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7.11.2018

Do not be afraid of hip surgery!

Artificial replacement of hip joints is one of the most common orthopedic surgeries besides knee surgeries. Although it is now more routine at major clinics, many patients push the hip surgery as long as possible, despite the severe pain.

Around 220,000 new hip joints are used annually in Germany. One of the most frequently asked questions is: When is the right time for a hip replacement surgery? The answer to this can vary greatly from patient to patient. "When all conservative measures such as physiotherapy and pain medication are exhausted and the daily routine of the patient is severely limited, often only one surgery is helpful, but ultimately the patient decides for himself", says Senior Physician Szymon Goralski of the Orthopedic Department at the University Hospital Leipzig.

He understands well the fears of the patient before the procedure. Many reservations can be cleared up in an explanatory discussion in the endoprosthetics consultation, the hip expert is convinced. The biggest concerns are, according to his experience, that after the operation, you no longer wake up from anesthesia or have severe pain afterwards. Both are unjustified from the medical practitioner's point of view. The procedure takes less than an hour. Patients do not necessarily need general anesthesia, but can watch the operation with regional anesthesia in the spinal cord.

"No one has to worry about pain, and special pain therapies help keep patients low on pain," explains Szymon Goralski. This also helps the doctors: the less pain, the better the healing process and the faster the patients are fit and mobile again.

Risks and complications

One of the most common complications after a hip operation is a relaxation of artificial spare parts. However, this usually only occurs after many years and is a normal wear and tear process. Even today, when using materials that have very little wear, an artificial joint holds on average only about twenty to twenty-five years.

After a fall or accident, it can also happen that the joint is dislocated or dislocated. However, this is rare. Both complications can be delayed or even prevented if the joint is surrounded by strong musculature that protects and strengthens it.

"Most of all, we doctors fear a bacterial infection on the joint," explains orthopedist Szymon Goralski. If germs have settled, often only a change of the artificial joint helps, so it must be operated again. To prevent this, the University Hospital Leipzig has imposed high standards of hygiene. Supported by a professor of hospital hygiene, hygiene measures have been introduced since the beginning of this year and are being implemented before the operation: on the eve of the operation, patients use a special antibacterial wash gel to reduce the number of germs on the skin. Otherwise they could invade the wound during the operation and later cause unwanted infections. In addition, they must not show any signs of infection before the operation, otherwise the surgery appointment will be postponed.

During the actual operation, the physicians use so-called minimally invasive techniques to ensure that the wound remains as small as possible and bleeds only slightly. The surrounding tissue and especially the muscles are largely spared. Wound drains, catheters and tubes are dispensed with in order to prevent germs from entering the inlet. Still in the operating room, a sterile, transparent bandage is created, which does not have to be changed during the entire stay in the hospital. So the wound stays germ-free all the time and the doctors still see if everything heals well. This allows patients to be mobilized faster.

Whereas patients had to stay in bed for days afterwards, today it is known that it is better to get up as soon as possible after the operation. So less muscle is broken down. With the help of physiotherapists, they are already on their own two hours after the procedure and, for example, can go to the toilet on their own.

"Fast track", meaning "speedy recovery", is the name of the program that actively supports the healing process. If the wound is dry, the patients can dress themselves again and go up and down stairs, it usually goes back home after only six to ten days.

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