Frequently Asked Questions
Why do I need a hip replacement?
The most frequent indication for the fitting of a total hip replacement is osteoarthritis, that is to say osteoarthritis of the hip. Other diseases may justify the fitting of a prosthesis, such as rheumatoid arthritis or necrosis of the femoral head. Some cases of fracture also require a prosthesis. In all cases, the pathology affects the proper functioning of the joint. When pain and mobility limitation result in significantly reduced activity and worsen despite medical treatment, surgery should be considered.
What is a total hip replacement?
A full prosthesis is intended to restore the geometry of the joint as well as its mobility. Clearly, it will allow the patient to “recover an unconscious hip”, that is to say to not be aware of their prosthesis. The principle of the prosthesis is to replace the femoral head with a prosthetic head and the cavity of the pelvis by a cup adapted to receive the prosthetic head.
What is the difference between a standard procedure and MIS?
A conventional procedure requires a relatively large incision (15cm to 25 cm). MIS procedures require an incision 7 to 12 cm, depending on the body size of the patient. The intervention with MIS technique may last slightly longer than with a conventional procedure (durations vary from one patient to another depending on the conditions and morphological configurations). The surgeon, alone, makes the selection of patients for hip prosthesis fitting, according to the nature of the disease and morphological configurations such as weight or age, for example.
What are the advantages of MIS procedures for the patient?
“These techniques have been designed to minimise damage necessarily inflicted to muscles, tendons and ligaments which occurs during all surgery. The implant and its prognosis are entirely identical to those of conventional techniques
Amongst the benefits:
– Less blood loss.
– Less pain compared to a conventional procedure: ligaments, muscles and tendons are not severed.
– A much faster recovery so that the patient may leave the care facility more quickly.
– The stability of the treated joint is greater, which greatly reduces the risk of dislocation.
– Rehabilitation is facilitated and accelerated, enabling resumption of normal life more quickly.
– Reduced risk of infection due to more restricted exposure to air of the surgical area.”
How soon after surgery may I resume normal activity?
What is the postoperative follow-up?
It is identical to that of a conventional procedure. The surgeon instigates a check up protocol for a period of six months, during which time physical therapy is prescribed. The number of sessions varies depending on the patient’s recovery. Even though the pain diminishes quickly and the prosthesis may be “unconscious”, it is important to follow the instructions of the surgeon.
Are MIS techniques new?
Single Incision MIS technique is not new. It is the culmination of a long process of research and development. There are an increasing number of French surgeons who have been educated and trained to perform the MIS Single Incision procedure.
Currently, thousands of patients have benefited, particularly in the United States, where the technique is used with outpatients. At present, there are many French surgeons being trained and educated to use this technique.
The transcollation technique is innovative and is the definitive concept in preservative surgery.
Full knee prosthesis with MIS technique
The ideal patient
– Slim leg
– Distortion of – 20°
– Good range of mobility
– Flexion of – 20°
– Not overweight
– Normal kneecap position
– No prior surgery for knee disease
– Non pronounced musculature
– Well-vascularised skin covering
The other type of patient
– A large leg
– Distortion of + 20°
– Limited mobility
– Previous surgery
– Significant musculature
– Poor skin condition
Why do I need a knee replacement?
The most frequent indication for PTH is knee osteoarthritis, which is the most common cause of knee pain from the age of 50 onwards. This is the most frequent type of osteoarthritis (three times more common than hip arthritis). In three quarters of cases, this is caused by internal tibiofemoral damage.
The development of knee osteoarthritis is progressive:
> Pain may radiate into the leg impairing walking in certain positions (rugged terrain, stairs, prolonged sitting positions and changing from sitting position to standing). Generally, when lifestyle is affected, one should consider having the knee joint replaced.
> Clinical examination shows an increase in size of knee through effusion, with points which painful to pressure at intervals on the exterior.
> A lateral movement that reflects osteocartilaginous wear, sometimes masked by a ligament retraction in the concavity,
> Review of morhotype: knee which deforms legs in O or genu valgum that distorts legs in X.
If, after following the treatment process (rehabilitation, reduction, medical, arthroscopy) no improvement in movement has been experienced, a knee prosthesis fitting is recommended.
What is a full knee replacement?
Replacement of the knee joint involves resurfacing the bone with a prosthesis. Like a normal knee, the prosthesis has surfaces which will allow support of specific loads. At present, the use of PTG is as safe as PTH, even if the knee joint is much more complex and less stable than the hip joint.
How is an artificial knee joint made?
The materials used to manufacture artificial joints play a crucial role: the implants are subject to extreme loads inside the body, which means particularly high resistance is necessary to withstand all load cycles during the period of use. Currently, the PTG components are heat forged so that resistance is optimised, providing excellent metallurgical and physical results.
How soon after surgery can I resume normal activity?
Traumatic injuries are decreased, pain is lessened, stability is maximised because the risk of dislocation is reduced: recovery is facilitated and return to daily activities is faster, and depends on the patient’s physical condition.
What is the postoperative follow-up?
The surgeon instigates a check-up protocol over a period of several months, during which time physical therapy is prescribed. The number of sessions varies depending on the patient’s recovery. Even though pain diminishes quickly and the prosthesis may be “unconscious”, it is important to follow the instructions of the surgeon.
The Physio “the patient recovers his well-being quickly”
The patient’s recovery is much simpler, because their mobility is increased. They recover their independence more quickly: after the second day, they may walk with only one stick. Rehabilitation is no longer focused on the recovery of independence, but on functional recovery. The patient is not “obscured” by pain or local care: they may recover overall well-being much faster than through conventional techniques.