Hip Prosthesis (Hip-TEP, Artificial Hip Joint)

Hip Replacement

Osteoarthritis of the hip, which is often treated with a total hip endoprosthesis (hip prosthesis, hip TEP), is one of the most common degenerative joint diseases. Approximately 200,000 hip prostheses are fitted in Germany every year.

Hip Pain Requires Precise Diagnostics

If the hip pain persists for a more extended period, the affected patient should be questioned precisely about the type, duration, and location of the complaints. Among other things, old injuries should be reviewed at this point, as these are often the cause of osteoarthritis development. A detailed examination of the joint should be carried out. In an X-ray examination, signs of osteoarthritis can be determined.

If there is uncertainty about the exact diagnosis or if a therapy that has been started is not sufficient, an ultrasound, MRI or CT examination, or scintigraphy (nuclear medical examination) might become necessary.

Convenient Time for Hip Prosthesis

Using surgical treatment methods is weighted up depending on the intensity and duration of the hip pain, age, and physical condition, as well as the patient's secondary diseases.

In surgical therapy, a distinction is made between joint-preserving surgeries and joint-replacing surgeries. However, the chances of success with joint-preserving surgeries decrease with increasing osteoarthritis stage and patient age. A high level of suffering, reduced quality of life, severe pain, restricted mobility, and therapy failure with conservative measures speak in favor of surgical intervention. Very high or low age is not necessarily a decisive factor in the choice of therapy.

Advantages of the Hip Prosthesis

The procedure must be discussed in detail with the patient and planned based on X-ray images before the surgery. Destroyed joint parts are removed during the surgery and replaced by artificial ones. Usually, this leads to pain relief and an improvement in the hip joint function. However, since the hip TEP can become loose over time, complete joint replacement is mainly recommended for older patients.

Alternatives to the Hip Replacement

For younger patients with severe pain, depending on physical activity, less frequent alternatives can be considered, such as a hip joint stiffening (arthrodesis) or a joint resection (Girdlestone procedure).

Which Hip Prostheses Are Available?

The hip prosthesis can be a cemented, cementless, or hybrid implantation (e.g., cemented stem and cementless acetabulum). Besides, bone transplantation or corrections to the bone structures may be necessary. For artificial joints, various material combinations of e.g., ceramic, metal, or polyethylene, are possible.

Risks Associated With Artificial Hip Joints

Bleeding, vascular occlusion, pulmonary embolism, or nerve/vascular injury may occur immediately after the surgery. The built-in prosthesis may loosen over time, which will make a hip prosthesis replacement necessary. Dislocations of the prosthesis can occur, or the previously existing pain can only be insufficiently reduced.

What has to be Kept in Mind After Implanting a Hip Endoprosthesis?

Immediately after the artificial joint has been placed, an X-ray check-up must be carried out to verify the prosthesis position. Patients should start moving again at an early stage so that they do not lose too much physical strength. Through physiotherapy and follow-up treatment ("rehabilitation"), we try to restore the patient's mobility best possible.

Excessive load by the physical activity should be avoided with a hip prosthesis. The patient's weight should be normalized, and regular check-ups are carried out by trained specialists to prevent consequential damage.

Which Physicians and Clinics Are Specialists for a Hip Replacement?

Patients who need an artificial hip joint want the best medical care. Therefore, the patient is wondering where to find the best clinic for an artificial hip joint.

As this question cannot be answered objectively, and a reputable doctor would never claim to be the best one, we can only rely on the doctor's experience. The more hip prosthesis surgeries have been carried out, the more the doctor becomes in the specialized field.

Therefore, artificial hip joint specialists are orthopedic surgeons who specialize in endoprosthesis treatment of the hip joint. They are the right contact for carrying out a hip surgery through their experience and yearlong professional activity as orthopedists with the main focus on hip surgery.

Sources

Orthopädie und Unfallchirurgie, Niethard, Fritz U.; Pfeil, Joachim; Biberthaler, Peter, Duale Reihe, 2014, 7. Auflage

S3-Leitlinie Orthopädie: Koxarthrose, Leitlinie der DGOOC und BVO, AWMF

Leitlinie Unfallchirurgie: Endoprothese bei Koxarthrose