Age-related osteoarthritis

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In male subjects, generally over the age of 65 and women over the age of 55, the bone at the level of the femoral head and neck becomes weaker than in younger subjects, and in these cases we therefore recommend the implantation of a total hip prosthesis instead of a resurfacing prosthesis. Our service was a pioneer in the implantation of total hip prostheses with modular jumbo-diameter heads, which permit adjustment of the length of the limb and personalised selection of the femoral neck as if it were a custom made prosthesis.

planificación preoperatorio de una prótesis total de cadera tamaño de la incisión para implantar una prótesis total de cadera por vía mini-invasiva

Left: preoperative planning of a total hip prosthesis.
Right: size of the incision for minimally invasive total hip prosthesis implantation.

Diagram of the implantation of a total hip prosthesis at the level of the femur:

In this case the femoral head must be sacrificed.

Esquema de la implantación de una prótesis total de cadera a nivel del fémur

These implants consist of an acetabular component composed of a titanium cup, where a polyethylene or ceramic core or a metal component is introduced and a femoral or stem component, either titanium or chrome-cobalt alloy, cemented or uncemented, which extends as far as the first third of the femur and to which a ceramic or metal head is added. In the present day, the use of minimal friction implants is preferred to avoid premature wear of the prosthesis, such as ceramic-on-ceramic, on high cross-linked polyethylene and even metal-on-metal. In this field, minimally invasive surgery allows a speedier post-operative recovery in many cases.

prótesis total de cadera bilateral prótesis total de cadera derecha implantada hace 15 años en un individuo de 41 años, hace 3 años le fue implantada una prótesis de superficie en el lado izquierdo

Left: total bilateral hip prosthesis. Right: total right­-hip prosthesis implanted 15 years ago in a 41-year-old. A resurfacing prosthesis was implanted on the left side 3 years ago.

Coxa profunda artrósica derecha prótesis total de cadera derecha no cementada con injerto autólogo en fondo de cotilo, cuello modular, cabeza grande y vástago anatómico. Obsérvese el mantenimiento de la longitud del miembro inferior y de su lateralidad-offset mediante el sistema modular de cuello y cabeza grande, que proporciona un implante individualizado a cada paciente

Left: Right coxa profunda osteoarthritis. Right: uncemented total right hip prosthesis with autograft at the rear of the acetabulum, modular neck, jumbo head and anatomical stem. Observe the maintenance of the length of the lower limb and its lateral offset via a modular neck and jumbo head system, which provides a personalised implant for each patient.

The durability of the implant, especially the femoral stem, ranges between 95% and 98% at twenty years, as opposed to the acetabular component which remains unaltered in 3 out of 4 implants at 15 years. Nevertheless, the popular notion that it is not possible to implant more than one or two hip prostheses at the most has been rendered obsolete. There are different designs for each case and in addition, the bone bank allows us to make more bone surface available for implanting the new prosthesis.