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Diagnosis
X-rays may show loss of the cartilage space in the hip socket and a "bone-on-bone" appearance along with bone spurs and bone cysts. A magnetic resonance imaging (MRI) or computed tomography (CT) scans may be recommend to confirm the diagnosis.
Nonsurgical Treatment
For hip arthritis, the first treatment a doctor may recommend is over-the-counter, anti-inflammatory medications. Certain nutritional supplements including glucosamine, could provide some relief. Short-term physical therapy may help improve strength and reduce pain. Transferring of weight to a walker helps relieve pain and walking ability.
Surgical Treatment
General anesthesia is most used for joint replacement surgeries but sometimes regional anesthesia is also used. This depends on your doctor, on your overall health and personal preference.
The damaged cartilage and bone is first removed. To remove the worn out ball of the ball-and-socket hip joint, the bone is cut to remove the femoral head. In order to insert a new joint, the damaged bone and cartilage must first be removed. Once the arthritic ball is removed, the worn out socket can be addressed. Unlike the ball, this bone cannot be cut off -- the socket of the hip joint is part of the pelvis bone.
A reamer is used to scrape away the damaged cartilage and bone and a smooth, perfectly rounded surface is got which accepts the new hip implant. Once the damaged bone has been removed, the new socket of the hip replacement can be inserted. The socket of the pelvis is called the acetabulum and the part of the hip replacement inserted into the socket is called the acetabular component. The acetabular component is held tightly in the pelvis by making the socket slightly smaller than the acetabular component and wedging the implant into the bone. The implant has a rough surface to allow bone to grow into the surface of the implant over time.
Now that the socket has been addressed, attention can turn to the ball of the ball-and-socket hip joint. The ball is supported with an implant inserted down the hollow center of the thigh bone (femur). This implant is called the femoral stem.
For the femoral stem to be held tightly in the bone special tools are used to shape the center of the thigh bone to accommodate the femoral stem. With the bone prepared, the femoral stem is inserted and held in the bone with or without cement.
If bone cement is used, the cement is inserted in a liquid form and the stem is then placed. The cement permanently hardens within a few minutes to hold the implant fixed within the bone. When no cement is used, the implant is called "press-fit." This means that the implant is wedged tightly into the bone. A rough surface covering the implant allows bone to grow into the implant over time.
With the stem inserted down the center of the thigh bone, the ball of the ball-and-socket hip joint can be inserted on top of the stem. A metal ball is tightly fit onto the top of the stem. |