It consists of replacing the hip joint with an implant. There are different systems of attachment of the prosthesis to the patient’s bone and different friction pairs (surfaces in contact for movement).The choice of implant is made based on scientific experience for each type of patient and is not as important as the correct placement of the prosthesis.

Cemented prostheses

The implant is fixed to the existing bone with a fixing material, a special cement (PMMA). Its main indication is in those patients with poor bone quality that can predict a lack of integration of an un cemented component. In addition to the quality of the bone there are other criteria for the use of these implants depending on the training of the surgeon. There are centers of great world prestige where the vast majority of implants are cemented regardless of the age or bone quality of the patient.

Un cemented prostheses

It is based on a process of biological fixation. This means that they have a porous surface that allows the bone to grow bone between the pores and maintain the stability of the implant. Many implants have a coating with osteoconductive components (hydroxyapatite) to promote integration. Generally a bone with good quality is required although it is not essential. Their use also depends on the surgeon’s experience with these implants.

Hybrid prosthesis

Combination of a component of the prosthesis fixed with cement and another not. The most frequent is that the cemented component is the femoral component and the acetabular without cement (hybrid prosthesis) although less frequent, it can be done the other way around (inverted hybrid).

Friction pairs (Tribology)

It refers to the two surfaces that are going to contact so that the movement of the joint takes place.

The most frequent is Metal Polyethylene (MP). The metal head of the femoral component moves over a polyethylene insert. Currently, to reduce wear secondary to friction, highly crisscrossed beam polyethylenes or polyethylenes with vitamin E (anti-oxidant) are used.

Polyethylene ceramics (CP). The ceramic femoral head moves over a polyethylene insert. It seems to present better results in relation to wear than the MP.

Ceramic ceramics (CC). Both the femoral head and the insert are ceramic. It is considered a pair of hard friction. It has less wear but its proper functioning is more dependent on the technique. It has been classically related to noise or breakage problems. Both complications are currently less frequent.

It is the replacement of the knee joint with an implant or prosthesis. In most cases knee prostheses are fixed to the patient’s bone by cement (PMMA).

Most common are prostheses in which the cartilage of the three compartments of the knee, thybic femur and patella are replaced. There are knee prostheses for special cases in which only one compartment of the knee is affected, they are unicompartimentales prostheses.

Replacement of the shoulder joint with an implant. The two surfaces of the joint (total prosthesis) or only that of the humerus (hemi prosthesis) can be replaced. There are options of coating prostheses that respect the patient’s bone more and special models for arthropathy secondary to rotators cuff pathology or for treatment of fractures, inverted prostheses.

The most common non-traumatic cause is glenohumeral osteoarthritis

Glenohumeral osteoarthritis (osteoarthritis of the shoulder) occurs when there is wear and tear on the joint, either of degenerative origin (age) or secondary to trauma. Characteristically, the patient refers pain to mobilization both actively and passively, to which is added a loss of shoulder function.

The treatment options are aimed at reducing the pain presented by these patients, the only option being the implantation of a prosthesis when the treatment of pain cannot be controlled in a conservative (non-surgical) way. Depending on the characteristics of the injury that presents the shoulder your traumatologist will choose the prosthesis that best suits your problem, since it will depend on the personal characteristics of the injury the choice of the correct indication of one or another prosthesis.

Replacing the elbow joint with an implant. The most frequent indications are inflammatory systemic diseases, the sequelae of trauma and osteoarthritis of the elbow. At the level of the elbow there may also be partial dentures, or radio head prostheses for fractures.

Osteoarthritis of the elbow

Osteoarthritis of the elbow may occur after trauma or degenerative causes.

The loss of normal elbow function is perceived with clinical pain as well as with a loss of function, which is reflected in a decrease in joint balance.

In the elbow it is especially important to achieve a good function especially in flexion, since the limitation in this movement is perceived as an impossibility of being able to use the hand for activities of daily life such as: eating, washing the face, combing, etc.

The degenerative process of the elbow follows an evolutionary course that, through your specialist in elbow surgery will indicate when it is time to perform the intervention, since the surgical options that can be offered will depend on the phase of joint degeneration in which you are, ranging from the most conservative option to the most complete option.