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What is a total prosthesis of hip?
A total prosthesis replaces the sick part of your articulation of hip.
It is made up of three joined parts:
The first part, the cotyle replaces the articular part of the hip.
And the two others, the collar and the stem are established in the femur.
 WHICH TYPE OF PROSTHESIS ?
There are many models of prostheses, different in their form, their materials, some are established without cement.
The model used in Tunisia is derived from a model used since more than 30 years ago, imported from France or Germany with excellent results which are maintained for many years. It is thus for us a pledge of safety and reliability.
The references of your prosthesis (mark, standard and reference) will be communicated to you.
THE SCAR ?
There are several ways of approaching the hip to establish prosthesis. The access used by our orthopaedists is on the high part of the thigh, on approximately 15 centimetres. The surgeon thus passes between the muscles, without cutting them, neither the bones, except the collar and the head of the femur which are replaced by the prosthesis.
WHEN DO WE NEED SURGERY?
Whatever the reason for which you suffer from the hip, there is never urgency for a surgical intervention. It consists indeed of a heavy intervention not void of a few complications which it is necessary to prevent by suitable precautions and examinations (even if progress of the anaesthesia and the great practice of this intervention make of it almost an intervention of routine).
WHICH BENEFIT SHOULD YOU DRAW FROM AN INTERVENTION ?
Whatever the reason for which you suffer from the deterioration of the articulation of the hip (deterioration of the cartilage or osteoarthritis, rheumatic disease, necroses, post-traumatic after-effect or infant disease), impotence is due to pains of increasing intensity of various localization, making walk difficult and with lameness and which could be handicapping in the everyday life, for the care of foot, to sit down, climb…, and to affect with long the knees and the spinal column.
A total prosthesis of hip, by replacing the damaged part of the articulation, gives again flexibility, dissolves the pains due to deterioration of the hip, and the function of the knees and the back. The majority of the operated people, at the end of a few months, "even forget" that they are carrying prosthesis, carry out a normal life and can even restart sports activities. A minority however will feel its presence from time to time, without constituting a significant embarrassment.
THE PRE-SURGICAL EXAMINATIONS
In addition to those prescribed by the anaesthetist, adapted in your health, it is imperative to seek by an analysis of urine, a radio of the teeth and a consultation with your dentist an infection which you could not feel, in order to treat it. Indeed, this infection can be propagated perfectly through blood with your prosthesis, even a long time after the intervention, with very serious consequences.
THE HOSPITALIZATION
In general, you will be seen by the orthopaedist and the anaesthetist 2 days before the intervention in order to supplement the pre-surgical check up. In the event of infection it will be necessary to treat it or else the operation would be deferred.
The first steps are made at the 1st or the 2nd post surgical day, walking again will be possible in both feet. The duration of hospitalization is 7 days.
DURATION OF STAY IN TUNISIA
On the whole, a one week hospitalization is to be considered, as well as a convalescence of 2 to 3 weeks in a half-board stay in the hotel of your choice.
COMPLICATIONS
They are rare, and do not have to make you forget that, in the large majority of the cases, a total prosthesis of hip will enable you to carry out a normal life. Some, potentially serious, are specific to this type of intervention and more frequent among patients in ponderal overload, than it is always desirable to reduce before the intervention.
Without being exhaustive, the most "frequent" but nevertheless exceptionally rare are :
 A phlebitis, which can exceptionally become complicated of a pulmonary embolism. In spite of the systematic use of anticoagulants, the risk exists during 6 weeks after the intervention, justifying the use of the anticoagulants for all this period.
A haematoma, often neglectable and which reabsorbs itself in a few weeks, but which can require a re-intervention to evacuate it.
A luxation (dismantling) of the prosthesis, because of a clumsy movement.
Ossifications around the prosthesis, which can decrease the mobility of the hip.
A urinary retention requiring a survey.
An infection of the prosthesis that we already evoked, and justifying all the precautions that will be taken before, during and after the intervention. It can also occur sometimes years after the intervention in the event of remote infection of the prosthesis (urinary, pulmonary, small "neglected" wound, etc…) or even after dental care carried out without antibiotic (think of informing your dentist).
THE FOLLOW-UP OF THE PROSTHESIS
A total prosthesis of hip will enable you in the large majority of the cases to carry out a normal life, other than some violent sports activities, but it remains an inert material, a mechanical element which can be deteriorated in the course of time. It can be also loosened. It remains very sensitive to the infections. It can leave some residual pains without even the existence of a particular anomaly.
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