Hip replacement most successful in modern surgery

Hamburg - It was just one careless step and as a result, Bertha Kaufmann twisted her foot and fell to the sidewalk.

"The top of my thigh bone was so badly broken that it also damaged my hip joint," the 83-year-old woman from Braunschweig, Germany said, recalling her accident nine years ago.

In Germany alone hundreds of thousands of people suffer the pain of problems with their hip, the second largest joint in the body. Often a replacement can help, as was the case with Kaufmann, who underwent hip replacement surgery after her fall.

"The cause of hip problems are many," said orthopaedic doctor and surgeon Klaus-Peter Guenther of the clinic at the technical university in Dresden. The most common cause is arthritis, which affects about 20 per cent of the population over
60 in Germany.

"The joint wears away completely over the years and ultimately every movement hurts," said Guenther.

Arthritis of the hip causes the joint's cartilage to be rubbed away by the heavy strains placed on it, leaving it ever thinner. The bone directly underneath the cartilage responds by compacting its structure. This is a protective mechanism, but it actually leads to a deformation of the joint, and that causes hip problems. These cases typically can be resolved with medicines and by hip replacement surgery.

Another lesser known cause of hip problems is a deformity of the bones in childhood.

"Hip dysplasia is one of the most common disorders in newborns," said Guenther. It involves a not fully or poorly developed socket of the hip joint and in serious cases can result in lasting damage that causes limping or difficulty walking.

Cases of hip dysplasia that are not treated can lead to big problems in adulthood, including the need for an artificial hip.

"Other childhood illnesses such as circulatory disorders affecting the hip ball should be treated early because over time they could also lead to problems," said Guenther, who is also a member of the board of directors of Germany's society for orthopaedics and orthopaedic surgery.

An artificial joint simulates the natural joint as precisely as possible, according to the German association for physiotherapy in Cologne. In the case of the hip joint, the layer of cartilage must be copied in addition to the bone so that the artificial joint functions as naturally as possible. A special feature of the hip joint is that, like the shoulder, it is a ball joint, and thus can freely rotate. This is something that a modern artificial joint also can do.

There's no need to fear having an artificial hip joint as a replacement for a hip that is plagued by arthritis or that has been broken.

"It is the most successful operation in modern medicine," said Guenther. In Germany approximately 140,000 people undergo hip replacement surgery annually because of arthritis of the hip. An additional 70,000 people in Germany receive therapy for fractures of the upper femur very close to the hip joint. (dpa)