Reasons for Hip Replacements
Hip replacement surgery is a front line treatment option for many situations involving the hip joint. The procedures can range form pinning and plating for fracture conditions to partial and complete replacements for fractures and arthritis.
Replacement surgery typically involves the implantation of a femoral (thigh bone) component and an acetabular (hip socket) component. These implants are made of high tech metals and space age polyethylene plastic.
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Sub-capital hip fracture
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The term, "sub capital" refers to any hip fracture that occurs at or just below the level of the femoral head, or the "ball" of the femur, where it connects to the "neck."
Because vital blood supply to the femoral head is disrupted in this type of fracture, the risk of death to the bone is quite high. Performing some type of "fixation" surgery such as a hip "pinning" or plate and screw procedure will almost certainly fail, resulting in the need for a replacement of some type anyway.
In this injury scenario, it is likely that only the femoral side of the hip will require replacement, because the fracture rarely inflicts any major trauma to the acetabulum (socket). The procedure is called a "hemi-arthroplasty" because it is literally "half" of a replacement.
Avascular necrosis as a reason for hip replacement
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Avascular necrosis is the term given to the condition of the femoral head in which death comes to the bone from a loss of blood supply from within the bone, from causes other than fractures.
Situations that can be responsible for avascular necrosis to occur can include chronic alcoholism, long term systemic steroid use (as in the case of an organ transplant recipient), or long term steroid abuse as is seen occasionally in the sport of professional athletics like body-building.
The risk of avascular necrosis is high in anyone who has sustained a hip dislocation because of traumatic disruption of blood supply.
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Osteoarthritis as a reason for hip replacement
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Osteoarthritis is widely considered the "garden variety" arthritis, and affects millions of people each year. The arthritic process involves the wearing down of the smooth joint cartilage that covers the ends of our bones. This cartilage is something akin to tread on a tire because as we age, the "tread" on the joint surface wears down to the point where bone surfaces rub together causing pain and deformity.
Causes of osteoarthritis can include prior injury to the hip (a.k.a. post-traumatic arthritis), chronic obesity and the natural aging process.
Systemic disease as a reason for hip replacement
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Systemic diseases such as diabetes, chirrosis of the liver and rheumatoid arthritis are big contributors to the general need for hip replacements, as well as other joints. These disease processes often involves the body's production of inflammatory, invasive and destructive tissue that encroaches into hip joint structures and destroys them.
Morbid obesity
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In the United States, our culture and society is rapidly becoming one of out-of-control obesity. The more weight our skeletal frames are forced to support, the more rapid the degeneration of joints and joint surfaces. The two most commonly affected joints are the knees and hip.
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