#Xray of normal hip replacement skin#
#Xray of normal hip replacement full#

These include full blood count (FBC), renal function test (U&E), fasting blood glucose, coagulation profile, liver function test (LFT) if required. The investigations obtained for determining anesthetic suitability starts with the blood work up. Assessment of patients for fitness in the pre assessment clinics Patient’s body mass index (BMI) is an important assessment parameter as obese population is at higher risk for prosthetic joint infection (PJI) and other wound problems post-surgery.Ģ.3. Likewise vascular status should be properly assessed and documented.

#Xray of normal hip replacement skin#

Skin condition of the leg been operated is of paramount importance and any signs suggestive of severe eczema or infection should need to be addressed before the surgery itself.

Any past surgical procedure with its effect should be determined that could possibly increase the risk of prosthetic joint infection as colostomy, ileostomy or urinary conduit close to the operating site.ĭuring robust clinical examination attention is paid to findings like fixed flexion deformity (FFD), leg length discrepancy (LLD), gait assessment including Trendelenburg or antalgic gait. Likewise any prior incisions at the operative area will require surgeon to carefully plan their surgical site incision, as this will create a flap with its healing problem if not selected properly. Further, any issues with spinal problems or previous spinal surgeries will require evaluating safety of the spinal anesthesia. Past surgical history with anesthesia given in the past helps to identify additional knowledge of patient’s response to prior anesthetic medication and their tolerance. Likewise anticoagulant medication will all need to be assessed for their indication of use and consideration given for holding them if possible otherwise bridging them with a low molecular weight heparin. Antiplatelet medication like clopidogrel need to be assessed by cardiologist to consider holding it a week before planned surgery, as this would otherwise increase the risk for perioperative bleeding with increased incidence of transfusion. This include allergy to any metal type or latex material. Medication history with any known allergies has to be documented and assessed carefully. steroid use and liver or kidney disorders. Patient past medical history should be obtained including significant comorbidities of other body systems as this will help clinician to obtain further assessment of patient body reserve prior to major surgery and in obtaining risk assessment which will help the clinician to optimize these risk beforehand and on occasion to book a special care bed post-surgery in a high dependency unit (HDU) to facilitate proper patient care.įurther, it is vital to obtain from patient history of medical comorbidities, which could have a serious bearing on response to healing after surgery like diabetes and immune deficiency states e.g. It is a good practice to both subjectively and objectively determine patient’s loss of function on Harris Hip score and its impact on the quality of life using SF36 or other acceptable scores of reporting system. Bear in mind radiculopathy pain can also present as pain surrounding gluteal region and thigh and has to be excluded by examination. There is no substitute of a thorough history and examination, which will make a clinician to arrive at a working diagnosis of arthritis of the hip joint. Obtaining meticulous history and examination However, with thorough preoperative planning, these goals are achievable while minimizing perioperative risks and complications.Ī famous quote of an American polymath, a scientist Benjamin Franklin is, “By failing to prepare, you are preparing to fail.” This is why preoperative planning is a vital step in the actual total hip arthroplasty.Ģ.1. The outcome is limited by the fact that no single prosthesis is suitable for all patients due to personal patient factors including variation in bone quality, bone anatomy, patient activity level and the postoperative expectations of the patient. The success of the above treatment is multifactorial including proper patient selection, preoperative procedure planning and surgeons ability to perform a satisfactory procedure that restores the biomechanics of the hip joint. Total hip arthroplasty (THA) provides an excellent pain relief and improvement in functional capacity along with improvement in the objective performance scores in patients with established debilitating arthritis of the hip joint.