Move Ahead with Confidence. Hip Replacement Solutions from DePuy Orthopaedics

Transcription

1 Move Ahead with Confidence Hip Replacement Solutions from DePuy Orthopaedics

2 The Healthy Hip Joint Pelvis Acetabulum (hip socket) Head of femur Neck of femur Femur (thigh bone) Head of femur in the acetabulum The hip is a ball and socket joint where the top of the thigh bone (femur) meets the socket of the pelvic bone (acetabulum). Hip bones are covered with a layer of smooth cartilage that cushions and protects the bones and allows you to move smoothly. Ligaments connect the bones of the joint to hold them in place and add strength and elasticity. Muscles and tendons keep the joint stable and mobile. Healthy hips allow you to move freely.

3 Hip Pain Arthritis is the leading cause of disability and the most frequent cause of discomfort and chronic hip pain. In fact, it s estimated that 1 in 5 people has some form of arthritis. Two-thirds of the people who have been diagnosed with arthritis are under the age of More than 650,000 in the UK have painful osteoarthritis in one or both hips, three quarters of whom are aged over A further one and a half million have X-ray evidence of hip osteoarthritis (but may not have any symptoms). 3 Of more than 100 types of arthritis, the following three are the most common causes of joint damage: Osteoarthritis Osteoarthritis is a disease which involves the wearing away of the normal smooth joint surfaces. This results in bone-on-bone contact, producing pain and stiffness. Rheumatoid Arthritis Rheumatoid arthritis is a systemic disease because it may attack any or all joints in the body. It affects women more often than men and can strike young and old alike. Unlike osteoarthritis, rheumatoid arthritis causes destruction of the joint through severe inflammation. The body s immune system attacks and destroys the (synovial) lining covering the joint capsule, the protective cartilage and the joint surface. This causes pain, swelling, joint damage and loss of mobility. Trauma-Related Arthritis Trauma-related arthritis results from damage to the joint from a previous injury. It also results in joint damage, pain and loss of mobility.

4 Osteoarthritis is a Degenerative Disease Healthy hip Diseased bone Diseased hip Osteoarthritis is a chronic condition characterised by the breakdown of the joint s cartilage. Wearing away of the normal smooth joint surfaces results in bone-on-bone contact, pain and stiffness. 4 Bone spur Thanks to hip replacements from DePuy Orthopaedics, more and more people are getting back to feeling like themselves. Erosion of cartilage

5 Osteoarthritis Gets Worse Over Time Pain, stiffness and reduced movement limit the activities you enjoy. Everyday activities like climbing stairs or getting in and out of the car become difficult. Hip replacement surgery can help reduce the pain and restore movement. Your surgeon will determine the hip implant system that is right for you.

6 Hip Replacement Surgery Preparing for Surgery Your surgeon will order tests to make sure you are healthy enough for surgery: Blood tests Electrocardiogram (ECG) Urine tests Chest x-rays There are some things your surgeon might recommend that you do to prepare for surgery: Lose weight if you are overweight Stop smoking Let your surgeon know about all medication you are taking you may need to stop taking certain medications before surgery After surgery Your surgeon will give you specific instructions about rehabilitation and recovery: Rehabilitation begins immediately after surgery Follow instructions and precautions for recovery at home More than two million hip replacements from DePuy Orthopaedics have been implanted worldwide. Julie, hip patient

7 Surgical Approaches for Total Hip Replacement The surgical approach for your total hip replacement depends on many factors including your surgeon s training and experience, and your weight and anatomy. Most incisions are between 10 and 22 cm long, depending on the approach and your specific anatomy. Anterior Approach Incision on the front of your hip Anterolateral Approach Incision on the side of your hip toward the front* Direct Lateral Approach Incision on the side of your hip* Posterolateral Approach Incision on the side of your hip toward the back Each surgical approach has advantages and disadvantages. Talk to your surgeon about which approach is right for you. * The Anterolateral and Direct Lateral approaches share similar skin incision sites as shown on the illustration. DePuy Orthopaedic is one of the first pioneering orthopaedic companies in the world. Fredrick, hip patient

8 How Hip Replacement Works Acetabular cup Liner Femoral head Femoral stem The cup and liner components replace your diseased hip socket. A femoral head and stem implant replace the diseased head and neck of your femur. Pelvis Femur During surgery, the acetabular cup and liner implant components are inserted into the pelvis. The diseased femoral head is removed and the femoral stem is inserted into the thigh bone.

