Hip Replacement

Hip Replacement

What Is Hip Arthritis?
In the hip joint there is a layer of smooth cartilage on the ball of the upper end of the thigh bone (femur) and another layer within your hip socket. This cartilage serves as a cushion and allows for smooth motion of the hip. Arthritis is a wearing away of this cartilage. Arthritis can develop as a result of some disease like rheumatoid arthritis, avascular necrosis, trauma or as a part of age related degeneration. Eventually it wears down to bone. Rubbing of bone against bone causes discomfort, swelling and stiffness.

What Is a Total Hip Replacement?
A total hip replacement is a surgery that removes the arthritic ball of the upper thighbone (femur) as well as damaged cartilage from the hip socket. The ball is replaced with a metal ball that is fixed solidly inside the femur(with or without bone cement). The socket is replaced with a plastic or metal liner that is usually fixed inside a metal shell. This creates a smoothly functioning joint that does not hurt.

What Are Alternatives to Hip Replacement?
In early osteonecrosis i.e. Stage I / II Before considering a total hip replacement, we may try other methods of treatment, such as exercise, walking aids, medication and core decompression.
Core decompression is drilling of holes in to the femoral head which can also be augmented with stem cells injection into these holes, which will help increase the blood supply of the femoral head. This may help to avoid or delay your surgery for a reasonable period of time.

Can we do Core decompression for stage III/ IV?
Core decompression is not effective for III/IV as there is already depression at weight bearing part of the femoral head. Core decompression with not help in improving mechanical symptoms caused by deformation of head.

Is a Cemented or Uncemented Prosthesis Better?
The answer to this question is different for different people. Because each person’s condition is unique, the doctor and you must weigh the advantages and disadvantages.
Cemented replacements are more frequently used for older, less active people and people with weak bones, such as those who have osteoporosis, while uncemented replacements are more frequently used for younger, more active people.
Studies show that cemented and uncemented prostheses have comparable rates of success. Studies also indicate that if you need an additional hip replacement, or revision, the rates of success for cemented and uncemented prostheses are comparable.

Am I too old for hip-replacement surgery?
Age is not a problem if you are in reasonable health and have the desire to continue living a productive, active life. You may be asked to see your personal physician for an opinion about your general health and readiness for surgery.

How long will my new hip last, and can a second replacement be done?
We expect most hips to last more than 10–15 years. However, there is no guarantee, and 5–10 percent may not last that long. A second replacement may be necessary.

What are the major risks?
Bleeding and clot formation are the most dreaded complications after joint replacement surgery. These are taken care by prophylactic use of antibiotics and blood thinners. Special precautions are also taken in the operating room to prevent infection.

Should I exercise before the surgery?
Preoperative physiotherapy exercises are always advantageous as they help in hastening the post-operative recovery.

Will I need blood?
Not all patients require blood transfusion. It is only decided after pre-anaesthesia check-up, whether a patient will require blood or not.

How long will I be in the hospital?
Most patients are hospitalised one day prior to the surgery and for five days after the surgery

Will I have pain after surgery?
Patients have maximum pain during the first 48 hours after the surgery. During this period patient is kept under continuous monitoring and appropriate measures are taken to decrease the intensity of the pain. Our anaesthetist will discuss with you what pain control option is best for you.

Will I need physical therapy when I go home?
Yes. Physical therapy will continue after you go home with a therapist in your home or at an outpatient physical-therapy facility. The length of time required for this type of therapy varies with each patient. We will help you with these arrangements before you go home.

When will I be able to get back to work?
We recommend that most people take at least one month off from work, even if your job allows you to sit frequently. More strenuous jobs will require a longer absence from work.

How often will I need to see my doctor following the surgery?
Ten days after discharge for suture removal. The frequency of follow-up visits will depend on your progress.

Will I need a walker, crutches or cane?
Yes. Until your muscle strength returns after surgery, you will need a walker, a cane or crutches. Your equipment needs will be determined by the physical therapist.

How will my physical activity be restricted after surgery?
High-impact activities such as contact sports, running, singles tennis and basketball are not recommended. Injury-prone sports are dangerous for your new joint. You will be restricted from crossing your legs. Your surgeon and therapist will discuss further limitations with you following surgery. You are encouraged to participate in low-impact activities such as walking, dancing, golfing, hiking, swimming, and gardening.

Will I notice anything different about my hip?
In many cases, patients with hip replacements think that the new joint feels completely natural. However, we recommend always avoiding extreme positions or high-impact physical activity. The leg with the new hip may be longer than it was before, either because of previous shortening due to the hip disease, or because of a need to lengthen the hip to avoid dislocation. Most patients get used to this feeling in time or can use a small lift in the other shoe. Some patients have aching in the thigh when bearing weight for a few months after surgery.