Total Hip Replacement

Thousands of patients have had a hip replacement in Mumbai. In a total hip replacement, the damaged bone and cartilage from the hip are removed and replaced with an artificial joint.

A hip replacement may be necessary in case of,

• i. Hip Fractures,
• ii. Hip Osteoarthritis, or
• iii. Avascular Necrosis of the Hip (AVN).

Hip Fractures

The hip joint consists of the acetabulum in the pelvic bone, the femoral head, and ligaments that assist weight-bearing, provide balance and enable a range of movements - front, back, sideways, rotation.

When a hip is fractured, there is a break in the upper fourth of the femur (thigh) bone. It can be a fragility fracture in elders or an accident fracture in youngsters. Furthermore, conditions such as osteoporosis or cancer weaken the bones around the hip and spine making them more susceptible to breaking. In such cases, a patient may require a hip implant or total hip replacement.

An X-ray can diagnose a hip fracture. It can also distinguish between an Intra-capsular fracture, Intertrochanteric fracture, and Subtrochanteric fracture. In addition to the x-ray, the doctor may request an MRI scan. The scan helps to determine the condition of the bone and soft tissues of the hip.

When Is Total Hip Surgery Recommended

When you suffer from the following symptoms or injury, you may require to undertake a total hip surgery:

• Hip pain that limits daily activities like walking or bending.
• Constant hip pain that persists even while resting.
• Stiffness of the hip that limits your ability to move or lift a leg.
• When anti-inflammatory drugs, physical therapy, or walking supports don’t help.
• Sudden injury limiting standing up or walking.

Hip Osteoarthritis

Hip Osteoarthritis is a type of arthritis that causes wear and tear of the hip. In India, it is the second most common cause of hip replacement surgery after knee osteoarthritis. Here, the articular cartilage of the hip begins to wears off, exposing the underlying bone. When the bones rub on each other, the friction causes pain.

The hip replacement surgeon may order X-rays or an MRI scan to diagnose hip arthritis. Only when mild pain killers, supplements, and lifestyle modification don’t help, the ortho surgeon will recommend total hip replacement surgery. In this surgery, the surgeon replaces the damaged shell (acetabulum) and the ball (femoral head). The shell is made from medical-grade plastic and the head from metal or ceramic.

When Is Total Hip Surgery Recommended

When you begin to see the following symptoms, it is time to consult the best orthopaedic surgeon for hip replacement. They include:-

• Pain in the hip, buttocks, groin, outer thigh.
• Stiffness when you initiate any movements after a period of rest.
• Hip movement becomes restricted and causes a limp.
• The ability to walk routinely reduces over time and becomes disabling.

Avascular Necrosis of the Hip (AVN)

Avascular necrosis or osteonecrosis of the hip occurs when blood supply to the bone is temporarily or permanently lost. This condition eventually destroys the hip joint. It may be due to injury, fracture, damage to blood vessels, long-term use of steroids, and excessive alcohol abuse.

Apart from clinical examination, the modalities used to diagnose AVN are X-ray’s, and in early stages where X-ray usually doesn’t pick up, MRI scan is helpful.

Only when anti-inflammatory medications, activity changes, physical therapy, bisphosphonates, and grafting don’t help, total hip replacement is needed. Also, if the collapse has already occurred, then the surgeon will suggest Total Hip Replacement surgery.

When Is Total Hip Surgery Recommended

The AVN condition progresses over months to even years. Since its symptoms are not easy to recognize, it is advisable to visit an orthopaedic surgeon for a consultation. Some of the symptoms are: -

• Early dull aching joint pain.
• Increased joint pain and difficulty to put weight on the affected limb.
• Restricted range of movement.

Procedure for Total Hip Replacement

The type of surgery depends on the age and the fracture pattern. It can either be a repair of the fracture or replacement of the head of the femur. The hip replacement surgery is a two-hour procedure. Here, the orthopaedic surgeon removes the damaged cartilage and bone and positions new metal, plastic, or ceramic implants. It restores the alignment and function of the hip. The sutures go in 2-3 weeks after surgery. During this time, your surgeon will require X-Rays to assess the healing process of the fracture.

Postoperative Care for Total Hip Replacement

Patients are encouraged to get out of bed on the same evening of the surgery or the next day. Your surgeon will also recommend:-

• A graduated walking program initially in your home and later outdoors.
• When to resume normal activities like climbing stairs.
• Specific daily exercises by a physiotherapist to restore movement and strengthen your hip.

Today, the best hip replacement surgeons have greatly improved the success rate of total hip replacement surgeries in India. Visit HKS clinic for a consultation today.