Hip orthoses are special orthopedic devices; they are used to unload the joint during diseases and injuries. When using an orthosis, the joint stops collapsing during movement, the pain subsides and recovery is much faster.
The hip orthosis must perform a good fixation function. The more serious the pathology, the stronger the fixation should be. Therefore, only a specialist should select a bandage after examination, then the treatment will be as effective as possible. The Yusupov Hospital employs highly qualified specialists who will conduct a high-quality examination and prescribe appropriate treatment.
What is an endoprosthesis?
The successful outcome of surgery largely depends on the quality of the endoprosthesis used, so the patient consults with a specialist in advance and selects a suitable model. When selecting, not only the budget is taken into account, but also the advantages and disadvantages of specific models, taking into account the patient’s pathology.
There are 3 types of fixation of endoprostheses - cementless, cement, hybrid. The design of the cementless model includes a liner, a bowl, a support leg, and a head. The cement model has a similar design, but the liner and bowl are not separated. By design, all models are divided into 2 types - single-pole and double-pole. The former are used to restore the head of the femoral neck, and the latter for the head and acetabulum.
At CELT you can consult an orthopedic traumatologist.
- Initial consultation – 3,000
- Repeated consultation – 2,000
Make an appointment
Standard prosthetics - 185,000 - 225,000 rubles.
Non-standard prosthetics - 265,000 - 315,000 rubles.
Included in the price:
the operation, consultation with an anesthesiologist and anesthetic care, dressings, medications, food and hospital stay, postoperative observation by the attending physician for a month (longer if necessary). The indicated price does not include the price of the endoprosthesis itself (it may vary depending on the manufacturer) and the preoperative examination.
1-3 hours
(duration of operation)
5-8 days in hospital
Indications
- femoral neck fracture
- pseudoarthrosis of the femoral neck
- aseptic necrosis of the femoral head
- hip dysplasia and congenital hip dislocation
- tumors of the proximal femur
- infectious (including tuberculosis) coxitis
- rheumatoid arthritis and other systemic diseases with the development of stage 3 coxarthrosis;
- unsuccessful results of previous operations
Contraindications
Absolute contraindications:
- diseases of the cardiovascular and respiratory systems, metabolic disorders in the stage of decompensation
- the presence of an active focus of purulent infection in the body
- hemiparesis on the side of the planned operation
- mental or neuromuscular disorders that prevent rehabilitation after surgery
- acute vascular diseases of the lower extremities (thrombophlebitis, thrombosis)
Relative contraindications:
- severe obesity
- severe cancer
- lack of conviction of the patient himself in the need for endoprosthetics and his unpreparedness for postoperative rehabilitation
Wearing a hip orthosis
The hip joint always experiences quite a lot of stress; if it is injured, it will be quite difficult to treat. This may be a mechanical injury or an inflammatory degenerative process, which is most common in older people.
In such situations, treatment usually begins with medications, and the doctor may also prescribe surgery if the fracture or joint is displaced. The Yusupov Hospital uses comprehensive and timely treatment, which is aimed at restoring and healing the pelvis so that problems do not arise later.
Hip orthoses help prevent re-injury while the muscles are still weakened. This is especially true for older people, because the hip joint can recover quite poorly. This is mainly associated with poor circulation.
A hip orthosis is used to fix it in a certain position. The orthosis is considered a fairly new device that has begun to replace the plaster cast. It can be removed, which is more convenient for patients, and in addition, its degree of rigidity is selected individually depending on the pathology.
If the patient had serious injuries, if it was necessary to fix the hip joint as much as possible, previously a plaster cast was used, which did not allow the person to move. Today, it is replaced by a rigid orthosis, which perfectly fixes the desired joint and at the same time gives the person the opportunity to walk, which is a big plus, since blood circulation improves during movement and recovery occurs faster. Soft orthoses can be used for inflammation; they partially fix the pelvis and at the same time do not allow it to collapse.
Design features of endoprostheses for the hip joint
More than 1000 types of endoprostheses are presented, since all joints are unique and there is a strict difference in shape and size. But for successful engraftment, it is necessary to treat the femoral canal (this will preserve 100% functionality of the joint).