9 PINNACLE Hip Solutions from DePuy Orthopaedics The DePuy Orthopaedics modular hip replacement system offers a range of components that allow your surgeon to choose the combination that s right for you. Established Product Range: Launched in 2001 Number Implanted Worldwide: Above 1 million (2012 data) Clinical Success: 96.0% survivorship of PINNACLE and CORAIL at 7 years Registry data from UK and Australia % survivorship of PINNACLE and CORAIL at 8 years From 1,582 implants in a multicentre study 7 Hip replacements from DePuy Orthopaedics offer advanced materials.

10 The Movement is in the Bearings DePuy Orthopaedics has led the way in the research and testing of advanced bearing options for patients. Bearings are where the head and cup liner meet and move against each other. Bearing elements can be metal, ceramic or polyethylene. Optimal bearing selection depends on your age, weight, activity level and other factors. Metal-on-Polyethylene The most commonly used bearing option Polyethylene accommodates various head sizes, so your surgeon can choose the implant that fits you best Durable and versatile for a precise insertion Ceramic-on-Polyethylene Ceramic used in a hip bearing is extremely hard and very smooth; to reduce the effects of friction as it moves Reduces wear on the polyethylene liner Ceramic is biologically inert it s tolerated well in the human body Ceramic-on-Ceramic Used for active patients because it offers durability and strength

11 A Range of Stems to Provide the Best Fit for You DePuy Orthopaedics, working with leading surgeons, developed cementless fixation for orthopaedic implants. Femoral stem of the hip system is inserted into your thigh bone (femur) and anchors your new hip joint in place. Advanced surface coatings enable femoral stems from DePuy Orthopaedics to achieve secure cementless fixation, contributing to a secure hip replacement. CORAIL Total Hip System With almost 25 years of clinical success the CORAIL stem has the most extensive experience of any hydroxyapatite (HA) coated femoral stem. Number of years in clinical use: 25 Number implanted worldwide: Over 900,000 Clinical success: 98.3% in place at 10 years 8 Major innovations: HA coating, Compaction Broaching and surgical preparation preserve more of your natural bone TRI-LOCK BPS (Bone Preservation Stem) This stem is smaller than many other stems, minimising the amount of bone removed during surgery. The high contact area and GRIPTION surface coating provide advanced fixation for today s more active patient. Extending proven TRI-LOCK heritage: the original TRI-LOCK stem was introduced in This implant was the first proximally coated taperedwedge hip stem available to orthopaedic surgeons and their patients. Since its introduction, the original TRI-LOCK stem has demonstrated 98% survivorship at 10 years. 9 Since the new version of TRI-LOCK was launched in 2008: 35,000 TRI-LOCK stems have been implanted worldwide. Major innovations introduced with TRI-LOCK BPS are: GRIPTION coating, optimised biomechanics, consistent seating height and implant geometry that preserves more of your natural bone.

12 Physical Therapy After 24 hours, you should begin to eat and drink regularly, according to your surgeon s direction. Your surgeon will recommend and supervise your hip rehabilitation program, which typically begins immediately after surgery. Isometric exercises (tightening muscles without moving the joint) will begin while you are still in bed. You may be instructed to do these exercises a number of times per day. You may be encouraged by the physiotherapist to move your ankle and other joints to remain strong. These exercises are designed to help you regain strength and mobility. The physiotherapist may teach you the safest methods for getting in and out of bed or a chair, on and off the toilet and other ways to protect your joint while you recover. Correct bed position do not sit up past 90 The physiotherapist may monitor your daily progress and inform your surgeon. Example of preparing to sit in a chair while using a walker

13 Progress The therapist may teach you how to dress, get out of bed without help and use a walker or crutches. You may continue to work to strengthen yourself in preparation for your return home. It is important for you to follow your surgeon s and physiotherapist s directions and proper positioning techniques throughout your rehabilitation. By the time you leave the hospital, you should be progressing well in regaining your mobility and stability. It is not uncommon to still experience some pain. Remember that full recovery typically takes three to six months. Home Care Just before being discharged, you may receive instructions for your at-home recovery. Once you arrive home, one of the first things you should do is call the surgeon and make an appointment for a follow-up visit. Look for any changes around your incision. Contact your surgeon if you develop any of the following: Drainage and/or unpleasant smell from the incision beyond 2 weeks Fever (temperature about 101 F or 38 C) for two days Increased swelling, tenderness, redness and/or pain Medication/Pain Control It is normal for you to have some discomfort. You may probably receive a prescription for pain medication before you go home. If a refill is needed, please call your GP or surgeon before you run out of medication. Please contact your GP if you have increased discomfort or pain.

