In our institution, classic implant of complete hip endoprosthesis lasts between 60 and 90 minutes. After preoperative treatment, the patient undergoes an operation, which includes a precise operative technique of approaching the hip joint which is then dislocated. It should be noted that the damage to the muscles is minimal, which enables a fast rehabilitation with the preserved function of hip muscles. After dislocation, the femur neck is sawn and removed together with the head. After that, the operating physician continues with the treatment of acetabulum (concave part of the joint in the pelvis). Acetabulum is widened with special instruments to the desired size, which was preoperatively measured in the X-ray image. Afterwards, depending on the type of endoprosthesis, the cup is placed. With cement-free endoprosthesis, the cup is thrust into the pelvis and may be additionally fixed with special screws. With cement endoprosthesis, the cement is used as a means for fastening the cup to the acetabulum bone.
After placing the cup, the same approach is applied to the preparation of the femur (upper leg bone). Firstly, the central bone canal is widened to the required size, then the femoral part of endoprosthesis (stem) is fastened. With cement-free endoprosthesis, the stem is driven into the femur, while with the cement stem, the stem is used the same way as for the cup. After implanting the stem, the head is placed on it, and the parts are repositioned (the head is placed back into the cup). All three components of endoprosthesis (head, stem and cup) are manufactures in several sizes, and are individually adjusted to every patient. Thus, the anatomy of the hip is reconstructed and the length of legs evened, as they are often uneven before the operation. After checking the movement of the joint and its stability, the operative field is closed by stitching the joint capsule, then the musculature and the final subskin, by special intracutaneous stitches located under the skin level, which cannot be seen. Such stitches do not need to be removed, and they are aesthetically most acceptable owing to the thin scar they make which eventually fades.
Four days after the operation, the patients are released from our institution and are recommended to continue with stationary physical therapy in one of the rehabilitation institutions for the following three weeks.
On arrival to the hospital, the patient should bring all original reports of the required laboratory and other tests (not more than 15 days old): leucocytes, erythrocytes, thrombocytes, haemoglobin, haematocrit, glucose, natrium, potassium, CRP, PV, APVT, fibrinogen, BLOOD TYPE AND Rh, irregular antibodies, urine (sterile!) 2. ECG, heart and lung X-ray.
Mira, Diana and Željka – hospital administrators
Phone: 00385-51-277-350 and 00385-51-277-406