Models with a cementless stem have a rough structure, allowing bone tissue to grow into the material. Experts call this installation method a “tight fit.” The leg is screwed into the femoral canal and tightly fixed. For endoprostheses of this type, titanium alloys are used, onto which calcium hydroxyapatite is applied (due to this, better compatibility with the tissues of the human body is achieved).
All technological laboratories create unique solutions, which allows you to select a model taking into account the severity of the pathology and the individual structure of the patient’s hip joint. For better fastening, arcs, protrusions, ribs, etc. are used in the channel. The selection of a suitable fastening is carried out after an x-ray or x-ray.
There are also differences in the shape of the legs, as curved, flared and straight models are available. The cross section can be 4-angled or round. All differences are thought out in order to ensure an even load on the joint.
Diagnostics
Before the operation, the specialist clarifies:
- General health and the presence of chronic and acute diseases.
- Blood clotting rate (coagulogram and OAC are prescribed).
- Allergy to anesthesia and medications.
- The severity of damage to the hip joint (diagnosis using X-ray and CT).
Based on the images, a suitable implant design is determined so that it takes root 100% and does not limit the functionality of the joint.
Hip orthosis. Price in Moscow
It is very important to choose the right orthosis so that it is comfortable to wear and fits correctly. Independent selection of fixatives is under no circumstances recommended, since you may not only not get the desired effect, but also get a negative result with side effects. For advice on wearing a brace, you should consult a doctor. At the Yusupov Hospital, the doctor will conduct a high-quality diagnosis and determine the required type of retainer that will be ideal for the patient. For hip orthoses, the price varies from 1,500 rubles to 15,000 rubles. The doctor will tell you which orthosis and where it is best to buy it in Moscow. You can make an appointment with a specialist by calling the Yusupov Hospital.
Types of hip replacement surgeries
Specialists perform partial or complete joint replacement using an implant. The selection is made based on the following information:
- Presence of chronic diseases.
- Strength of cartilage and bone tissue.
- Age.
- The degree of damage to the joint.
Older people get a partial replacement because they do not put extra stress on the implant. But there is a significant drawback - the service life of the structure is only 5 years and after the expiration of the period, replacement is recommended. A complete replacement is difficult to tolerate, since the operation takes a long time and spinal anesthesia or full anesthesia is used. The trauma to soft tissues is significant, which causes extensive blood loss. But there is a serious advantage - the function of the hip joint is restored by 100%, and the service life of the implant exceeds 15 years even with physical activity.
Selection of surgical technique
The choice of technology is made based on the following information:
- Age.
- Presence of acute and chronic diseases.
- Strength of cartilage, joints, bones.
- Degree and type of damage.
To access the injured area, a posterior, combined, anterior or anterolateral incision is used. A posterior incision is preferred because it reduces morbidity. Other types are also used, but only for repeated surgery. After access to the desired area, the tissues are moved apart and fixed, the joint is opened, and the damaged tissue is removed. Next, the femoral head and acetabulum are removed if total joint replacement is chosen. After this, the implant is fixed, sutures are applied, drainage is created and restoration begins.
Types of prostheses by design
Real human joints have only 2 parts: the head and the acetabulum. Hip endoprostheses consist of 4 components:
- Acetabular cup. Can be made of metal, ceramic, or a combination of the two.
- Acetabular liner. Used as a gasket between the artificial cup and the head. Made from high quality, highly durable plastic.
- The head of the femur, corresponding in size to the liner and attached to the femoral stem. They are made from plastic, metal, ceramics or combinations thereof.
- The femoral stem, used as a support for the new joint. It is made of porous metal, so over time it becomes overgrown with bone tissue, increasing strength.
Types of artificial hip joint designs:
- cap - it is used if there are preserved bone components;
- complex - mixed construction of cementless and cement type;
- cementless - made, as a rule, from titanium alloys, has a rough surface to allow the growth of human bone tissue for more reliable fixation;
- individual, which is made taking into account the individual structural characteristics of the patient’s joint, is used if it is impossible to use a standard design due to extensive destruction;
- standard – fixed with bone cement.
