- April 15, 2017
I’m Kenneth Gustke, MD. I’m a orthopedic surgeon at the Florida Orthopaedic Institute and I’ve been in practice here for 35 years. So my practice is basically hip and knee arthritis surgery. Uh, which for the most part is doing total knee replacement surgery and total hip replacement surgery. Total hip replacement surgery is probably the most successful operative intervention we have in all of medicine. It has a between a 90 to 95% success rate in terms of relieving pain. So what we do at the, uh, the actual surgery is you can see this arthritic ball that I’m outlining here with this cursor. So we remove the ball at this level as I’m showing here. And then we have to pair this, the socket we call the acetabulum, which is a hemisphere of bone, which we then matched to the perfect hemisphere size of the sockets. So then once we prepare the bone properly, we can then put the acetabular component in and then we put in a bushing inside the socket. So once we have the socket in place, we prepare the bone. So it again matches the exact shape of the implant that fits his size bone the best. So then when you’re finally done, you can then put the ball on top of the stem and you can make, put the ball at different positions on the stem so that you then re-correct their lengths.
So this is the x-ray after the surgery. Then you can see we have the implant, this femoral component in there. And this is the socket and the area in between, which doesn’t show up as, as, as, as dense of materials. Since it’s not metal as the plastic surface, I did not have to use any screws in him. And one of the things I was pointing out is reestablishing the normal biomechanics of the hip joint. And you can see the distance between the bones is the same as the other side. And if you draw a line. this particular bone across the pelvis, you see this area, which is the same on the other side, is exactly the same level. So we’ve essentially mirrored the hip to his other side but now have the total hip processes center. And by making a close to his normal anatomy as possible, we have that proper balance between the muscles.
We didn’t cut any of them, all souls in his instance, so we don’t have to worry about them not healing and then we can be more confident that we can allow him to do an activity that we cross that do an activity that requires such an extreme range of motion after the patient undergo surgery. There’s a rehabilitation process, so the patient needs to strengthen their muscles after the surgery. Invariably, when a patient presents with an arthritic hip, they’ve been favoring it for quite some time, usually years. And so as a result of inactivity, their muscles deteriorate. When we replaced their hip, we’ve eliminated the pain, but we haven’t, we established a normal hip because they still have weak muscles and we can’t replace muscles or strengthen muscles with the surgical procedure. So that’s when the patient’s part of the recovery and ultimately resolved becomes very important.
It is important that the patients do the exercises properly and at the right time. If the patient is not supervised or if the patient isn’t informed as to which muscles are appropriate at different points after surgery, they’re more likely to go on and over-exercise. And the result develop tendonitis or bursitis, which will then set them back and that we have process. Or if they’re not supervised or told what exercise to do, they may not do enough exercise and their recovery time may be prolonged. So it is very important that we have this partnership between the surgeon and the patient to be able to obtain the ultimate result, the patient desire.
