Hip osteoarthritis

Generally for hip osteoarthritis 

If your hip (hip) you hurt during movement or even at rest and sleep and need intensive medication to relieve the symptoms then it is most likely to suffer from advanced osteoarthritis.
Osteoarthritis is a degenerative etiology that affects articular cartilage and subchondral bone of all body joints.

The loaded joints such as the knee and hip because they hold all the body exhibit more frequent and more intense symptoms and lead patients to Orthopaedic Surgeon to take the final treatment option.


Normal hip joint (AAOS)


Normal hip X-ray 


Hip osteoarthritis


Severe right hip osteoarthritis

Typical causes pain and reduced mobility of the hip joint

The most common causes of chronic pain and impaired function of this is arthritis. Osteoarthritis, rheumatoid arthritis and traumatic arthritis are the most common types of the disease ..

• Osteoarthritis usually occurs in people 50 years and older and often found hereditary history arthropathies, many times during the development of the hip early age observed dysplasia form which will lead to faster progression to the end time.

• Rheumatoid arthritis is an autoimmune disease with inflammation of the synovial membrane and premature deterioration of the articular cartilage of the joint resulting in faster onset of symptoms of pain and stiffness

• Traumatic arthritis usually follows an injury to the joint as a serious intra-articular fracture. The fracture may cause the irreversible necrosis of the femoral head known as osteonecrosis. Articular cartilage can be injured and soon to develop osteoarthritis.

ORTHOPEDIC DEVELOPMENTS: 

ALMIS - MINIMAL INVASIVE HIP ARTHROPLASTY

The modern technique ALMIS hip arthroplasty relates to minimal invasive joint replacement since during joint exposure the muscle structures are not cut but separated by creating a ‘contoured window' through which the surgery is conducted.

The advantages of ALMIS including the immediate and painless mobilization of the patient after surgery which minimizes the days of hospitalization and allows the patient to faster restoration of social and professional activities.

A further advantage of the method ALMIS over other minimal invasive methods is not use mechanical traction system of the lower limb during surgery may cause complications.

CONSERVATIVE TREATMENT
THERAPY: 

Osteoarthritis treated for many years with conservative treatment consisting of:

  • Stem cell therapy: Treatment with autologous stem cells is currently one of the most important developments in the field of regenerative medicine. The indications are from light to moderate arthritis of the hip joint and usually at ages up to 55-60 years. The aim of therapeutic approach with autologous stem cells is to halt the progression of arthritis and rebuild new cartilage cells in the joint. The process takes place in the operating room where bone marrow is obtained from the pelvis from which, after a specific treatment, isolated stem cells and under the direction of X-ray machine - C-arm, - injected exactly at the point of joint damage.


Under fluoroscopic vision, the needle is in the arthritic hip joint


The stem cells injection

• medications such as anti-inflammatory drugs, particularly protection formulations of articular cartilage such as chondroitin sulfate, hyaluronic acid. The sulphate chondroitine taken every day and for long periods which can reach 4-6 years with short breaks. Hyaluronic acid is mainly applied to intra-articular injection every 6 months at weekly administration (5 injections). Its action is essential lubricant since it offers the overworked joint components that enable to move with ease.
The intra-articular injection of collagen is now a new therapeutic approach with very good results in those cases in which the patient does not want the surgery of his problem.
The combination of intraarticular injections of hyaluronic acid and collagen is a modern therapeutic proposal.

• physiotherapy comprising exercise program to maintain muscle strength and balance between muscle groups, and also improve the range of motion thereof.

• special aids (cane, splints) may provide relief for some time.

• loss of unnecessary weight which puts not only the musculoskeletal system and the entire organization

• avoid excessive tiredness of the affected joint with relevant limit intense activities.

In advanced stages of osteoarthritis but these measures are not sufficient and need more radical solutions is imperative.

OPERATIVE TREATMENT
THERAPY: 

ALMIS HIP ARTHROPLASTY

​AnteroLateral Minimal Invasive Surgery

 

The Orthopaedic Surgeon in consultation with the patient and his family will decide together on the usefulness of surgery for each patient.

Total hip arthroplasty in force since 1960 and went through many stages of development and improvement as regards the materials and the design.

Today orthopedic community has in the hands of a wide range of designs and materials, each of them serves the specific needs of each individual and the peculiarities of diseases.

Especially chrome-cobalt and high strength ceramic materials alloys offer excellent anatomical fit and resistance over time.

