I'm a young 67-year-old male with hip arthritis in one hip. I want to get the fastest recovery possible. My surgeon is going to use a cementless implant with a special gel that will speed up bone growth. What can I expect during rehab and recovery with this kind of approach?
Cementless implants are used now whenever the patient has good bone stock. The surface of the metal parts is porous or textured. It looks like coral. Bone can grow into the metal pores and bond the implant. But it takes longer for the joint to become stable compared with cemented implants. That's where the osteoinductive gel comes into play. Osteoinductive means it helps foster bone growth.
With the osteoinductive gel, cementless implants can get integrated into the bone much faster. In doing so, the risk of fibrous (scar) tissue filling in between the implant and the bone is much less. That creates a more solid, stable joint to handle weight-bearing loads of adults who want to move, walk, and play! Biologic fixation is improved with the bone stimulating gel, which in turn, decreases the risk of implant failure.
You can expect faster functional and clinical recovery within six months. Right after surgery, your surgeon may recommend a period of protected weight-bearing (using crutches or a walker). This gives the bone time to attach itself to the implant. This protected weight bearing helps to ensure there is no movement between the implant and bone so a durable connection can be established. But that doesn't mean you'll be down and out of the action.
A physical therpaist will work with you right from the start with muscle strengthening exercises. You may get up standing and just put weight into the joint during the first 24 hours. Walking with an assistive device usually begins within 48 hours. If you are active, strong, and stable, you maybe able to use crutches rather than a walker. You'll need some type of assistive device for the first few weeks to month. Patients are usually allowed to go from two crutches to using only one crutch at the end of the first four weeks. A single crutch may be used for another couple weeks up to a month (depending on your progress).
A recent study comparing results for patients who received cementless implants with and without the gel showed that the gel group doubled their function in the first 40 days. There was a gradual progression of improvement from then up through the first six months. Similar results were observed in the control group (no gel) but with a lower level of improvement noted in the first 40 days. In both groups, functional improvement reached a plateau and did not change further by the end of the 12-month post-operative period.
Wolfram Thomas, MD, et al. Osteoinductive Gel in Cementless Hip Joint Replacement: A Randomized Prospective Study. In Current Orthopaedic Practice. November/December 2009. Vol. 20. No. 6. Pp. 655-659.
*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.