Hip Pain
If you are looking for the cause of your hip pain or you do not know exactly what is causing your hip pain, let us guide you through our hip pain diagnostics and arrive at the most likely diagnosis. First of all, conservative therapy is attempted for hip joint arthrosis. However, if this fails, there is still the possibility of treating the disease through surgery.
A further indication for surgery may also be to prevent permanent deformities of the joint from developing at the base of the arthrosis. There are different surgical procedures, which are selected according to the individual condition of the patient. The type of surgery used depends primarily on the underlying cause of the arthrosis and the stage it has reached.
In addition, personal factors of the patient also influence the decision, such as his or her age, profession, level of suffering and whether or not there are any additional illnesses. In principle, joint-preserving operations can be distinguished from joint-replacing operations (hip prosthesis). The most frequently performed therapy to treat hip joint arthrosis in a joint-preserving manner is the so-called repositioning osteotomy.
In this procedure, a malposition on the damaged joint is removed in order to restore the natural axial relationships in the hip. There are various techniques for this, all of which have in common that one or more bones are cut through and the acetabulum is then brought back into its correct position. This is primarily intended to prevent the progression of an existing arthrosis.
This is why this operation is used especially in children and adolescents. Changes in the joint that do not yet represent the full picture of arthrosis, but are almost certain to lead to hip arthrosis, can also be treated with this type of surgery. These include, for example, bone malpositions following bone fractures, a femoral neck angle that is too steep or too flat, and an acetabulum that is too flat.
The most common surgical measure, however, is the hip joint replacement, whereby a so-called endoprosthesis is inserted. This is usually a total endoprosthesis (TEP), which means that the entire joint (i.e. both the acetabulum and the femoral head) is removed and replaced by artificial joint parts. The prosthesis is usually made of either plastic or metal.
In addition, a distinction is made between cementless and cemented prostheses. The cemented prostheses are fixed in the femur by a plastic mass and their advantage is that patients can be mobilized almost immediately after the operation. However, there is a risk that the prosthesis will loosen again over time.
This is why this option is particularly suitable for older patients. For younger patients, the cementless prosthesis is usually used, in which the prosthesis is anchored in the thigh and the bone is then allowed to grow into the prosthesis. As a result, it achieves a higher degree of strength than the cemented prosthesis and therefore has a longer service life.
Even if the prostheses have become quite durable, it should always be remembered before an operation that, especially if it is performed at a young age, the probability is relatively high that the patient will have to undergo a replacement operation in the course of his or her life, thus exposing himself or herself again to the stresses and risks of this procedure. Therefore, the decision to have early surgery should not be taken lightly. During this type of surgery for hip arthrosis, there is often quite a lot of blood loss.
Therefore, bruising often occurs in the hip area. In addition to blood vessels, nerves can also be damaged during the operation, although the risk of this is minimal if the operation is performed correctly. Injury or crushing of a nerve can either cause pain or temporary or permanent weakening of the gluteal muscles.
Surgery for osteoarthritis of the hip joint is a major procedure, which therefore involves some complications and risks. In the foreground is the risk of postoperative thrombosis of the deep veins of the leg or pelvis.These can initially cause permanent damage to the leg and, in the worst case, can be carried over and lead to a pulmonary embolism, which is often fatal. As with any operation, hip joint replacement can also lead to wound healing disorders and infections of the wound.
These are usually easily manageable, but in rare cases deep prosthesis infections occur, which inevitably leads to the removal of the prosthesis. In addition, there are rare serious complications: Some patients may develop an allergy to the implant, which would also require replacement of the prosthesis. Sometimes there is also a difference in leg length or the bones never heal properly after the operation.
In exceptional cases, the pain may persist after the operation. However, hip joint replacement is an extremely good therapy option, with 95% of prostheses still functioning after 10 years. Synovectomy is also an option in the surgical treatment of hip joint arthrosis. In this procedure, the inner skin of the joint capsule is removed, as this shows a high tendency to inflammation in osteoarthritis, which can often lead to joint effusions.
