REVIEW OF AN ARTICLE

Total Hip Arthroplasty



Total Hip Arthroplasty

Introduction

The article relates to the total hip arthroplasty for osteoarthritis in publicly funded health care systems. In order to understand the concept, we first have to analyze what is the total hip arthroplasty, its reasons and its outcomes.

The total hip prosthesis is one of the greatest advances in orthopedic surgery of this century. The pioneers in the design and use was Sir John Charnley, an orthopedic surgeon, with the collaboration of a team of engineers, developed the technique and materials used in total hip replacement. This technique involves the replacement of an arthritic or damaged joint with an artificial joint called prosthesis.

It is a structure of the body where two bones fit. In the case of the hip are the thigh bone is termed femur, whose upper end is a sphere, with a cavity in the pelvis that is named cotyle. The ends of the bones forming a joint are covered with a material called cartilage sleek arlticular. This material dampens forces acting on the underlying bone and allows the joint to move easily and painlessly. The articulation is surrounded by a capsule coated in its interior by a thin membrane called synovium. The synovial membrane produces a lubricant (synovial fluid) that helps in reducing overall friction and wear of the joint. The bones are united by ligaments that maintain the stability of the joint. Wrapping find joint muscles and tendons also help maintain stability and allow for movement.

The most common reason for placing a total hip prosthesis is to eliminate pain and disability that causes severe joint destruction. The joint surfaces may be damaged by arthritis, a process which produces wear of articular cartilage. The joint can also be damaged by rheumatoid arthritis. In this disease, the synovial membrane produces chemicals that attack and destroy the joint surface articular cartilage.

Background of the Case

The case is about the total hip arthroplasty of the patients in the publicly funded health care systems, which are generally known for having inadequate resources to meet up the demands. Therefore, patients have to wait in their turns for operations. This is the case of a healthcare where many patients came on referral, and had to wait from 3 to 6 months according to their conditions. Patients with the poorer conditions got the appointment earlier than the patients with normal conditions.

Methods

The patients in the study who needed the total hip arthroplasty were on the referral for a surgeon in London. Outcome measures were assessed at baseline and every three to six months until at least three months after the surgery.

Results

There were 553 patients who were potentially eligible for the surgery. From 553, 123 were placed on a waiting list since they did not have the worst condition. However, 114 underwent the procedure immediately and 99 of them returned for post-operative assessment. At first, there were no measurable difference in the health-related quality of life and mobility among patient having long waits or short ...