Hip joint endoprosthesis. Price, service life, photo, x-ray. Zimmer, Smith Nephew

In case of irreversible damage to the hip joint, doctors decide replace the injured bone tissue with an endoprosthesis. The price of such an operation is from 70,000 rubles. and varies from the type of prosthesis to be installed and the further observation of the attending specialist.

What materials are used for hip arthroplasty?

For the manufacture of endoprostheses, specialized metal alloys with a high survival rate, ceramics and ultra-durable polyethylene are used. The artificial joint consists of two parts: the femoral head articulated with a rounded cavity in the pelvic bones.

Between them there is a plastic spacer for increased mobility, which has high strength, increasing the service life while observing the recommended loads. Thanks to the materials used, the implant has unlimited mobility.

Some manufacturers use materials that have a low survival rate, so when buying an implant, it is important to know what materials the endoprosthesis is made of. This will help reduce the risks of developing serious complications.

Types of hip implants

There are 2 signs by which prostheses are divided: a friction unit, which implies between which materials movements will be carried out, and the type of fixation.

Types of friction units:

• Ceramics-polyethylene. This is a more durable analogue of the metal-polyethylene friction unit. The femoral head is ceramic and the spacer is made of polyethylene.
• Ceramics-ceramics. The most optimal choice, it has high stability and survival rate. Ceramic head and insert. Suitable for all types of patients with different physical activity, has a high cost, therefore it is rarely used.
• Metal-polyethylene. The head is made of metal, the liner is made of polyethylene. This friction pair is used for the longest time. Has good technical and wear characteristics. Suitable for patients with moderate physical activity
• Oxinium-polyethylene. This pair has a low coefficient of friction, which increases the service life of the prosthesis. The head is made of oxinium (an alloy of zirconium and niobium), the liner is made of polyethylene.

  

Fixation types:

• Cementless.
• Cement.
• Combined.

Fixation methods

There are several ways to fix the endoprosthesis. The choice of a certain one is influenced by the age of the operated person, his gender, and the peculiarity of the bends of the bone.

Cement

Cement fixation is performed using specialized bone cement, which is supplied in medical institutions not with a ready-made mixture, but separately a polymer powder with an initiator and an ampoule with monomer. They are mixed immediately before the operation, additional materials are added if necessary.

Such fixation is more preferable for older people, for women after menopause and those with a wide bone canal and thin bone walls.

Also, doctors decide to use the cement technique for infectious diseases, since cement can be add an antibiotic that suppresses inflammation, and rehabilitation with this method of fixation goes much faster.

Cementless

Cementless fixation implies the use of a prosthesis with a texture into which bone tissue can grow. In theory, this method increases the durability of the prosthesis, but has a large number of complications., as the bone may grow incorrectly, or the patient will not follow the recommendations prescribed by the doctor after the operation.

Also, the service life of the prosthesis is increased due to the fact that it is possible to select a specific pair of friction.

Due to the fact that antibiotics cannot be used with this technique, the risk of inflammation in patients with additional factors during healing increases.

In addition to the disadvantages in the form of a high risk of complications, cementless fixation is more expensive than cement fixation and requires long-term rehabilitation.

Combined

Hybrid commit involves the use of both methods. The leg is cemented into the femur bone, and the head is screwed into the calyx. According to long-term observations of doctors, such fixation is optimal for patients of all categories.

Indications and contraindications

Indications	Contraindications
Tumor processes in the hip joint and femur	Absolute contraindications	Relative contraindications
Fractures of the femoral neck	Severe osteoporosis	Varicose veins of the legs
Bilateral ankylosis of the hip joints	HIV infection	Obesity grade 3
Fracture of the hip bone in patients over 75 years of age	Technical impossibility of installing the implant	Hormonal osteopathy
Mental illness	Diseases of the internal organs
Femoral head necrosis	Incurable diseases of the endocrine system	Haemorrhoids

How to use a prosthesis

After the operation, a physiotherapy specialist begins to work with the patient during the first day, so that recovery occurs with a minimum risk of complications.

First, the patient is taught how to get out of bed and go to bed correctly, so that the rehabilitation proceeds correctly. The patient then re-learns to walk by performing specific exercises under the supervision of an instructor.

The first exercise performed by the patient is stair walking. Descent from the stairs begins with the operated leg, and the ascent from the healthy leg. There are several options for this exercise: walking with crutches without assistance and moving with the handrail.

Walking without help

Climb:

1. First, a healthy leg is placed on the next step.
2. Then, relying on crutches, move the leg with the endoprosthesis to the healthy limb.
3. Then rearrange the crutches to the legs.

Descent:

1. The first step is to move both crutches to a lower level.
2. Leaning on crutches, move the leg with the implant down.
3. Then move your good leg to the bottom step.

Moving with a stair rail

Climb:

1. First, the patient's hands move along the railing.
2. Then a step is performed with the healthy leg.
3. Then, leaning on the railing, the patient transfers the operated leg.

Descent:

1. At the beginning, the hands go down the railing to the level of the next staircase.
2. Then, with an emphasis on the hands, the leg with the prosthesis is moved.
3. Then a step is taken to a lower step with a healthy leg.

