ARTHRITIS OF THE HIP JOINT

The main long-term problems of joint replacements are wear of the socket or loosening of the components' attachment to the bone.

With time and stress, fixation of cement to bone can fail. It is hoped that cementless replacements will be able to withstand more vigorous activities, and have greater longevity than cemented replacements. They have not been in use long enough for anyone to be sure yet that this will be the case. Both cemented and cementless hips should, therefore, be treated with the same care. You should minimize activities which could cause loosening (see below). If the implant comes loose, movement between it and bone can cause pain and require re-operation.

Most patients are pain-free after 3 months. However, from time to time, especially in the first year, you may have a twinge of pain which you can ignore. If you have pain that does not go away, or seems to increase from day to day, you should come in to see Dr. Huddleston for x-rays and evaluation. It could signify infection or loosening.

The longevity of your hip replacement can be increased by:

It is important that you not become overweight, since excess weight increases the stresses on the hip replacement, and can cause loosening. Every pound of weight gained increases the forces on your hip by three pounds!

The possibility of infection occurring around the replacement is another concern.

Therefore, if you develop any infection, you should consult your family physician and have him treat it promptly. Viral infections, such as colds and most sore throats, are not a problem. Dental work can push bacteria into your bloodstream and cause an infection in your joint replacement. We recommend that you take antibiotics before dental work (other than simple cleaning of your teeth). You will be given a plastic card to keep in your wallet containing information about dosage. Note that the American Academy of Orthopedic Surgery has recommended that antibiotics be taken for dentistry for two years after hip replacement. Dr. Huddleston recommends that you do so for the rest of your life.

If you are to have cystoscopy, bronchoscopy, or colonoscopy you should also be covered by an antibiotic. Doctors vary on their recommendations as to which antibiotics should be used and for how long.

The following are our recommendations:

Dental, Upper Respiratory, Gastrointestinal and Genitourinary Procedures:

Not Allergic to Amoxicillin: Amoxicillin 500 mg. Four capsules one hour before the procedure.

Allergic to Amoxicillin: Keflex or Duricef 500 mg. Five tablets one hour before the procedure.
OR: Clindamycin 600 mg, Zithromax 500 mg, or Biaxin 500 mg 1 hour before the procedure.