14 Resuming Activities It s common for hip replacement patients to visit their surgeon at four to six weeks, three to six months and one year after surgery. Your surgeon may request to see you once a year after the first year, even if you are not having problems. Since recovery is different for each person, your surgeon will inform you when you can resume activities such as returning to work and driving. You may resume sexual activity at any time as long as you keep all hip precautions in mind. It is important to be active in order to control your weight and muscle tone. It generally takes two to three months before you can resume low-impact aerobic activities such as walking, bicycling and swimming. Jogging, high-impact aerobics and certain sports should be avoided. Although your new hip is made of very durable materials, it is subject to wear and tear. Important Safety Information As with any medical treatment, individual results may vary. The performance of hip replacements depends on age, weight, activity level and other factors. There are potential risks, and recovery takes time. People with conditions limiting rehabilitation should not have this surgery. Only an orthopaedic surgeon can tell if hip replacement is right for you.

15 Special Instructions Any infection must be promptly treated with proper antibiotics because infection can spread from one area to another through the bloodstream. Every effort must be made to prevent infection in your implant. Before undergoing any new treatment, you should always tell all your doctors (including dentists) that you have a hip replacement. If you are to have dental work performed, please call your GP prior to having this work done. Your GP will most likely prescribe an antibiotic for you. Antibiotics must be used before and after any medical or dental procedure a precaution that must be taken for the rest of your life.

16 References 1. Arthritis Prevalence: A Nation in Pain. Arthritis Foundation web site. Available at: Prevalence.pdf. Accessed June 12, Odding E, Valkenburg HA, Algra D, Vandenouweland FA, Grobbee DE, Hofman A. Associations of radiological osteoarthritis of the hip and knee with locomotor disability in the Rotterdam Study. Ann Rheum Dis 1998;57(4): Lanyon P, Muir K, Doherty S, Doherty M. Age and sex differences in hip joint space among asymptomatic subjects without structural change: implications for epidemiologic studies. Arthritis Rheum 2003;48(4): Arthritis Foundation Web site. Accessed November 15, National Joint Registry for England and Wales, NJR data from 1st April th March 2012 on DePuy products supplied for post-marketing surveillance, NJR Centre, Australian Orthopaedic Association National Joint Replacement Registry. Annual Report, Adelaide. AOA Retrieved from: 7. Barrett WP, Kindsfater K. 96.1% 8-Year Survival of the PINNACLE Multi-liner Acetabular Cup in a Prospective Multi-Center Study. DePuy Orthopaedics, Inc. Warsaw, IN. November Hallan G, Lie SA, Furnes O, Engesaeter LB, Vollset SE, Havelin LI. Medium and long-term performance of 11,516 uncemented primary femoral stems from the Norwegian arthroplasty register. J Bone Joint Surg [Br] 2007;89-B(12): Burt CF et al. A Femoral Component Inserted Without Cement in Total Hip Arthroplasty. A Study of the Tri-Lock Component with an Average Ten Year Duration of Follow-up. J Bone Joint Surg [Am] 1998;80-A(7): This publication is not intended for distribution in the USA. DePuy Orthopaedics EMEA is a trading division of DePuy International Limited. Registered Office: St. Anthony s Road, Leeds LS11 8DT, England Registered in England No DePuy Orthopaedics, Inc. 700 Orthopaedic Drive Warsaw, IN USA Tel: +1 (800) Fax: +1 (574) DePuy International Ltd St Anthony s Road Leeds LS11 8DT England Tel: +44 (0) Fax: +44 (0) DePuy International Ltd. and DePuy Orthopaedics, Inc All rights reserved version 1 Issued: 07/12 CA#DPEM/ORT/0612/0104