What is a Total Hip Replacement?
(Left) The individual components of a total hip replacement. (Center) The components merged into an implant. (Right) The implant as it fits into the hip. Courtesy of https://orthoinfo.aaos.org/
When the hip joint has worn to the point when it no longer does its job, an artificial hip (called a prosthesis or implant) can take its place. The surgery to implant prosthesis is called a total hip replacement. Total hip replacement entails replacing the acetabulum with an artificial liner as well as replacing the proximal femur or thigh bone with an artificial stem. It is an excellent procedure for the treatment of hip pain and arthritis. Furthermore, it provides for a more mobile hip. The most apparent benefit of hip replacement is dramatic pain relief period almost all patients have complete, or near complete, relief of pain. As the pain lessons, function also improves. Most patients have better range of motion and less limping. Implants are made of metal alloys and strong plastic parts and can be joined to your bone with a press-fit or by acrylic cement.
WHAT IS ROBOTIC-ASSISTED JOINT REPLACEMENT?
Robotic orthopedic surgery Is an innovative procedure that utilizes the precision of the robotic-arm system to help with total and partial knee replacement surgery, as well as total hip replacements. A virtual 3D model of your joint is built after CT scan, and then the robotic arm helps to guide the orthopedic surgeon through the procedure. It also allows the doctor to adjust your plan during the surgery itself. While studies are still being conducted on robotic surgery versus traditional joint replacement, one 2017 study found at 8 weeks post operatively, patients who had undergone robotic arm assisted surgery reported 55.4% lower pain scores than those who had gotten traditional joint replacement surgery.
During your surgical consultation, you and Dr. Siddiqi may decide to proceed with robotic assisted surgery. This would include the need to have one additional diagnostic test done. You will need to have a CT scan performed at one of our recommended Imaging facilities that are authorized and have the specialized equipment and protocol in place to perform this specific scan of your operative leg. This scan will create a 3D image of your joint you are having surgery on as well as a few additional images of your hip, femur (thigh bone), knee, tibia, and fibula (lower leg bones), and your ankle. This is NOT an MRI; you will NOT be placed in a small tube nor is there any IV contrast or dye used for this scan. It should take approximately 15 minutes to complete the scan. Ideally, we recommend that you have this scan done approximately 1-2 months prior to your surgery so that we can be sure it is completed. If your scan is greater than 6 months old, you will need to repeat the scan as your bones change.
WHAT IS THE DIFFERENCE BETWEEN TRADITIONAL SURGERY AND ROBOTIC SURGERY?
During both traditional and robotic surgery, the muscles and tendons will not be cut. Traditional surgery relies on the surgeon to determine the appropriate cuts into the bone for appliance (prosthesis) application. Robotic surgery uses the computerized images created from your CT scan to create a 3D blueprint to determine diseased bone (arthritis bone) and good healthy bone. The surgeon then operates the robot as a guide to cut away this bone tissue to make a more precise cuts, prosthesis placement, leg alignment, and soft tissue balance.
WHAT SURGICAL APPROACH IS USED FOR HIP REPLACEMENT?
We perform a direct anterior approach to the hip for all primary and revision surgeries. The direct anterior approach based on the literature and our own experience has shown to have patients return to their activities of daily living and high impact activities quickly.