The method Minimal Invasive Surgery based surgical philosophy surgery with minimal tissue damage.
In hip surgery today do not cut soft tissue - muscle, but access to the joint is the separation of muscle groups so as to approach or hinge surgically possible bloodless manner.

The benefits of ALMIS of this method is that the patient:

has minimal blood loss which means that you will not need to transfusion during or after surgery
minimal postoperative pain contributes to faster mobilization of the patient immediately after surgery
because the muscle groups not cut the person has faster recovery and return to daily activities
the use of devices such walker, crutches or walking stick remains at 20 days compared with the conventional method needed assist for six weeks.


Total arthroplasty of the right hip

From total hip arthroplasty find relief patients with symptoms such as:

• Pain in the hip which limits daily activities such as walking and rest.

• The pain continues during rest and sleep

• The rigidity limits the ability of motion and raising the leg

• Medication insufficient relief from symptoms

• Side effects of medication do not allow their use

• Other treatments such as physical therapy or the use of special walking aids can not cope

Woman 48 years old, profesional athlete with acetabular dysplasia and hip osteoarthritis.  ALMIS hip arthroplasty 17 days post op

Man 82 years old after minimal invasive total hip arthroplasty, 30 days postop

REHABILITATION: 

Παραμονή στο νοσοκομείο μετά το χειρουργείο

Η παραμονή στη κλινική θα κρατήσει από 2-3 ημέρες και θα εξαρτηθεί από την πορεία της υγείας του ασθενή και το επίπεδο της αποκατάστασής του.

Ο μετεγχειρητικός πόνος θα αντιμετωπιστεί εντατικά με τη λήψη ειδικών σύγχρονων φαρμάκων κάτω από τη πλήρη καθοδήγηση του θεράποντος Ορθοπαιδικού.

Κατά τη διάρκεια του κλινοστατισμού ένα χοντρό μαξιλάρι ανάμεσα στα πόδια θα εξασφαλίσει τη σωστή και ασφαλή θέση των ισχίων.

Η βάδιση και η ελαφρά δραστηριότητα είναι πολύ σημαντικά στοιχεία για την γρήγορη αποκατάσταση του ασθενή. Τα ειδικά βοηθήματα βάδισης (περπατούρα) θα χρειαστούν για τις πρώτες 15-20 μετεγχειρητικές ημέρες.

Οι ειδικές κάλτσες πρόληψης φλεβικής θρόμβωσης καθώς και η συσκευή ανύψωσης της λεκάνης της τουαλέτας θα συμπληρώσουν τον κύκλο προστασίας του ασθενή.

Φυσικοθεραπεία

Η φυσικοθεραπεία γίνεται σε καθημερινή βάση στη κλινική όπου πραγματοποιείται η εκμάθηση χρήσης των βοηθημάτων βάδισης, εφαρμογή προγράμματος ενίσχυσης των μυϊκών ομάδων, βελτίωση του εύρους κίνησης της πάσχουσας άρθρωσης καθώς και ασκήσεις βελτίωσης της αναπνευστικής λειτουργίας.

Η φυσικοθεραπεία θα συνεχιστεί και στο σπίτι για 10-15 συνεδρίες.

Καθημερινή φροντίδα του χειρουργικού τραύματος από τον Ορθοπαιδικό χειρουργό ο οποίος θα σας ενημερώνει για την εξέλιξη της υγείας σας. Τα ράμματα θα αφαιρεθούν σε 15 περίπου ημέρες από την ημέρα του χειρουργείου.

Διατροφή

Η διατροφή μετά το χειρουργείο πρέπει να αποτελείται ειδικά από κρέας (μοσχάρι, κοτόπουλο, χοιρινό), και πολλά φρούτα που θα εξασφαλίσουν επαρκή ποσότητα πρωτεϊνών και βιταμινών κα μετάλλων αντίστοιχα τα οποία θα βοηθήσουν στη γρηγορότερη και σωστότερη επούλωση των χειρουργικών τραυμάτων.

Για τις επόμενες 15-20 ημέρες η βάδιση θα γίνεται με υποβοήθηση με τη χρήση βακτηριών (πατερίτσες) ή περπατούρας.
Μετά τις έξι εβδομάδες από το χειρουργείο ο χειρουργημένος ασθενής μπορεί να περπατά ανεξάρτητος από βοηθήματα και να εντάσσεται στις καθημερινές του δραστηριότητες.

Η επιστροφή στην εργασία του θα χρειαστεί 2-3  μήνες ανάλογα της φύσης του επαγγέλματος του ασθενούς.