Total Hip Replacement Surgery

 

Q1 What is wrong with my Hip joint?

 

A1 Hip joint is a ball and socket joint and it comprises of ball shaped head of the femur(thigh bone) and the socket or acetabulum in the pelvis. Bony surfaces of the hip joint are covered by smooth articular cartilages thereby cushioning the hip joint and enabling the parts to move easily. However, in Osteoarthritis , a chronic disease, the articular cartilage wears away causing severe hip disability, excruciating pain and stiffness.

 

Q2 When is Total Hip Replacement surgery recommended?

 

A2 Total Hip Replacement (THR) surgery is usually recommended when:

 

• Severe damage of the hip joint has taken place due to Osteoarthritis or injury.

• Pain medication-Antiinflammatory medicines, physical therapy and other non surgical treatment measures are no longer effective.

• You find it nearly impossible to perform daily activities without severe pain and restricted range of motion and quality of life is significantly affected by your hip arthritis.

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Q3. What is done in Total Hip replacement surgery?

 

A3 During the Total Hip Replacement surgery, the head part of the thigh bone(Femur) and the acetabulum(socket  in pelvic bone) are replaced by artificial parts or prosthesis. Artificial hip parts comprises of two components namely a cup called acetabular component and a stem and a ball called the femoral component. The damaged cartilage and the affected bone are first removed and the bony surfaces are then reshaped to accommodate the prosthesis or artificial joint.

Your surgeon will close the incision after evaluating new joint’s range of motion and verifying that it is properly positioned with the help of an X ray and will make sure that it functions efficiently. Most surgeries are performed under General anaesthesia. A good proportion of patients, nearly 90% get dramatic pain relief and enhanced function of the hip joint that usually lasts for good 10 to 15 years.

 

Q4 Which implant would be right for me?

A4. There are several factors that come into play while deciding the type of implant, most suitable in your case such as your age, gender, weight, lifestyle, your stature, intensity of your physical activity, condition of your bones like, if they are inflicted with degenerative bone disease or osteoporosis. Besides the above, the specialist's experience with the outcome of those implants, before suggesting any particular implant in your case, is also important. Furthermore, the specialist also takes into consideration the stability of the implant, its range of motion and wear and tear resistance in your case.

In nutshell, your specialist is the ultimate authority to take the decision of the type of implant most suitable for you. However, it would certainly be better if you acquaint yourself with sufficient knowledge about them for understanding of your doctor's choice.

 

Q5 What is the total recovery time post Total Hip replacement surgery?

 

A5 It usually takes 3 to 6 months to recover after Total hip replacement surgery. The hospital stay is around 3 to 4 days. The factors that determine the exact time of recovery are type of surgical approach taken, your response to the surgery and your overall health. It is imperative that you follow your surgeon's instructions religiously to get best results in shortest recovery time.

 

Q6 How long does the artificial hip last?

 

A6 Normally, the life of the artificial hip prosthesis is around 10 to 15 years. However, it may vary from person to person.

 

Q7 What are the causes of hip replacement failure?

 

A7 Hip replacement failure is caused mainly due to loosening of the artificial ball.

 

Q8 How safe is Total Hip replacement surgery?

 

A8 Total hip replacement surgery is a very common procedure done on a routine basis on the patients with need for one. It has good success rate. Furthermore, thorough evaluation of your clinical condition, requirement for and benefits of surgery will be done by your surgeon before proceeding with the surgery. Credentials of your specialist are crucial for the success of any surgery and this surgery is no different. Healthcaretripindia affiliated hospitals have the best of specialists, who are globally trained in countries like USA and UK, highly skilled and have decades of experience in carrying out joint replacement surgery with incredible success rate in good number of patients.

 

Q9 What is minimally invasive Total Hip replacement surgery?

 

A9 Minimally invasive THR surgery, also called Direct Anterior Hip Replacement or Anterior approach to Total hip replacement, is a muscle sparing approach. No muscles are cut rather muscles are moved aside, tendons are not detached, small incision (3 to 4 inch) and the hip joint is accessed from the front of the thigh. It benefits the patient in terms of reduced pain, quick recovery, early resumption of normal daily activities without the fear of hip dislocation and shorter hospital stay leading to economic benefits as well as early return to family and friends thereby giving boost to recovery. Furthermore, precautions needed in order to prevent hip dislocation are not necessary as such and this approach ensures a better hip function after surgery. Other approaches to Total hip joint replacement surgery are lateral and posterior approach where in the hip joint is accessed from the side and the back respectively.

