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Artificial joint replacement

Artificial joint replacement

1. Cemented Endoprosthesis

1. Cemented Endoprosthesis

The hip shaft and socket are secured to the pelvis and to the upper thigh bone using a rapidly hardening synthetic material, the so-called bone cement. A joint which has been cemented in place can be used immediately...

2. Cement-free Endoprosthesis

2. Cement-free Endoprosthesis

The hip shaft is pressed into the bone. The hip socket is pressed into position or is screwed in. Because of the use of bone-compatible materials, these components settle down well in the bones and the joint is fixed for the long term.

3. Hybrid-Endoprosthesis (Mixed form)

3. Hybrid-Endoprosthesis (Mixed form)

3. Hybrid-Endoprosthesis (Mixed form)

In the so-called hybrid implantation technique, the advantages of both systems are combined. The socket is anchored without using cement but the prosthesis shaft is cemented into the upper thigh bone.

What are artificial joints made from?

In general, the following materials are used: Steel alloys or titanium, highly compressed synthetic materials and ceramics. Because a high level of blood loss cannot be ruled out during an operation to fit a prosthesis, and because the date of the operation has usually been fixed in advance, it is possible that the patient will have to donate some of his/her own blood before the operation. This donation is usually made at an out-patient unit about 2-4 weeks before the planned operation.

The Operation itself

The in-patient stay in hospital lasts for about 2 weeks. This will be followed by appropriate rehabilitation measures, preferably conducted in a rehabilitation unit over a period of 3-4 weeks. Intensive physiotherapy is used to promote mobility and the building up of muscles again. Even everyday movements, such as the correct method of getting in and out of a car will have to be re-learnt. The object is to train the muscles of the leg and pelvis so that they can derive the maximum benefit from their restored mobility.

The correct endoprosthesis

After rehabilitation you should be largely free from pain. It is important that you continue to do your daily exercises at home after being discharged from hospital. After a few months you will be able to enjoy your life to the full again – both at home and in your career. You should continue to pursue your hobbies and to play sport. You may do all forms of sort which do not overtax the joints; swimming, cycling, walking, cross-country skiing, Nordic walking or gymnastics. You should not, however, put too much strain on your joints and should not do any heavy lifting (a max. load of 20 % of your own bodyweight is recommended) and you should refrain from strenuous sports, such as squash, tennis or Alpine skiing. In the months and years following your operation you should make sure that you take advantage of your doctor’s regular follow-up services, even if you are symptom-free. In this way, you will give your doctor the chance to monitor your recovery and rehabilitation.

Dr. med. Bernfried Pikal
MEDICUS Issue 1/2005

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Der künstliche Ersatz eines Gelenkes

Artificial joint replacement

According to the nature of the complaint, the patient will previously have been prescribed physiotherapy, baths, compresses, pain-relieving and anti-inflammatory medications. Arthroscopy with joint rinsing or an injection in the joint may have given you temporary relief from your symptoms. When the pains and the impediment in your joint increase and the means of conservative treatment are exhausted, the doctor will recommend a surgical intervention: the implantation of an artificial joint, also known as total endoprosthesis.

In artificial joints an attempt is made to imitate the biomechanics of the natural joint as closely as possible. The worn-out surfaces of the cartilage of the damaged joint are replaced with smooth, stable surfaces. Using the test results and x-ray images the operating surgeon determines the model, size and method of fixing the implant. Everything is based on your individual needs. Your age, sex, bone quality, bodyweight and not least your level of physical activity are all relevant considerations. Artificial joints generally last for about 12-15 years.