Artificial femoral head replacement

As we all know, the reason why people can stand and walk is that our bones support our bodies. But sometimes, accidents or illnesses always cause problems with our bones. At this time, artificial hip replacement is needed to help people replace the unusable bones. Artificial femoral head replacement is a very mature technology, but patients should also pay attention to some complications.

The most common femoral head disease is femoral head necrosis. For those who are on the verge of collapse or have already collapsed and deformed, and who suffer from long-term pain and functional disabilities, artificial hip replacement surgery can be performed. The surgical technique is mature and has a high success rate. There are many types of artificial femoral heads, and their designs and materials are constantly being improved. Artificial femoral head replacement has the advantages of good joint movement and early getting out of bed. However, there are many complications, mainly four types: infection, dislocation, loosening and stem breakage, which are difficult to treat. Therefore, the indications for surgery should still be strictly controlled.

Comminuted fractures of the femoral head and neck; subcapital femoral neck fractures in the elderly; patients with failed reduction of femoral neck fractures; patients with nonunion of old femoral neck fractures, in which the bone of the femoral neck has been absorbed while the acetabulum remains normal; patients with femoral neck fractures who cannot cooperate well with treatment, such as hemiplegia and Parkinson's disease; patients with benign femoral head tumors who are not suitable for scraping and bone grafting; for pathological femoral neck fractures caused by malignant metastatic tumors, artificial femoral head replacement can also be performed to relieve the patient's pain.

Surgical procedures

① Make a posterolateral incision.

② After exposing the hip joint capsule, make a T-shaped incision along the edge of the acetabulum and suspend the edge of the joint capsule with a thick silk thread. Preserve the joint capsule and acetabular labrum. Remove the femoral head.

③ Trim the femoral neck stump, retain the medial cortex of the femoral neck above the lesser trochanter, and trim the lateral cortical bone of the femoral neck to the base of the greater trochanter. The femoral neck was trimmed so that the length of the cortical bone left in front and behind the cut surface was equal.

④ To expand the medullary cavity, the medullary cavity file should be inserted into the medullary cavity close to the trochanteric side. Fill the bone cement into the medullary cavity after it is balled up, insert the prosthesis, make the neck support contact with the femoral neck, and maintain the anteversion angle until the bone cement solidifies.

⑤Reposition the artificial femoral head and remove the broken bones or bone cement blocks in the acetabulum after reduction. After the femoral head is reduced, the two silk threads that pull the joint capsule are ligated. The posterior joint capsule is sutured. Suture the muscles and skin.

Postoperative Care

Postoperative care: The leg is immobilized, and depending on the pain tolerance, care can be provided for activities and further functional rehabilitation.