A hip prosthesis is the replacement of a damaged joint with an artificial joint consisting of a femoral component, a component in the pelvis (acetabulum) and an intermediate component between the two.
HIP REPLACEMENT IN ORTHOPAEDIC SURGERY
Hip replacement is the most commonly performedarthroplasty in France. It is essential in cases of severe and disabling osteoarthritis(coxarthrosis), as it is the only effective treatment, since infiltrations do not provide lasting relief, as they sometimes do in the case of the knee.
Decisive progress has been made over the last 10 years, both in terms of the prostheses themselves and the way they are fitted (anterior approach, 3D planning).
Clinique Paris-Lilas has acquired a special orthopaedic table for minimally invasive anterior placement of hip replacements.
In addition to the planning and use of modern cementless prostheses, this means we can look forward to a virtually "forgotten" prosthesis, with over 95% survival at 10 years, without complications or wear and tear, in patients who are being operated on at an ever younger age (120,000 fittings each year in France).
After 30 years of development, the usual complications of THA, such as loosening and wear, had mobilised research into the implants themselves, but not into how to place them (approach, conventional 2D planning methods).
The challenge, however, is to normalise walking after prosthesis, whatever the patient's age, type of sporting activity or cause of hip joint destruction.
Decisive progress has been made in this area over the last ten years, with :
the more widespread use of the anterior approach (without any muscle section, which in its minimally invasive form enables THR to be performed with an approach of around 7cm), but which is more technically demanding and requires the use of a special orthopaedic table, which is available at the Clinique Paris-Lilas.
the use of 3D computer planning based on a simple CT scan carried out in the clinic (with specific settings for the equipment), making it possible to predict more accurately the components to be fitted during the operation. If necessary, a custom-made prosthesis can be ordered.
association with an innovative form of care, Rapid Recovery After Surgery (RRAS), sometimes called Enhanced Recovery After Surgery, which places the patient at the centre of all medical decisions and care. It aims to achieve faster recovery of functional abilities after orthopaedic surgery, with the objective of a quicker return to the family environment and to normal daily activities, in complete safety. Its principles are based on the use of modern anaesthetics and injection protocols, combined with an effective organisational scheme involving information, preparation upstream of the care pathway and effective management of pain by anticipating its occurrence.
Ultimately, this approach makes it possible to
optimise the functional results and satisfaction of patients who are increasingly sporty and/or demanding, without the need for cumbersome logistics and on a routine basis.
make the procedure safer and quicker, by increasing its reproducibility (ideal choice and positioning of implants).
facilitate post-operative rehabilitation, resulting in a shorter hospital stay and more rewarding physiotherapy work for both parties.
hope for a rapid return to normal life, with a "forgotten" prosthesis, in a patient who is involved and empowered.
hope for increased longevity of the THP in young, active patients, whose anatomical and biomechanical characteristics will have been restored as well as possible (although the patient should be informed of the greater risk of wear in the event of intensive sports practice).
avoid foreseeable problems in the short, medium and long term, which guarantees optimum results for both the patient and the treatment team.