The most commonly used types of artificial hip joint are standard ones. This is explained by the fact that standard types of structures are well adapted to the conditions of the human body, have high wear resistance, reasonable price, and long service life.
Revision endoprosthetics
Performed if severe complications arise during rehabilitation:
- Broken prosthetic leg.
- Loosening of the joint.
- The appearance of scar-adhesive tissue.
- Penetration of infection and accumulation of pus.
The main difficulty is the lack of bone tissue, since it was removed during the main operation. The expert has to clean the area and re-fix the implant. It is impossible to re-install the prosthesis during sepsis, since the infection quickly enters the organs and penetrates the blood (a complication that is extremely rare).
What are the risks of surgery?
Installation of a prosthesis requires removal of the ligaments that stabilize the joint. Therefore, after the operation, only the muscles will be responsible for keeping it in the correct position. If they do not function sufficiently, for example, due to underdevelopment and lack of training, and the patient allows himself dangerous sudden movements, this often leads to dislocation of the joint.
Even the following simple movements are dangerous after endoprosthetics:
- normal bending of the leg, for example, while sitting or raising the knee;
- extension - during the swing when hitting the ball;
- crossing the legs inward, or adducting;
- moving the leg to the side;
- rotation inward or outward (adduction and expansion of the feet with straight legs).
How is hip replacement performed at the CELT clinic?
- Painless
The operation is performed under general anesthesia or with epidural anesthesia (the type of anesthesia is chosen by the patient together with the anesthesiologist), in any case the operation is painless for the patient. - Low-traumatic
The operation is performed through a lateral external incision 10-15 cm long in the upper part of the thigh. The head and neck of the femur, as well as cartilage from the surface of the acetabulum of the pelvic bone, are removed in stages, followed by replacement with prosthetic components. - Effective and safe
There are many different models of endoprostheses: cemented, cementless, with different options for the femoral part, heads and cups of the joint (ceramics, plastic, metals). The choice of endoprosthesis is determined by the patient’s age, his activity in everyday life, and the specific clinical situation.
Thanks to extensive experience, modern equipment and surgical instruments, orthopedic traumatologists at the CELT clinic successfully perform such operations completely safely for the patient.
Why do they trust us and choose the CELT clinic?
- An experienced doctor, Professor Vladimir Sergeevich Zubikov, performs endoprosthetics operations. For more than 30 years, he has been treating joint pathologies, including cases complicated by suppuration, instability, and fracture of the endoprosthesis.
- Thanks to the extensive experience and high quality of work of the anesthesiological team, we do not deny the right to surgery to very elderly patients; this is a feature of our clinic.
- Our selection of endoprostheses is individual; we do not rely on “what is available...”.
- The CELT clinic is a multidisciplinary institution; we have the opportunity to consult a patient with a specialist of almost any profile if necessary, carry out diagnostics using various methods, treat complications and concomitant pathologies.
Reviews of doctors providing the service - Hip replacement
Several months ago, Igor Grigorievich performed arthroscopic surgery on my acromioclavicular ligament.
Installed dogbone implant. Everything is great, I lead an active lifestyle and play sports. I already forgot which side it was from! Read full review Alexey
25.11.2019
Dear employees, dear management of the Endosurgery and Lithotripsy Center, good afternoon! 2 months ago I had hip replacement surgery performed by specialists from the Center: Vladimir Sergeevich Zubikov - orthopedic traumatologist, doctor of medical sciences, doctor of the highest category, ... Read full review
Pershin Vladimir Alekseevich
20.08.2018
Classification of endoprostheses
Classification of hip replacements is carried out according to the following categories:
- method of fixation (cement, cementless, combined);
- materials used (polymers, titanium, steel, ceramics);
- primary endoprosthesis or revision replacement.
Surgical intervention for joint replacement can be carried out only after a detailed study of all the features of the patient’s disease, selection of a suitable implant, diagnostic studies and detailed consultations with all the necessary doctors. Total hip replacement or replacement of individual elements may be required.
