TP HCMPeople with hip disease at Tam Anh General Hospital in the past 6 months increased by more than 48% over the same period last year, to more than 500 cases, of which about 70% were under 40 years old.
On April 20, MSc.BSc.CKI Le Dinh Khoa, Head of Joint Reconstruction Department, Orthopedics Trauma Center, Tam Anh General Hospital, Ho Chi Minh City, said the above information, adding that in the past these diseases were often It occurs at the age of 50 or older due to many reasons such as degeneration, a history of hip disease, being overweight… Currently, the disease tends to get younger.
Lack of exercise, alcohol abuse, tobacco… are factors that promote hip disease to occur earlier. Minimally invasive joint replacement techniques have overcome the disadvantages of previous surgical methods such as joint re-dislocation, limited movement, inability to squat… After surgery, patients can play sports, heavy labor. These factors help young people feel more secure when choosing joint replacement surgery.
Common hip diseases are hip dysplasia, hip degenerative arthritis…, of which femoral head necrosis is the most common. These diseases cause a lot of pain, hinder daily activities, and even make it impossible to work or walk, requiring the use of a wheelchair.
Like Mr. Kiet, 35 years old, he had osteonecrosis of the femoral head just a year ago but his hip function was seriously reduced. He didn’t go to the doctor, and then the pain was so severe that he was treated in many places, taking enough medicine without improvement. Recently, he walks with short legs and high legs, unable to carry heavy objects.
Another case is Ms. Hoa, 28 years old, who also suffered from femoral head necrosis for nearly two years. Not wanting to have a joint replacement when she was young, she tried to endure it, but her hip pain was severe, she had difficulty walking, and could not perform daily movements such as squatting, crossing her legs, or going up stairs.
According to Dr. Khoa, hip diseases in the early stages can be treated conservatively with medication and physical therapy. When the disease progresses, causing severe pain and seriously affecting daily activities, hip replacement is the optimal method. Patients who do not receive timely treatment may experience complications such as skeletal deformation, limping, and disability.
Doctor Khoa (right) replaces a patient’s hip joint. Illustration: Tam Anh General Hospital
Doctor Khoa said there are 4 big goals in hip replacement surgery for young people in general. One is to completely restore hip function to ensure that the patient is not limited in movement and can perform difficult positions such as squatting, having sex, and doing heavy labor. Second, increase the durability of the artificial joint, maximize the life of the artificial joint, and prolong the joint’s use as long as possible.
Third is to preserve maximum bone after the first surgery, creating conditions for the second surgery (if necessary) many years later to take place more easily and less expensively. Fourth is quick recovery, reducing hospital stay and post-operative recovery time, helping patients return to their daily activities sooner, saving treatment costs.
To achieve those goals, it is necessary to combine many factors such as pre-operative preparation, surgical techniques, appropriate joint selection, and rehabilitation exercises.
Mr. Kiet and Ms. Hoa both had their hip replaced with minimally invasive surgery, preserving maximum bone. “This is a difficult surgery, especially for young patients due to high mobility needs. The surgery needs to meet many criteria for the artificial joint to function well and have a long life,” said Dr. Khoa.
Before surgery, the doctor uses specialized TraumaCad software to measure and select the appropriate size joint for each patient, the location of the joint during surgery… Thereby reducing joint wear as well as increasing range of motion. Postoperative movements for patients.
With a traditional incision, approaching through the posterior approach, the doctor must cut the external rotator muscle group and the joint capsule. This makes it take longer for the patient to recover, making it easier for the joint to dislocate when performing squatting or cross-legged positions. To fix it, the doctor applies new minimally invasive joint replacement techniques such as ABMS external anterior incision, SuperPATH incision, and direct anterior incision. These techniques help completely preserve muscle groups and important attachment points of the joint capsule, effectively reducing pain and blood loss.
Joint design and bone-preserving surgery techniques help minimize bone loss, ensuring that after a long period of using an artificial joint, the patient’s bone mass is still enough for the next joint replacement (if any). There is no need for bone grafting or the use of other, more expensive bone compensation joint designs.
According to Dr. Khoa, the bone-preserving joint design uses a monolithic acetabulum made of titanium-coated polyethylene to help the bone grow quickly and adhere firmly to the artificial joint. At the same time, this joint has elasticity similar to the elasticity of the patient’s bones, limiting osteoporosis or joint loosening. The thigh component uses a short shank that can be individually customized for each patient, limiting the need for too much bone drilling and curettage.
After surgery, Mr. Kiet and Ms. Hoa recovered quickly, could walk and were discharged from the hospital after only 1-2 days.
The patient will undergo rehabilitation after surgery for a period of time. Joint movement depends not only on the joint socket but also on the participation of the joint capsule and tendons and muscles surrounding the joint. Therefore, exercising to strengthen these soft tissues helps patients recover faster after surgery and have better post-operative joint function. Strong muscles reduce pressure on the artificial joint during movement, increasing joint durability.
Mr. Kiet walked after surgery without any assistive devices. Image: Tam Anh General Hospital
Most diseases of the hip joint, if detected promptly, can reduce pain, improve mobility and slow disease progression with conservative treatments such as medication, physical therapy… without cost. need surgery. Therefore, doctors advise patients to have regular health check-ups or see a doctor immediately if there are unusual signs such as pain in the hip joint and surrounding joints, dry and stiff joints, limited movement, and difficulty performing rotational movements. joint form…
When hip replacement is indicated, the patient should have surgery soon to avoid serious complications affecting the spine, pelvis, knee joints, ankle joints… Doctor Khoa said with the development of medicine and today’s technology, the safety of hip replacement has been significantly improved. Young patients should go to reputable medical facilities with a team of specialized doctors and full equipment to ensure effective treatment.