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Hip arthroplasty in Kyiv
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 Hip joint arthroplasty is surgery of joint surfaces (head and cup) replacement with artificial implants. It is performed in case of joint affections and dystrophic diseases which can’t be cured in non-surgical way. Apart from traumas arthrosis is one of main diseases, in which endoprosthetics is required. Coxarthrosis is a pathology accompanied by destruction of the hip joint resulting in movements limitation, shortening of the femur and pain syndrome development. Violated blood supply of cartilage and subchondral zone is basic mechanism of arthrosis development. Dependently on the kind of pathological changes there are 4 stages of the arthrosis. Artificial joints are produced from different materials such as titanium, tantalum, ceramics, polyethylene or stainless steel, cobalt, chrome. Main requirements for prosthesis components are biocompatibility, strength and replaceability. Prostesis components fixation is fulfilled by two methods: -mechanic (carrying out of anatomic cuts with following splicing of surface with the bone; - cement (with the help of special medical cement). The choice of method depends on the patient’s age, osteoporosis degree and deformation of the joint. The doctor chooses model and type of joint fixation. Last time four-component hip joint prostheses won wide popularity as far as there is no necessity to remove the whole prosthesis in case of its wear but only the cup’s head or insert. Components which have been spliced with the bone may be left for the rest of life. Repeated interventions with joint components replacement is called revision endoprosthetics. Hip joint prostheses may be of three types:
total (femur’s cup and head are replaced);
semipolar (only head is replaced; it makes it possible to perform minimally invasive intervention in aged patients with hip fractions);
  • revision systems.
    Basic indication for total hip joint endoprostetics is pain syndrome: the patient decides it by himself when to fulfill replacement intervention. It is not recommended to wait until development of movements limitation in the affected joint and remarkable shortening of the femur as far as it makes further surgery more complicated for both the doctor and the patient. With the development of modern devices and minimally invasive technologies joint replacement surgery is not anymore severe and blood-consuming. The patient starts walking on the same evening or next day after intervention. Mid time of staying at in-patient department makes 2 – 3 days. Hip joint prosthesis price lies between 500 and 5000 USD dependently on its model and manufacturer.
Hip arthroplasty Horobets


Recommendations to patient before hip athroplasty:

First of all visit your family doctor. Previously you can fulfill clinical blood count, blood glucose, proteinogram, urineanalysis and ECG. Additive diagnostics will be prescribed if needed by therapeutist or orthopedist in hospitalization. It is important before surgery not to skip taking drugs prescribed by doctors of other specialities. Anticoagulants should be used if recommended by a doctor only. It is also needed that you discuss the necessity of using crutches or orthoses as well as taking some drugs with orthopedist on the stage of planning the date of surgical intervention. On the day of operation you need to come to a clinic fasting, which means that you should not take any food in the morning. In case there is long interval between diagnostics and operation, please, discuss the possibility to take some foods and beverages with your anesthesiologist. You may shave your hip 1 - 2 days before operation. It is allowed for patients to take phone, notebook, personal hygiene items, including toothbrush, toothpaste and shower gele to the ward. Clinic is providing each patient with hygienic items, towels, gowns, bed linen, one time slippers and 3-times meals. Each ward is equipped with a toilet room, TV-set, functional bed and WiFi-net. Patient's relatives may visit him adhering to sanitary and hygienic requirements; in case of quarantine visting patients is limited. Minimal period of staying in the clinic after the hip arthroplasty makes 2 days.

Recommendations to patient after arthroplasty of the hip joint

(This is general information and may be not objective enough in each individual case and therefore should be obligatory agreed with doctor)

Basic principles:
Gradualeness of loads. Implants stability is provided by not only axes of loads but also tendons, muscles and joint's capsule. Stitched during operation tissues and scars around implants need to grow together and strengthen. These processes take approximately 3 - 4 weeks. Remember: absence of loads leads in atrophy, however, harsh overloads may cause affection of tissues; gradual load promotes strengthening of soft tissues and bones.

Thromboembolism prevention. After the operation there is risk of vessels occlusion with blood clots caused by sedentary regimen and vascular pathology. Therefore it is necessary to intake anticoagulants (blood diluting drugs) during 1 - 3 weeks up to complete restoration of motile regimen. The course of these drugs and their dosages should be prescribed by doctor individually. It is of great importance to provide thorough self control of fulfillment of all prescriptions both in the hospital and at home. It is also recommended to use elastic bandages and compression stockings to prevent thromboembolism. Avoid blood pressure rise and palpitations while doing exercises and/or walking. 

Maitenance. Getting up from the bed first time should be done with a help of either relatives or social workers in order they could support you or soften your falling down in case if you lose the balance. It is recommended to sit during 3 - 5 minutes in the bed before standing up on the legs. Don't forget to roll your legs with elastic bandage or put on compression stockings.  

Body weight control. Gaining the weight decreases capacity of implants' working components and harms the organism by overloading the heart and violating blood supply. Thus it is stricktly recommended to move regularly and correct dietary habits by taking healthy quantitatively and qualitatively balanced diet. Before starting the diet it is preferable to consult your family physician or dietologist.  

Infections prophylaxis. There is a risk of implant contamination after endoprosthetic operation. Infection may permeate from outside or develop inside the organism. When visiting doctors, dentists, physiotheraputists always inform them about you have implants. Any bacterial infection of any localization in the organism should be obligatory treated as far as it is diagnosed. 

It is impossible to underevaluate importance of adhering to healthy lifestyle: it is known that smoking and alcohol abuse poison one's organism, worsen its immunological responce and blood circulation. 

Connection with doctor. Never be shy to call your doctor in case if you have some doubts or if you forgot to ask something. It may resque your life and prevent complications. Pay special attention on worsening of pain, increasing of edema, soaking of bandage, postoperative wound reddening, local or general body temperature increase, shortening or deformation of the extremity, acute reduction of movements volume, sensitivity loss, retrosternal aches, dyspnoea, complicated defecation or/and urination, etc. After hip joint repacement it is necessary to prevent luxation of its components. First few weeks after the intervention growing and strengthening of soft tissues and muscles are going on, therefore flexions in hip joint for more than 90°, tighs crossing and marked inner or external rotation of hip especially when it is flexed should be avoided. Bed, chairs and toilet should be high enough - not lower than patella's upper edge.   

Excess flexion and external rotation should be better limited for the rest of life if life conditions allow it. In this regimen luxation risk is reduced and working capacity of implant's components is remarkably increased. 


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