Replacement of hip joint – perioperative procedings

Abstract

Developing industry, technology and mechanization as well as the era of fast transport and communication development that increase the number of traumas and motor system conditions, all lead to the development of orthopaedics. One of the achievements is the increasingly improving endoprosthesis – an implant that replaces the damaged joint surfaces, and, thereby, allows the patient to move effortlessly on their own. Since the 1950s, there has been a steady development of the hip joint arthroplasty; the shapes of the implants, the clamping systems and materials of which they are made, change and get modified. The hip joint is one of the most important joints in the human body. It is a joint that belongs to the connections of the lower limb girdle. It is formed by the acetabulum of the pelvis and the head of the femur. Advanced changes of the joint that lead to stiffening and limiting the range of motion on the joint, and to fracture are all indications for the hip joint replacement. In order to diagnose correctly, the physician must perform a medical examination of the patient, first an interview, and then a physical examination. These examinations should be followed by radiological, biochemical and examinations. The choice of treatment method depends on the age, general condition of the patient and the type of fracture. The conservative method relies on the placement of a direct skeletal traction with a Kirschner wire and placement of the limb on the splint with an appropriate weight adjustment. This form of treatment takes from 6 to 10 weeks, until the bone is fixed. One of the surgical methods is artroplasty. It is a method used mostly in elderly patients. Preparation of the patient for the endoprosthesis placement surgery consists of both the physical and the psychological part. Rehabilitation of the patient in the early post-operational period improves blood circulation in the lower limbs, reduces the risk of clots, bedsores and allows for strengthening of the muscles as well as enhances the functionality of the operated hip joint. The moment the patient is discharged after the surgery, the role of the nurse for the patient and his family changes from the caring and therapeutic to educational. The nurse informs the patient and his family that if they follow all the recommendations, they will avoid the post-surgical complications and regain their full functionality fast.