Total Hip Arthroplasty

During the weeks of February 7 through February 17, I observed a total hip arthroplasty on a 56-year-old Caucasian female patient who suffered from a femoral neck fracture and damage to the acetabulum. The fracture was a result from a car accident where the patient's knees collided with the dashboard, forcing the femur into the hip and breaking the femur.

For this report I will concentrate on total hip replacement, its components, main surgical technique, and complications. Sir John Charnley first developed total joint arthroplasty in the 1960s (Skinner 395). In a total hip replacement "the articular surfaces of the acetabulum and femoral head are replaced" (Lemone 1241). A prosthesis is then used to replace the entire head of the femur and a portion of the femoral neck. A prosthesis of ultrahigh-molecular-weight polyethylene (UHMWPE) is then inserted into the remodeled acetabulum (Lemone 1242 & Skinner 395). The original procedure developed by Charnley consisted of a stainless steel prosthesis for the femur and a 22-mm femoral head. Now we have different femoral head sizes (22, 25, 25.4, 28, 32, and 35mm) and different femoral lengths ranging from 110-160mm (Skinner 395). The bone attachment technique has also evolved during the years into two generic designs, the cement fixation and the porous ingrowth prostheses (Skinner 395).

Cement and uncemented are the two basic types of total hip replacement. Both types have the same bearing surfaces, either ceramic or cobalt chromium alloy that articulates with a UHMWPE bearing surface (Skinner 399). Ceramic and cobalt chromium alloy each have their own set of pros and cons. Ceramic heads will theoretically produce less debris and result in a longer life of the hip replacement, but c...

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...held screwdriver. Total hip arthroplasty has introduced me to orthopedics, a field of medicine that manages to incorporate tools I am accustomed to dealing with.

Works Cited

"Arthroplasty and Total Joint Replacement." The Lippincott Manual of Nursing Practice. Ed. Sandra M. Nettina. 7th ed. Philadelphia: Lippincott, 2001. 993-995.

Lemone, Priscilla, RN, DSN, and Karen Burke, RN, MS. "Joint Arthroplasty." Medical-Surgical Nursing. 3rd ed. Upper Saddle River: Pearson Education, 2004. 1241-1243.

Lusardi, Michelle M., PhD, P.T., and Caroline C. Nielsen, PhD. "Use of Orthoses in Total Hip Arthroplasty." Orthotics and Prosthetics in Rehabilitation. Boston: Butterworth-Heinemann, 2000. 227-230.

"Total Joint Arthroplasty." Current Diagnosis & Treatment in Orthopedics. Ed. Harry B. Skinner, MD, PhD. 3rd ed. New York: Lange Medical Books, 2003. 395-396, 398-403.