Femoral head prosthesis

The femoral head mainly refers to the bones in our buttocks. Since we often sit for a long time, the buttocks are often under great pressure. Therefore, more and more people are suffering from diseases in this area, and severe cases may even cause femoral head necrosis. In order to completely cure this disease, an artificial femoral head needs to be replaced, but the femoral head prosthesis is fake after all, so you must pay attention to care issues after the operation.

The artificial femoral head must be kept at a slight valgus of 130° to 140° and a 15° anteversion. The base of the prosthesis neck should be parallel and close to the cross-section of the femoral neck. Do not use excessive force when driving the femoral head. If there is resistance, check the direction carefully to avoid penetrating the cortical bone. One thing that must be pointed out is that the soft tissue around the artificial hip joint should be of appropriate tightness (with normal tension). If it is too tight, it will easily wear the acetabulum, while if it is too loose, it will be unstable and may easily damage the acetabulum [Figure 6 ⑴ ⑵]. This is also closely related to the choice of prosthesis neck length and placement position.

Nursing and rehabilitation

1). Be careful when moving after surgery, keep the limb in abduction, internal rotation, and extension. Keep the affected limb in abduction and neutral position for 1 to 2 weeks to prevent adduction and external rotation to avoid dislocation. Then use corrective shoes in the same position for 2 to 3 weeks.

2). After surgery, use a sufficient amount of dual or triple antibiotics, both intramuscularly and intravenously until the body temperature stabilizes, and then intramuscularly inject for about a week.

3) Effective negative pressure suction is extremely important, mainly to prevent infection, and to observe and record the changes in the color of the drainage fluid and the drainage volume. The drainage tube should not be left in place for more than 72 hours, and the tube can be removed only when the 24-hour drainage volume is less than 20 ml.

4). Before walking, take a routine X-ray to check the position of the artificial femoral head in the acetabulum, which is also convenient for postoperative follow-up comparison.

5) After surgery, the unfixed joints should be moved immediately, muscle contraction exercises should be performed, and lower limb massage should be performed to prevent deep vein thrombosis. After 2-3 days, the patient can sit up and gradually increase the active and passive ranges. The stitches should be removed 10 days after surgery. The patient can walk with crutches 3-4 weeks after surgery. The patient should walk with crutches for protection within half a year, and physical therapy can be used during the exercise process. After abandoning the crutches, the patient should still pay attention to avoid excessive activity and injury. If pain or local inflammation occurs, follow-up treatment should be given in a timely manner. Patients who use biological fixation should exercise in bed within 6 weeks after surgery so that bone tissue can grow into the micropores on the surface. Then the patient can walk with crutches from no weight bearing to gradually increasing weight bearing. In short, it is important to pay attention to weight control at all times.

6). Strictly follow up every 2 to 3 months to guide exercise. Regular X-ray examinations are performed to detect complications early. If there is pain or inflammation, the cause should be found and treated in time.