Total Hip Replacement

Abstract

The surgical procedure known as total hip replacement was developed primarily for patients suffering from severe arthritis of the hip. On admission, the patient is hobbling down the hall with aid of a cane. one or two crutches, a walker. or he may even be in a wheelchair with signs of severe pain on his face. Then, two weeks after his surgery. the patient is bearing full weight on the operative leg, has a relaxed smile on his face. is walking with a straight back, and is using a cane only for support. He is ready for discharge and is well on the way to leading a normal active life again. In the surgical procedure performed here at Cedars of Lebanon Hospital in Los Angeles by Drs. Sidney Grant, Mark Stern, and Phillip Spiegel. the acetabulum is replaced by one of polyethylene plastic and the head of the femur is replaced by a metal prosthesis. Both appliances are fixed into position with a cement. methyl methacrylate, which is mixed from a powder and liquid at the time of surgery. This surgery has been performed extensively in Great Britain and Canada. butt not as frequently in this country because the cement has not received Food and Drug Administration approval for general use. The criteria for patients undergoing total hip replacement at Cedars of Lebanon are that the patients be over 55 years of age, have no history of osteomyelitis or wound infections. and are well motivated. Other important criteria are that the severity of arthritic pain is increasing and that other forms of reconstructive surgery. have either failed or are not feasible. If both hips of a patient are affected, the second operation is done six months after the first.