 

In contrast to the above anterior approach, the other two conventional Total hip replacement approaches or ways to access the hip joint involve separating muscles and tendons in order to access and replace the hip joint from either side or back of the hip. They come with their own setbacks in terms of increased pain, delay in recovery which may extend from months to even years and increased possibility of hip dislocation which is largely responsible for Hip replacement failure. Certain precautions after this surgery need to be strictly adhered to in order to prevent Hip dislocation such as absolute no to crossing of legs, bending of hip joint beyond 90 degrees and increased rotation.

 

Q10 What are the possible complications of Total Hip Replacement surgery?

 

A10 There might be very little chance of complications arising out of hip replacement surgery. Your surgeon will make every possible effort to avoid them by adopting certain measures such as prescribing antibiotics and blood thinners. However, if at all complication/s may occur, they might prolong recovery time or hamper complete recovery. 

The risk and vulnerability towards getting possible complications will be explained to you. Only after your mutual consent and if benefits of the surgery outweigh the possible risk/s, the surgeon will take the plunge of carrying out the surgey.

The possible complications may be listed as follows:

• Infection

• Blood clots

• Leg length Inequality

• Dislocation

• Loosening of the implant

• Wear and tear

• Miscellaneaous problems such as blood vessel and nerve injury, stiffness, fracture and bleeding

 

Q11 Is there anything I can do to protect my hip joint?

 

A11 Certainly yes! There is lot that you can do to help yourself in protecting your newly found freedom in the form of new hip joint. You can follow the simple steps as mentioned below:

 

• Follow a regular light exercise regime for adequate strength and mobility of your new hip joint.

• Be cautious and avoid falls or injuries as it may necessitate another surgery.

• Prior to any dental procedure keep your orthopedic surgeon informed and at the same time inform your dentist so that they can guide you appropriately. They may prescribe you a course of antibiotics prior to any dental procedure.

• Religiously follow your orthopedic surgeon's instructions and go for regular follow up visits with him/ her.

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Q12 How is revision hip surgery different from primary hip replacement surgery?

 

A12 Revision hip surgery may involve removal or exchange of part/s of initial hip replacement. Depending upon the part/s to be removed, based on their attachment to the patient's bone, it may accompany some bone loss and loss of musculature leading to compromise in the strength and the functionality of the hip joint post surgery. Complications are more common in revision hip surgery and the results are unpredictable in terms of its durability. For the surgeon as well as the patient, it is more challenging to carry out or go through the revision hip surgery. Even more so, the duration of the surgery is also extended. 

 

 

Hip replacement surgery in India

 

• Low cost coupled with quality.

• Good results

• Best hospitals with state of the art infrastructure and most advanced technology in place.

• Globally trained,highly experienced orthopedic surgeons.

• Great ambience

• Compassionate staff to look after

• Hospitals accredited with international organizations such as JCI(Joint commission International) for quality standards.

• Language no barrier.English speaking people and if required,translators are available for your convenience.

• Most economical accommodation available at a walking distance from the hospital. Wide range of options starting from guest house, service appartments to five star hotels, best suited to your budget and choice.

• FDA approved high quality implants

 

Dr S.K.S Marya

MBBS, MS(Ortho), DNB, MCh(Ortho),FRCS,FICS

Chairman-Medanta Bone and Joint Institute

Medanta The medicity,Gurgaon,Delhi-NCR

Dr Ashok Rajgopal

M.B.B.S, M.S,M.ch. Ortho,F.R.C.S (Edinburgh)

Chairman and Executive Director

Fortis Bone and Joint Institute

Fortis Group Of Hospitals

Dr Jayant Arora

MRCS (Edinburgh), CCBST (Royal College of Surgeons, UK)

DNB (Orthopedics), MS (Orthopedics), MBBS

VSP, Belgium, Knee Arthroplasty

Senior Consultant, Dept. Of Orthopedics

Columbia Asia Hospital, Gurgaon,Delhi NCR.

Dr Mudit Khanna
MBBS, MS(Ortho), MCh(Ortho) UK, MRCS(UK)
Senior Consultant, Advanced Joint Replacement Surgery
Wockhardt Hospital, Mumbai

Dr Darius F. Soonawalla
MBBS, MS(Ortho), DNBE(Orthopedics), FRCS(England)
Orthopedic and Joint Replacement surgeon
Wockhardt Hospital, Mumbai

Dr Abhay M. Nene
MBBS, MS(Ortho)
Consultant Spine Surgeon
Wockhardt Hospital, Mumbai

Prof. Mani N.J 

MBBS, MS(Orth) MCh Orth. (UK)

Senior Consultant and HOD

Dept. Of Orthopedics

Baby Memorial Hospital, Kozhikode(Calicut), Kerala