Prosthetic Socket

The hip replacement surgery during the years

Hip replacement is a medical procedure in replacing the hip joint by a synthetic implant. It is the most successful and cheapest safest way to joint replacement surgery. The first recorded attempts at hip replacement that took place in Germany, used ivory to replace the femoral head.
The use of hip became more widespread in the early 1930, artificial joints were made of steel or chrome. They were considered better than the arthritis, but there were a number of drawbacks. The main problem was that the joint surfaces could not be lubricated by the body, leading to wear and loosening, and therefore the need to replace the joint again (known as the servicing).

Attempts to use Teflon produces joints that causes osteolysis and carried out in two years. Another major problem was infection. Before advent of antibiotics, surgery of the joints carried a high risk of infection. Even with antibiotic treatment, infection remains cause for some revision operations. These infections are not necessarily caused during surgery, but can also be the result of bacteria entering the bloodstream blood during dental treatment.

The modern artificial joint owes much to the work of John Charnley at Manchester Royal Infirmary, and his work in the field of tribology resulted in a design that completely replaced the other designs in 1970. Charnley's design consisted of three parts - (1) a metal (originally stainless steel) femoral component, (2) an ultra high molecular weight polyethylene acetabular component, which is fixed to bone with cement (3) bone special. The joint replacement, which was known as the low friction arthroplasty, is lubricated with synovial fluid.

The small head femur (22.25mm) for wear issues was only suitable for sedentary patients, but - on the positive side - a huge reduction in the resulting friction resulted in excellent clinical results. For over two decades, the design of Charnley low friction arthroplasty was the most widely used system in the world, very exceed the available options (like McKee and Ring).

In 1960 Burma's an orthopedic surgeon, Dr. San Baw (June 29 diciembre 1922-7 1984), pioneered the use of ivory hip prostheses to replace ununited fractures of the femoral neck (hip bone), when first used an ivory prosthesis to replace the fractured hip bone of a 83 years Burmese Buddhist nun, Daw Punya. This was done while Dr. San Baw was the chief of orthopedic surgery at the Mandalay General Hospital of Manadalay, Burma. Dr. San Baw used over 300 ivory hip replacements from 1960 to 1980.

Presented a paper entitled "Replacement Ivory for ununited hip fracture neck of femur at the conference of the British Orthopaedic Association held in London in September 1969. A 88% success rate was seen in patients that Dr. San Baw's ages ranging from 24 to 87 were able to walk, bend, biking and playing football a couple of weeks after a broken hip bones were replaced with ivory prostheses. Dr. San Baw use of ivory, at least in Burma during the 1960's, 1970 and 1980 (before the illicit ivory trade became rampant throughout the decade starting in 1990) cheaper than metal. Moreover, because the qualities physical, mechanical, chemical and biological properties of ivory, found that there was a "biological binding" best ivory human tissues near the ivory prostheses. An excerpt from the article, Dr. San Baw, who presented at the Conference of the British Orthopaedic Association in 1969, is published in The Journal of Bone and Joint Surgery (British edition), February 1970.

In the last decade, several evolutionary improvements have been made in the procedure Total hip replacement and prostheses. Many hip implants are made of a ceramic material rather than polyethylene, which dramatically reduces some research indicates wear on the joints. Metal on metal implants are also gaining popularity. Some implants are joined without cement, the prosthesis is given a porous texture in which the bone grows. This has been shown to reduce the need for revision of the acetabular component. Surgeons often still use bone cement for femoral component, however, has had great success after 35 years of clinical experience.

The latest events are more competitors Minimally Invasive (MIS) approaches, which may lead to soft tissue damage, much less a faster recovery. CAOS (Computer orthopedic surgery assistance) are also marketed largely by the implant manufacturers, but their value remains largely untested .. computer-assisted surgery is said to better navigate prosthesis implantation.

An alternative to total hip replacement (THR) is the surface hip replacement (HSR), also known as hip resurfacing. With ATC and HSR, a prosthetic socket is pressed into the pelvis. With THR, the end of the femur is an amputee, a metal stem is inserted into the femur, and holds a ball pin that fits into the socket. With resurfacing, the end of the femur is amputated, the outer surface of the ball of the femur replaced by a cylindrical metal cover. Resurfacing eliminates the common problem of HRT loosen the metal shaft of the femur. Resurfacing preserves bone stock if a review is always necessary. A larger diameter ball and takes a closer mimic the natural structure of the joints, reducing the risk of displacement and improved range of motion. There have been no published clinical evidence to show today CoCr metal-metal articulating surfaces have the effect osteolytic bone that devices polyethylene had earlier. Ten years the success rates of hip resurfacing from studies in England reported the success of equal or greater than the total standard hip replacement in patients of comparable age. In the United States, the first modern resurfacing device with FDA approval in May 2006, while 90,000 resurfacings have been made worldwide.

Patients should be aware of all surgical options before hip replacement surgery. surgeons hip have different surgical techniques and surgical results. Currently, there are several different incisions to access the hip joint. The approach posterior (widely used by most orthopedic surgeons) separates the gluteus maximus, in line with the muscle fibers to enter the joint hip. Other methods of access to the hip on the lateral side of the hip joint. In contrast to the approach and lateral approach, the previous method used natural interval between the soft tissue to access the hip joint. Its main disadvantages are that the risk of damage to the lateral femoral cutaneous nerve, and is not widely available to the public because fewer surgeons have been trained in this technique.

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