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Osteoarthritis of the hip is a disease that causes pain in the hip joint at the base of the foot, and it is said that there are an estimated 5 million patients nationwide. Surgery is considered when pain does not improve with lifestyle modification, exercise therapy, and drug therapy. We will summarize the main surgical methods, arthroscopic surgery, osteotomy, and total hip arthroplasty.

In osteoarthritis of the hip, the cartilage between the femur and pelvis wears away, causing inflammation and pain. Many cases progress with aging. The number of patients is estimated to be 5 million, and women tend to be more susceptible. In addition to lifestyle improvements such as reviewing lifestyle habits, treatment includes exercise therapy and drug therapy, but if these do not improve the pain, surgery is considered. Major surgeries include arthroscopic surgery, osteotomy, and total hip arthroplasty.

In many cases, the surgical treatment used for early hip osteoarthritis is arthroscopic surgery. A 1 cm incision is made in the skin at 2 to 3 places, and an arthroscope with a diameter of about 5 mm and instruments are inserted into the joint. Inflammation is improved by removing cartilage pieces and inflamed tissue in the joint. It is minimally invasive and requires a short operation time of 1 to 2 hours.

Osteotomy is generally performed when the symptoms have not progressed so much and the cartilage is sufficiently preserved. There are pelvic side and femoral side surgeries. After surgery, rehabilitation is performed over 4 to 6 weeks, such as gradually increasing the load on the operated leg.

If it progresses to the end stage, consideration of artificial hip joint replacement is required. A surgical procedure to replace the damaged part of the hip joint with an artificial hip joint (implant). In artificial hip replacement surgery, after resecting the damaged part of the hip joint, a cup-shaped part is attached to the hollow of the pelvis, a base part called a stem is inserted into the femur, and a ball-shaped part is attached to the end. In many cases, the pain has almost disappeared, and it is said that the legs can move almost freely. After surgery, rehabilitation takes about two weeks. Until now, this surgery was mainly performed on elderly patients, but with the extension of the useful life of artificial hip joints to around 20 to 30 years, more and more people are choosing this surgery among younger age groups.

In hip arthroplasty, surgery using a robotic arm (robot arm) became insurance coverage in 2019. A robotic arm is a doctor-operated system that scrapes or assists in the placement of the bone into which the prosthesis components are placed. As a procedure, the patient's hip joint is photographed in advance by CT and a 3D model is created. Using this model, we simulate how to cut the bone and how to implant the artificial hip joint before surgery. During surgery, the doctor operates the robotic arm according to the navigation system while looking at the 3D images of the preoperative plan.Since movements other than the preoperative plan are automatically controlled, the advantage is that the surgery can be performed more safely and accurately.

This time, we introduced surgical methods for hip osteoarthritis (arthroscopic surgery, osteotomy, and total hip replacement), but in any surgery, it is important to continue postoperative lifestyle improvement, exercise therapy, drug therapy, etc. In addition, as osteoarthritis progresses, treatment options become limited, so if you wish to have surgery, it is better to consider it early.