An increasing number of procedures are being performed on young and active individuals who aim to return to an active lifestyle, thanks to the latest-generation hip prosthesis. Every year over 600,000 hip replacement surgeries are performed worldwide. A prestigious scientific journal, “The Lancet,” has dubbed total hip replacement surgery as the surgery of the century
It’s a highly successful procedure capable of resolving hip disability and pain.
Over time the surgery has undergone various modifications both in terms of surgical techniques and materials.
Until a few decades ago the operation was mainly reserved for elderly individuals.
It was performed when degenerative arthritic conditions prevented them from walking, limited mobility in daily activities, and most importantly hindered a pain-free and independent life.
Nowadays an increasing number of surgeries are performed on younger patients, including athletes, who need to return to an active life without functional limitations.
Thanks to state-of-the-art hip prosthesis all of this is possible.
Faster recovery times, longer implant lifespan and reduced stress for the patient are all benefits.
The possibility of a shorter hospital stay duration for such surgeries is undoubtedly an important factor for reducing hospital costs as well.
Advancements in the procedure
There are three factors that have contributed to the advancement of this procedure.
Minimally invasive approaches to the hip joint
Minimally invasive approaches include two main options: the modified postero-lateral and anterior approaches.
Both allow access to the hip joint while minimizing aggression on soft tissues, tendons, and muscles, reducing bleeding, post-operative pain, and the risk of hip dislocation.
This helps patients to quickly resume their normal lives.
Additionally, these approaches have the advantage of leaving a very small scar relative to the patient’s physical structure.
Innovation in prosthetic designs
Smaller and less invasive stems allow for smaller surgical incisions and significant bone preservation.
This is made possible by advancements in scientific and engineering knowledge regarding materials.
If replacement of the femoral stem is necessary due to a complication, it will be possible to remove a mini-invasive stem and replace it with a traditional one.
This procedure is much less aggressive than revision with the long stems typically required.
Improved prosthetic materials
The study and development of materials increasingly resistant to wear have been the most significant area of improvement to ensure the longevity of implants.
Modern femoral stems feature osseointegrated coatings that firmly and quickly anchor to the bone, becoming part of it.
Acetabular cups are made of titanium with a three-dimensional shape similar to bone, which allows for quick ingrowth of bone tissue, growing inside and around it.
The most commonly used coupling involves a ceramic femoral head (highly wear-resistant) with a polyethylene acetabular insert.
Modern polyethylenes are processed to ensure tremendous wear resistance and resistance to oxidative stress, with a significantly longer lifespan than older-generation polyethylenes.
The durability of hip prostheses has been confirmed to exceed 30 years.
Once the prosthesis is implanted, stability is achieved to the extent that the patient can bear weight on the operated joint from the first day after the surgery, which is especially important for older individuals who need to walk as soon as possible.
In cases where the patient has severe bilateral hip osteoarthritis, simultaneous replacement of both hips can be planned.
This is possible thanks to minimally invasive techniques and is recommended for patients in good general condition.
Minimally invasive hip prosthesis: what does it involve?
It is a technique that allows for the replacement of the joint with safe and durable artificial prostheses, restoring joint functionality.
Minimally invasive hip replacement is the latest-generation technique, but not a novelty for many orthopedic surgeons who have been successfully performing such procedures for years.
Minimally invasive technique is a safe procedure, fast with quick recovery times.
It should be performed in specialized facilities by experienced surgeons using modern prostheses, characterized by high-quality materials and long-term durability assurance. Recovery is swift and the patient can start physiotherapy on the same day of the surgery and walk without crutches as early as 3-4 days after the operation.
All the advantages
The hip prosthesis designed for minimally invasive procedures is smaller than traditional ones, made of titanium, ceramic and polyethylene.
This latest-generation prosthesis allows for a minimal incision (7-10 cms compared to the 20-30 cms of the traditional technique), reducing the size of the scar.
It spares muscles, cartilage and bone parts, resulting in less pain and reduced bleeding.
Minimally invasive surgery also reduces pain, blood loss, hospital stay and recovery time.
The outcomes of hip prosthetic surgery are excellent and long-lasting.
The average lifespan of a hip prosthesis today
Technological innovations have extended the lifespan of a prosthesis, ensuring maximum patient safety for many years.
The average lifespan of a well-crafted implant, in a patient leading a healthy lifestyle, exceeds 25 years.
Several factors affect its longevity, including:
- trauma
- weight
- excessive physical stress
- other specific complications.
All materials are subject to wear, but technological innovations in this field offer advantages in terms of strength, biocompatibility and durability.
Each type of prosthesis today has the potential to be excellent in terms of reliability and safety, with features that make it more or less ideal for the patient’s needs and hip geometry.
That’s why each intervention is personalized for the patient.
How is the prosthesis composed?
The hip prosthesis is typically composed of the following materials:
- titanium
- ceramic
- polyethylene
When referring to materials for the latest generation of hip prostheses, it involves a combination of elements: the type of stem and the type of cup.
Each patient has their own prosthesis, depending on the shape of the joint, the quality of the bone and the patient’s age.
The surgical intervention begins with digital planning in which the surgeon selects the most suitable implant for that patient.
The choice of material combination depends on the patient’s age, type of pathology, available space, and any other existing conditions.
The most commonly used materials are the ceramic-ceramic coupling (an option for younger patients) and the ceramic-polyethylene coupling (the most widespread).
The latest generation of hip prostheses is considerably durable because they are made with better materials than in the past.
However, patients should take care of their prostheses by engaging in physical activity responsibly and prudently.
The implantation of a latest-generation prosthesis is a feature of Dr. Vanni Strigelli’s method: learn more on the dedicated page to the prosthesis intervention.
