An operation that radically changes the quality of life of patients

Osteoarthritis is the most common cause of hip pain in people over the age of 50. What can arthroplasty offer?

Globally, patients from 1990 to 2020 osteoarthritis Hips per 100,000 people rose from 17.02 to 18.70. This upward trend is expected to continue due to the rapidly aging and increasing rate of the world’s population obesity observed all over the world.

The risk of hip osteoarthritis is 18.5% for men and 28.6% for women. Research shows that people who live to age 85 have a 25% risk of developing hip osteoarthritis. All of the above explains the growing interest of the orthopedic community in improving both surgical techniques and materials used in total hip arthroplasty.

“It has been proven that whole hip arthroplasty It is a relatively low-cost, safe surgical procedure with great results in improving the quality of life of patients. According to new research, hip replacement surgery not only improves quality of life, but may even prolong life.” says sir. Dimitrios Dovris Orthopedic Surgeon at Metropolitan Hospital, MD, PhD, D.Av.Med and continues to explain all things related to total hip replacement:

Total Hip Arthroplasty: Materials

Total hip arthroplasty, like any other surgery, has a low number of complications. The long-term maintenance of a good result of arthroplasty depends on patient-related factors, the surgeon’s experience and surgical technique, as well as the quality and combination of materials used.

The characteristics of different implants and conflicting studies in the literature make it difficult to choose the best implant. The biggest controversy is the use of different materials on the loaded surfaces of prostheses. CoC (ceramic-on-ceramic) implants show the least amount of wear, but the risk of breakage and cracking is high.

CoP (ceramic on polyethylene) has a higher wear rate than CoCs, but is more durable. MoPs (metal on polyethylene) have the lowest cost but the highest wear rate.

“There is no such thing as a perfect implant, but there is an ideal implant for every patient. Implant-to-patient adaptation and implant selection is a complex task and must take into account many factors, such as bone quality and the patient’s overall health. Good initial implant selection will determine its survival rate and ultimately patient satisfaction, and will minimize both the social and financial costs of subsequent revision total hip arthroplasty. The development of new biomaterials that combine the use of new nanoparticles with antimicrobial activity to reduce the risk of infection, among other improvements, will increase the success of these complex surgical procedures and the long-term survival of the implant.”notes.


Surgical access to the hip is traditionally performed laterally or posteriorly to monitor placement of materials. In recent years, anterior access and Anterior Minimally Invasive Surgery AMIS (Anterior Minimally Invasive Surgery) have seen a leap forward. It tends to become the standard approach both in the US and globally.

“AMIS is characterized by reduced skin incision, and its difference from other techniques is that the muscles and tendons are simply displaced temporarily to accommodate the materials. In this way, damage to the soft tissues, vessels and nerves of the area is significantly reduced. The advantages of the method are reduced postoperative pain, shorter recovery and hospital stay, smaller skin scars, faster return to daily activities and less blood loss.

Another very important difference is the reduced risk of displacement and prevention of lameness, which helps by protecting the muscles instead of cutting them. Another advantage is that it is possible to use radiological control during the operation due to the fact that the patient is in a supine position during the operation, which is very important to prevent post-operative imbalance. the expert emphasizes.


“Managed hip replacement is based on a CT scan of the hip taken preoperatively. The three-dimensional nature of CT provides more detailed information about a patient’s anatomy than a two-dimensional radiograph, thereby allowing a computer model of the pelvis and femur to be created. This model is used to plan the size, orientation and location of hip replacement materials. The computer model and drawing are uploaded to the AR headset, allowing the surgeon to visualize them directly while performing the operation.
This way, the surgeon can see the patient’s unique anatomy to precisely place the implant. AR technology holds great promise for hip surgery, both for preoperative simulation and training of surgeons, as well as enabling orthopedic surgeons to perform more precise and safer operations,” he explains.

MAKO Robotic Arthroplasty

The procedure begins with a special CT scan of the hip using the MAKO software, which creates a three-dimensional model of the affected hip on the system’s computer. The surgeon then develops and customizes the entire procedure depending on the characteristics of each patient, thus creating an individual preoperative plan.

The surgeon uses minimally invasive surgery (MIS) to expose the joint. Then, under the guidance of the surgeon and according to the preoperative plan, the MAKO robotic arm prepares both the acetabulum and the upper femur, helping to place the implants with extreme precision and error-free, avoiding any misalignment problems.

“Total hip replacement remains an exceptional procedure that often changes patients’ quality of life. There will always be debate about the potential benefits and outcomes of different approaches, different materials for constructing implant posts and loading surfaces, and differences in restorative protocols. Surgeons must consider each patient’s needs according to their anatomy, age, and expectations.
“Robotic orthopedic surgery is the most advanced medical technology available to treat arthritis and serious diseases of the knee and hip.” Mr. Dobris concludes.

*Metropolitan Hospital stands out in Greece as the first hospital in Europe to adopt and apply this technology with 8 years of experience and more than 1,500 operations with the MAKO system, and is also an international Center of Excellence for this technique.

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