What happens during the operation?

Anaesthesia

The operation can be performed under a general or local anaesthetic (epidural). Both methods offer advantages: with a general anaesthetic, the muscles are more relaxed, which is important for the operation, whilst a local anaesthetic has less effect on the patient's general condition. The method used depends on a number of individual factors – the decision is reached and information provided during the preoperative discussion with the anaesthetist. The entire procedure normally takes between 45 and 120 minutes.

Start of the operation

Once the anaesthetic has taken effect, the patient is moved into the supine or lateral position on the operating table. The leg to be operated on is then disinfected and covered with sterile drapes.

The surgeon makes an incision of around 20 cm in length in the outer side of the femur. The tissue below is pushed to the side in order to expose the hip joint. The surgeon now has a good view of all the parts of the hip joint. He then transects the femoral neck and removes the damaged femoral head.

Question: What is the difference between standard and minimally invasive surgical techniques?: The length of the surgical incision varies from case to case and with standard hip prosthesis operations it is between 10 cm and 30 cm. This provides the surgeon with an excellent view of the site of the operation but on the down side the healing phase takes longer as a greater amount of tissue must heal.
Consequently, over the last few years minimally invasive surgical techniques have been developed increasingly. The skin incision with such methods is not only shorter (8 cm to 10 cm) but the operation is also particularly atraumatic for all the other structures such as the muscles and ligaments. This means the healing phase is shorter. However, this surgical method is not suitable for all patients. Consult your attending doctor.

Replacement of the acetabulum

The surgeon then prepares the acetabulum for placement of the prosthetic cup: he firstly mills out the worn acetabulum in order to remove the damaged cartilage and create room for the prosthetic cup. This is then placed in the pelvis bone, when doing this the surgeon must ensure that it is correctly aligned. There are a variety of ways to secure the artificial acetabular cup in the bone: it can be wedged or screwed into the bone or securely bonded to the bone using bone cement.

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