MEDICAL ENVIRONMENT OF TOTAL HIP-REPLACEM ENT

Total hip replacement is an extremely frequent operation for the treat ment of degenerative joint disease, Indication for surgery must take i nto account the patient's general status, associated diseases, multipl e joint involvement, and the efficacy and tolerance to medical treatme nts, The decision to operate is taken together by the physician and th e patient. The degree of functional impairment and the patient's age a re important factors, The patient must be informed that the period of hospitalization will be approximately 15 days and that good results ar e obtained in approximately 98% of the cases, Preoperative consultatio n with the anesthesist will focus on associated diseases with special attention to possible infectious foyers, Early post operative care inc ludes a 48 hour antibiotic reginien, thromboprophylaxy with low molecu lar weight heparin for 3 days followed by anti-vitamin K for 6 weeks, and non-steroid antiinflammatory drugs for 5 days of up to 6 weeks in case of suspected risk of ossification, At mid-term, complications may include hematomas, infection and luxation, The fixation may also fail in certain cases where transtrochanter access was used, Long-term fol low-up monitors for possible late onset infection and late luxations w hich usually result from prosthesis wear and more rarely from muscular causes.