Hip Replacement in Houston: Magnum Hip Replacement Makes the Total Hip Replacement Procedure Even Better
Considering a hip replacement in Houston? The total hip replacement procedure is one of the best operations in orthopedics. Magnum hip replacement has made this operation even better. Magnum hip replacement is now being referred to as “anatomical” hip replacement because the implant mimics the natural size of the patients own hip. There are two major advantages from Magnum hip replacement. First, the anatomical size of the implant with the large ball and socket makes the goal of surgery, walking without a limp and no pain, much more likely. Second, Magnum replacement makes the most common complication of hip replacement, dislocation of the ball from the socket, very unlikely.
Advances in Total Hip Replacement
The primary concern of the patient who requires a total hip replacement procedure should be how well it works, and the length of time the implant will function and provide satisfactory results.
A total hip consists of two components, a cup and a stem which has a ball attached to it. When total hip replacement was first developed, the implants were cemented on both the pelvis side and the femoral side. Cement has been shown to last about 10 to 15 years. For this reason, Boney-ingrowth hip replacement was developed. Boney-ingrowth hip replacements have a titanium porous metal surface to allow the patients own bone to grow into the prosthesis and hold it in place without cement. This type of metal fixation to bone without cement has the potential to last a lifetime. Dr. Likover, a hip surgeon in Houston, performs almost exclusively Boney-ingrowth total hip replacement for this reason on both femoral side and cup side.
Ceramic, Metal on Metal Magnum Hip Replacement
The other issue, which is the factor in the length of survival of the implant, is the junction between the ball and the socket known as the "interface". Originally, total hip replacement was developed with a metal ball and a polyethylene (plastic) socket. It has been shown over time that polyethylene without a metal backing deforms and wears out. Metal-backed polyethylene sockets have been used in America for many years, and still are in many cases. The newest interfaces now available are either metal-on-metal with a solid metal socket, ceramic on ceramic with a metal backed socket, or an E-polyethylene socket with a metal backing. The stem in all cases is bony in-growth porous metal. Both metal-on-metal and ceramic on ceramic interfaces have the potential to last a lifetime. There have been problems with ceramic on ceramic squeaking and thus Dr. Likover uses only ceramic head on polyethylene dual mobility "big ball" magnum implants.
The most common complications of small ball hip replacement is hip dislocation. If the patient inadvertently assumes a squatting position, crosses his or her legs or trips and falls, these abnormal positions might cause the ball to dislocate from the socket after it has been implanted. A dislocation of the ball from the socket usually requires to patient to come to the hospital and be placed under anesthesia to allow the doctor to pull the implant back into place. By using a big ball and a big socket, the chance of dislocation is greatly reduced because it is very difficult for a large ball to come out from the socket. The original hip replacement had a very small ball (22mm) and dislocation of the ball was a very common problem, especially in the early postoperative period. A big ball implant uses an implant about the same size and the patient’s natural hip. Sometimes the ball is 55 mm across which is almost triple the size of the ball of the original total hip replacements(22mm Ball).
New Magnum Dual Mobility Hip Replacement to Avoid Metal on Metal Potential Problems
Magnum hip replacement was initially done with metal on metal. A concern has developed since 2011 whether a metal on metal implant will cause increased metal ions in the blood such as chromium ion and nickel ion. Metal ions have not been shown to cause illness or damage the human body in a large number of cases. A magnum hip with the benefit of a low dislocation rate can now be done with a metal-polyeythylene interface avoiding the issue of metal ions being released from a metal on metal inter-phase. This is new in 2011. This type of hip is called a “dual mobility hip”. It is currently not recommended to do metal on metal in females. In men it is still reasonable. If you are concerned about metal ions, a dual mobility mangnum hip with a very low dislocation rate due to the natural and large size of the ball and cup is the hip for you. The hip is placed with porous in-growth stem and cup made out of porous titanium with no cement used on either component.
Total Hip Replacement Recovery & Restrictions
People ask about an anterior approach versus a posterior approach. Anterior approach has been promoted by some surgeons as “better”. All studies show the results and rate of recovery are the same for either approach. Dr. Likover’s patients average two nights in the hospital following a total hip replacement procedure. Post op care with a non-magnum hip has life long restrictions against crossing the legs or bending over. A magnum hip does not require these restrictions of your personal activity.
Minimally Invasive Hip Replacement
A word about "minimally invasive" hip replacement. Minimally invasive has been promoted by various orthopedic surgeons as a "major breakthrough." This has turned out to be a lot of "hype”. Basically, with this type a procedure the incision is so small the surgeon cannot see what he is doing.
This type of surgery can result in the implants being placed in a poor position causing all types of problems including instability, dislocation and earlier failure of the implants. Dr. Likover performs a total hip replacement procedure with as small an incision as possible. It is far more important to get the implant positioned correctly for a successful outcome than to be overly focused on the size of the skin incision.
Dr. Likover allows his patients to discontinue crutches as soon as possible and switch to a single crutch or cane at the patient's own rate. Usually by three to four weeks following the surgery, the patient is walking quite nicely without support. Total hip replacement patients usually improve their gait pattern for several months, and by four to six months, it is difficult in many cases to detect that the person had any surgery, let alone hip disease. Many patients walk normally without the slightest limp.
If you have any further questions about a Magnum hip replacement in Houston, please contact me and I will be happy to answer them. Send me a message.