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

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

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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.

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References in periodicals archive ?
Reduction of blood loss with tranexamic acid in primary total hip replacement surgery.
Caption: Figure 3 Number of patients aware that dislocation is risk factor with total hip replacements.
Today, most total hip replacements are performed in a minimally invasive fashion, using one of three main approaches.
Charnley, "Radiological demarcation of cemented sockets in total hip replacement," Clinical Orthopaedics and Related Research, vol.
Total hip replacement (N=4)###34(2.8)###85(4.8)###85(4.7)###85(2.5)###47(5.0)###42(5.1)
Different options including arthrodesis, Girdlestone arthroplasty and total hip replacement (THR) are used for its treatment.
Does BMI affect the outcome of primary cemented total hip replacement? J Bone Joint Surg Br 2004; 86 (Suppl): 81
In December 2012, the American Academy of Orthopaedic Surgeons, the American Association of Hip and Knee Surgeons, and the Hip Society issued a statement on these devices, which said that recent reports from national joint registries have reported that the failure rates of total hip replacement surgery using metal-on-metal implants are two- to threefold higher than "contemporary" total hip replacement surgery using non-metal-on-metal devices.
Dislocation ranks as the most common reason for failed prosthetic joints, and studies point to an increased dislocation risk among obese patients 4' undergoing total hip replacement (THR).
"Total hip replacement gives new life to people suffering debilitating hip pain from arthritis." He adds that his Sarasota-based practice, Kennedy-White Orthopaedic Center, has experts in both anterior and posterior approaches.
In related news, Pluristem on August 7 announced it has received approval from the Paul-Ehrlich-Institute (PEI), the medical regulatory body in Germany, to begin a Phase 1/2 randomized, double blind, placebo controlled study to assess the safety and efficacy of its PLX cells, through intramuscular injections, for the regeneration of injured gluteal musculature following total hip replacement.

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