Rehabilitation tips:

• After surgery, sleeping on your side is limited to sleeping on the side of your healthy leg, which will reduce the risk of joint dislocation.
• Treatment of complications after colds must be accompanied by antibiotics.
• Within 3 months after the operation, it is worth limiting visits to the baths and saunas, as well as taking hot baths.
• After surgery, physical activity should be minimized for better implantation of the endoprosthesis.
• It is important to monitor your diet and control your weight gain, as sudden weight gain can lead to dislocation of the hip joint.
• Items weighing more than 3 kg cannot be carried.
• Preference should be given to physiological postures (not straining the body) or the horizontal position of the trunk.

Life time

A hip joint endoprosthesis, the price and service life of which depends on the materials used, is used on average for about 15-20 years. The strongest friction pair is oxinium-polyethylene; when using this unit, the service life can increase up to 30 years. When worn out, the endoprosthesis must be replaced.

Where to buy a hip joint replacement?

A hip joint endoprosthesis should only be purchased with the consent of the attending physician who will perform the operation. The price will depend on the chosen manufacturer of the implant, as well as on the nuances of the operation, such as a pair of friction and the method of fixation. A cement-retained endoprosthesis will be cheaper.

You can purchase an implant by placing an order online. The advantages of such a purchase are that there is a large selection of prostheses on the Internet with various friction units and methods. fixation, a variety of manufacturers and, accordingly, each patient can purchase an endoprosthesis at an acceptable its price.

It is also possible to purchase a hip joint endoprosthesis in the clinic where the operation is planned. This option will not cause trouble for the patient, since everything will be dealt with by the attending physician, who knows all the subtleties of choosing a good endoprosthesis.

Assortment of hip joint endoprostheses, their characteristics

The choice of endoprostheses on the traumatology market is quite wide. Their variety depends on the country of manufacture and the materials used in the implant.

Leading suppliers of endoprostheses in Russia:

• Zimmer.
• Biomet.
• Stryker.

Corail joint

Cementless hip joint replacement suitable for primary prosthetics. The manufacturing company has 30 years of experience in the production of endoprostheses and high survival rate.

Characteristics:

• Titanium alloy.
• High resistance to damage.
• High compatibility of the endoprosthesis with natural tissues of the body.
• The joint fits all articular heads.
• The anatomical shape of the joint prevents the implant from sinking.

DURALOC system

DURALOC Acetabular Cup Prosthesis is suitable for cementless hip replacement for the first and repeated use.

Characteristics:

• Choice of liner.
• Wide range of cup sizes.
• Materials with high survival rate.
• The minimum service life is 15 years.

Proxima model

The Proxima Hip Arthroplasty System is designed for initial implant placement.

Characteristics:

• The model can withstand high physical activity.
• The system provides the usual load on natural bone.
• Suitable for cementless prosthetics.

ASR system

This system of hip arthroplasty after the patent was considered the most optimal, but in the course of studies have shown that ASR implants have a high risk of complications and materials with a low acclimatization.

Pinnacle hs

One of the best hip replacement systems, as it is suitable for any patient. The doctor using this implant model has the opportunity to choose a pair of friction and the type of fixation, depending on the anatomical features of the patient and his lifestyle.

Characteristics:

• Choice of friction unit.
• The possibility of cement and cementless fixation, as well as their combination.

Endoprosthesis REEF

Characteristics:

• Suitable for patients of all ages.
• Has a cementless fixation.
• Designed for severely damaged bones and hip joints.
• The minimum service life of the implant is 13 years.

Zimmer

This implant has many varieties, but they all have approximately the same characteristics:

• High wear resistance (it is highly likely that the prosthesis will not have to be replaced).
• Large selection of femur shapes, which will allow doctors to take into account the anatomical features of the patient.
• Variety of joint head sizes.
• Choice of friction pair.

Smith nephew

The range of prostheses from this supplier is very wide, which allows you to choose the most suitable prosthesis for each person.

Characteristics:

• Anatomical shape that reduces stress on the hip joint.
• High mobility.
• Materials with a high survival rate.
• High strength.

The cost of the endoprosthesis and the procedure for its transplantation

A hip joint endoprosthesis (the cost of an implantation operation is at least 70,000 rubles) will be more expensive to install in a private clinic. The cost is also influenced by the skill level of the doctor.

The hip joint endoprosthesis, the price of which varies depending on the materials, has an initial cost of 90,000 rubles. and low technical and biological characteristics. Because of this, there is a risk of complications, and the service time of the implant is significantly reduced compared to more expensive counterparts.

High-quality materials used in the manufacture of a hip joint endoprosthesis will increase the likelihood of survival of the artificial joint. The higher the cost of the endoprosthesis, the longer its service life and the higher the survival rate. The maximum price reaches 120,000 rubles.

Hip replacement surgery is inevitable in case of serious damage to the bone tissue. The higher the price of the implanted bone implant, the lower the likelihood of complications and the longer the service life of the artificial joint.

Article design: Vladimir the Great

Video about hip endoprostheses

Malysheva on hip replacement: