device to restore its function.

total hip replacement

Enlarge picture
TOTAL HIP REPLACEMENT: (Prosthesis)
Surgical procedure used in treating severe arthritis of the hip. Both the head of the femur and the acetabulum are replaced with synthetic components or augmented by artificial components. See: arthroplasty; illustration

Patient care

Preoperative: The patient is educated about the procedure, postoperative care, and the expected surgical outcomes. The patient may donate blood before the procedure for use if needed, and blood-saving techniques are used during the surgery. The patient is instructed about postoperative limitations, hip abduction methods, use of a trapeze, mobility regimen, gluteal and quadriceps setting, and triceps exercises. The importance of respiratory toilet is explained, and the proper technique for use of incentive spirometry is taught. Prescribed antibiotics and other drugs are administered. Reports of laboratory and radiological studies are reviewed, and the physician is notified of any abnormal findings. The patient is informed about pain evaluation techniques and the availability of analgesics. Epidural or intravenous PCA may be employed. Preoperative preparations are carried out (skin, gastrointestinal tract, urinary bladder, and premedication), and their significance is explained to the patient. The patient should be encouraged to verbalize feelings and concerns.

Postoperative: Dressings and drainage devices are monitored for excessive bleeding, and the area beneath the buttocks is inspected for gravity pooling of drainage. Dressings are replaced or reinforced according to the surgeon's protocol. Vital signs are monitored, and neurovascular status of the affected extremity is checked frequently, comparing it to the unaffected limb. Analgesics are administered as prescribed and required, and the patient is evaluated for response. The patient is repositioned frequently in prescribed positions, and the integrity of all supportive equipment (splints, pillows, traction devices) is maintained during repositioning. The patient should avoid crossing his legs and internal rotation, which enhance the potential for dislocation of the prosthesis and interfere with venous return. Respiratory status is assessed, and incentive spirometry and deep breathing and coughing are encouraged to prevent pulmonary complications. An exercise program and early ambulation (often on the day after the operation) should begin as prescribed by the surgeon (type and extent of weight bearing on affected limb) and in collaboration with the physical therapist. Raised toilet seats and reclining chairs are used to prevent hip flexion. A diet high in protein and vitamin C is provided, wound healing assessed, and skin breakdown prevented. Antithrombotic devices and anticoagulant drugs are given if prescribed, and the patient is assessed for complications like thrombophlebitis, embolism, and dislocation. The patient will usually be transferred to a rehabilitation center or may rehabilitate at home. Teaching on discharge focuses on the exercise regimen and limitations of the patient's activity and the importance of swimming and walking. Outpatient orthopedic follow-up and therapy are arranged as required. The patient should participate in a weight reduction program if necessary.

illustration

hip

1. the region of the body around the articulation of the femur and the pelvis.
2. loosely, the hip joint.

hip bone
os coxae, which comprises the ilium, ischium and pubis. See also Table 10.
hip dislocation
manifested by inability to bear full weight on the limb, excessive mobility of the limb, crepitus at the joint, and in some cases shortening of the limb.
hip dysplasia (HD)
is manifested (1) radiographically by a shallow acetabulum, a small, misshapen femoral head and sometimes osteophyes, and (2) clinically, by a lax joint, weak rump muscles with or without lameness. In dogs inheritance has a degree of influence on the occurrence of the disease. See also degenerative joint disease.
hip flexion posture
posterior presentation of a fetus in the birth canal with the hocks flexed.
hip joint
the ball-and-socket joint formed between the head of the femur and the acetabulum of the pelvis.
hip laxity
subluxation of the coxofemoral articulation, a feature of hip dysplasia (above).
hip sling
a metal clamplike device used to lift a downer cow. Comprises two loops which fit over both iliac tuberosities (coxal tubers) and which are clamped together so that the cow is closely held. The sling is lifted with a block and tackle or by a frontend loader or hoist on a tractor.
total hip replacement
replacement of the femoral head and acetabulum with prostheses that are cemented into the bone; called also total hip arthroplasty.
References in periodicals archive ?
Various investigators use different methods for operative treatment of old unreduced fracture-dislocations including subtrochanteric osteotomy, Girdlestone procedure, arthrodesis, endoprosthetic replacement, and total hip replacement.
The cohort study, published in the American Heart Association journal Stroke, assessed about 66,000 people in the Netherlands who had total hip replacements and compared them to people who shared their age and sex, but who did not have the procedure.
Group 2, the total hip replacement control group, comprised all patients who had their operation performed between January 1, 2009, and December 31, 2009.
Out of a total 48 million surgical procedures performed in the United States in 2009, 676,000 were total knee replacements; 327,000 were total hip replacements, according to the Centers for Disease Control and Prevention.
ON THE CASE: Solicitor Aisha Ahmed at Armitage Sykes (PC231211Cahmed-01) * JOINT: The metal DePuy ASR XL acetabular system total hip replacement and, below, an X-ray of how it fits in the body
Marya and Bawari, orthopedic surgeons in India, provide a guide to total hip replacement surgery for beginners that first introduces its history and evolution, then discusses implant systems and design.
As total hip replacement indications extend to increasingly younger populations, [the patients'] mortality risk will diminish, and a vast majority will remain at risk for revision for decades," Dr.
A fifty-nine year old gentleman with protrusio osteoarthritis of both hips was scheduled for a right total hip replacement.
Total hip replacement as a surgical treatment has developed over the last two centuries.
Orthopedic surgeons have long advised patients at such extremes of discomfort to get a total hip replacement and swap their offending joints for prostheses.
Subject: Primary and revision total hip replacement surgery.

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