Total hip replacement - which hip implant are best ?
The first hip replacement was performed around 40 years back, which was called Charnley hip apparatus back then after the name of Sir John Charnley, who performed the first hip replacement. Much advancement in techniques and type of implants has happened since then. From a smooth, polished stainless steel stem and a plastic socket, which were cemented or glued into place at that time, there are a variety of implants available now which are either cemented or not cemented for the bone to grow around the implant.
|Cemented and Un cemented Hip Implant options|
Though cemented implants have a long track record and continue to do very well, most of the hip replacements done in United States these days are not cemented, but are inserted in the bone so that the bone grows into the implant anchoring them.
In the last 10 years, major improvements in the artificial bearing surfaces of implants have been approved for use in the U.S. The stem portion of most hip implants is made of titanium- or cobalt/chromium-based alloys. They come in different shapes and some have porous surfaces to allow for bone in growth.
The ball portion of the implant and the acetabular socket is made of variety of materials which include:
· metal on metal (MoM)
· metal on plastic (polyethylene or UHMWPE)
· ceramic on plastic (UHMWPE)
· ceramic on ceramic (CoC)
Because of different variety of implants available, it has become a matter of major discussion and decision between the patient and the surgeon. Not only the implant options, the technique and technological advances are also a matter of important decision. Terms such as “ capping the femur” “ minimally invasive hip replacement surgery” are frequently used terms besides “Metal on metal”, “porcelain hip” which are a major point of discussion and decision.
The patient is often left wondering “Which is the best hip implant for me?” “Should I or should the surgeon decide about the type of implant and technique to be used on me?” “Is the latest and technique and implant best for me?”
The fact is that no one knows what the "best" implant is. Experts say that the ideal hip replacement implant is the one that allows for normal activities, normal motion, and last the patient's lifetime.
It is also important to note that not everyone is a good candidate for all techniques and implants. The decision about which type of hip replacement to be done over another should be based on knowledge about its durability, use and drawbacks. Majority of new implants or surgical techniques have shown to have patient specific or implant specific drawback.
For example, minimally invasive hip replacement with smaller incision is many a times detrimental in adequately placing implants. Ceramic-on-ceramic total hip replacement has shown squeaking in 1 to 2 percent of patients. Total hip resurfacing, or capping the femur, may work well for some people, but not in others and in certain groups may increase the risk of femur neck fracture. Currently, it can only be done with metal-on-metal bearing surfaces and not everyone is a good candidate for these bearing surfaces. That's because metal-on-metal hip replacement has the potential downsides of allergy and hypersensitivity reactions — which may occur in one out of 1,000 patients. There are also fears of elevated metal ion levels in the bloodstream that could potentially cause detrimental long-term health problems, but this potential problem is purely theoretical and has not been proved in humans despite decades of use.
The best way to choose the right implant for you is to discuss this with your surgeon. The surgeon would consider your age, gender, weight, lifestyle and severity of joint degeneration. The doctor will also look at necessary and possible range-of-motion with the implant, stability of the implant and wear-resistance of the materials in light of your physical and lifestyle activity considerations.
The best or right implant for you is the one which fits the following criteria:
· The implant has minimum track record of 10 years
· The surgeon has used the implant before
· The implant is fit to be used for your specific condition
Total hip replacement has proved to be a boon for the patients for many years now. Implants and technology shall continue to evolve, but the best implant for you can be chosen after understanding the risks and benefits of it.
IndiCure is the most renowned name for providing affordable hip replacement surgery in India. For more information about best hip replacement options for you write to us at email@example.com or call us at +91 9320036777 or +91 9818462127