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- Hip osteoarthritis is a common problem
as you reach middle age,
yet there are very few long-term solutions
for treating it.
We're going to talk today about the most popular procedure
for treating hip osteoarthritis, a hip replacement.
Your hip is a ball and socket joint.
The socket forms a deep cup and surrounds
the ball of your femur or upper thigh bone.
There are thick muscles surrounding
the front and back of your thigh.
This combination of a deep socket and strong musculature
make your hip a very mobile yet stable joint.
The surfaces of the ball and socket joint in your hip
are covered with a smooth, slick
cartilage surface or gristle.
As you age, this surface wears and tears.
It's just like losing tread on a tire.
The surface that wears the fastest
is the one that has the most stress placed on it
when you're bearing weight.
Once the surface wears away,
the bones of your ball and socket joint
start to rub against one another,
and you have hip pain.
A hip replacement eliminates your pain
by stopping the bones from rubbing against each other.
This procedure gives your ball and socket
a new joint surface, which glides smoothly
and without pain.
It's important to understand how your hip pain develops,
as well as what happens when you get a hip replacement.
Let's take a look at the anatomy
or parts list of your hip.
First of all, we have the ball of the ball and socket joint.
The ball is connected to the end
of the thigh bone or femur.
The ball sits in the socket, and the socket
is a portion of the ilium bone.
The ilIum bone connects to the tailbone or sacrum.
Above the sacrum is the spine.
So again, we have this big bone called the ilIum.
On the end of the ilium, we have the socket,
the socket which has on its surface
that nice smooth gristle.
In the socket sits the ball of the hip joint,
again on the ends of the ball is nice smooth gristle.
The ball sits on top of the thigh bone,
which is called the femur.
This is the normal parts list.
What happens when we have arthritis of the hip,
or an arthritic hip?
Well, the ball, which is normally smooth and round,
develops some flattening, the gristle wears away,
and often bone spurs develop.
The thigh bone often stays normal.
Also the socket develops some wear and tear.
Again, the gristle wears away,
and there's often some large spurs
around the socket as well.
So again, this is an arthritic or worn socket.
Arthritic, worn out ball,
sitting in an arthritic, worn out socket.
What happens in a hip replacement?
First of all, what do we remove?
Well, we remove the entire ball,
and we do so by cutting the bone at this level
that we call the neck, so that we are left with
something that looks like this.
The entire thigh bone, save the ball.
The ball we remove, and we throw it away
in the garbage pail.
We put in a new ball that's metal.
Red is supposed to be metal.
There's the middle of the ball.
The ball is attached to a metal stem
that is inserted into your thigh bone.
How about the socket?
Well, we also put in a new socket.
This socket can either be metal or plastic.
So we have a new ball, which is metal,
connected to a stem, and a new socket,
which can either be metal or plastic.
Hence a hip replacement.
There are several factors that can contribute
to the development of hip osteoarthritis.
Any one or combination of these factors
puts you at an elevated risk.
First, previous hip injuries.
These can be from old sports injuries,
fractures, or any previous trauma to your hip.
Hip alignment.
The alignment of your hip can be altered
also from any previous fracture or injury.
But it can also be congenital,
meaning you were born with it.
Think of your hip as a balanced tire.
If it is out of alignment, it leads to wear and tear
of the surface with the most pressure on it.
Family history, genetics.
If your parents, your siblings, your grandparents
had hip osteoarthritis, there might be a likelihood
that you will also have it.
Finally, avascular necrosis, sometimes called AVN.
Well, with this AVN, the ball portion
of your ball and socket joint,
loses part of its blood supply and dies.
This accelerates the wear and tear in your hip.
The development of AVN is usually caused
by alcoholism, previous fractures
or dislocations around the hip,
or sometimes steroid treatment for other diseases.
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