Total Hip Replacement

Two different techniques regarding fixation of implants are used in modern joint replacement. In elderly patients it is often more reasonable to use bone cement in order to obtain optimal longevity of the prosthesis in the often osteoporotic bone. The advantage of this method is that the prosthesis made of stainless steel is stable from the very first day and will not loosen in the weaker bone of an elderly person.

The acetabulum will be replaced by a cup made of polyethylen and will be fixed by bone cement as well. This method has been applied worldwide for more than 40 years and is still the “gold standard”. The connection is stable directly. In more than 95% of the patients the prosthesis has not become loose and had to be revised even 15 years after implantation.

Fixating hip prostheses in younger patients with good bone stock without bone cement is an established method as well. The implants are fixated by being pressed or screwed into the preshaped bone. In cementless fixation titanium implants are used. This biomaterial shows excellent bone ongrowth. Precise fitting is mandatory, the implants have to be stable directly after the operation, then bony ingrowth can stabilize the prosthesis secondarily.

In Rheinfelden a titanium cup which is screwed into the bone or a press-fit cup are used as cementless acetabular implants. Both cups have shown very good results in the literature and in the experience of the Rheinfelden surgeons and patients. The stem is a straight titanium implant used since many years with excellent results. The results of this method are not worse than the results of cemented prosthesis.

In each individual case, implant material is chosen providing the best prognosis for both function and stability of the implant. In both cases we recommend the use of crutches for 6 weeks after the operation

For a hip replacement usualy 2 weeks hospital stay is required.