Joint Replacement Surgeon in Delhi

Quick Guide to Total Hip Replacement Implants

Total Hip Replacement offers excellent pain relief and restoration of function in patients with Hip arthritis. Total Hip replacement is one of the most successful surgeries in orthopaedics and recent advances in material technology has added to the functional outcome and longevity of the surgery.

Hip replacement surgery can be Non-Cemented (without use of Bone Cement), Cemented (implants fixed with Bone Cement) and Hybrid (Usually Non-cemented Acetabulum and Cemented Femoral stem)

Non-Cemented (or Cementless) fixation depends on surface in-growth of host bone on rough surface of metal implants and is preferred for young patients with good bone quality. It is expected to provide better longevity or implant survival.

A standard Non-Cemented Total Hip Implant consists of:

Metal Shell (Titanium / Co Cr Metal alloy) is fixed in the acetabular socket or pelvis
Acetabular Liner or Insert (Cross-Linked Polyethylene ‘XLPE’ / Delta Ceramic) locks in metal shell
Femoral Head 28/32/36 mm (CoCr Metal Alloy / Delta Ceramic / Oxinium) locks on stem
Femoral Stem (Titanium / Co Cr Metal alloy) is fixed in Femur or thigh bone
Cemented Fixation provides immediate fixation with use of PMMA bone cement and is preferred for elderly patients or in patients with poor bone quality.

A standard Cemented Total Hip Implant consists of:

Cemented Acetabular Liner (Cross-Linked Polyethylene ‘XLPE’) is fixed in the acetabular socket or pelvis
Femoral Head 28/32/36 mm (CoCr Metal Alloy / Delta Ceramic / Oxinium) locks on stem
Femoral Stem (Stainless Steel / Titanium) is fixed in Femur or thigh bone

The choice of implant depends on several factors such as age, activity level, stage of disease, weight, other lifestyle factors. The older implants were metal on polyethyene articulations with metal heads measuring 22 / 28 mm. There are now options available like metal on cross linked polyethylene, ceramic on crosslinked polyethylene and ceramic on ceramic articulations with larger head sizes for better stability and longevity. Larger Head size upto 32 or 36 mm offer better range of motion and better protection from dislocation.

Some Implants are reserved for special situations like in patients with previous fractures, abnormal structure of bone, redo/revision surgeries, or patients with higher risks of dislocation e.g. Dual mobility Implant, constrained liners, long femoral stems etc. They are discussed in detail with patients who may require these implants during their surgery.

Delta Ceramic / Oxinium femoral Head with Cross-Linked Polyethylene (XLPE) Liner reduces rate of polyethylene wear and is our Preferred articulation. In combination with 32 / 36 mm head size this articulation is expected to offer improved range of motion, stability and better longevity or implant survival.