Dr Sumit Mahajan
Hip replacement, or arthroplasty, is a surgical procedure in which the diseased parts of the hip joint are removed and replaced with new, artificial parts. These artificial parts are called the prosthesis. The goals of hip replacement surgery include increasing mobility, improving the function of the hip joint, and relieving pain.
Who Should Have Hip Replacement Surgery?
People with hip joint damage that causes pain and interferes with daily activities despite treatment may be candidates for hip replacement surgery. Osteoarthritis is the most common cause of this type of damage. However, other conditions, such as rheumatoid arthritis (a chronic inflammatory disease that causes joint pain, stiffness, and swelling), avascular necrosis( which is the death of bone caused by insufficient blood supply), injury, fracture, and bone tumors also may lead to breakdown of the hip joint and the need for hip replacement surgery.
In the past, doctors reserved hip replacement surgery primarily for people over 60 years of age. In more recent years, however, doctors have found that hip replacement surgery can be very successful in younger people as well. New technology has improved the artificial parts, allowing them to withstand more stress and strain and last longer.
What Does Hip Replacement Surgery Involve?
The hip joint is formed by ball at the end of the femur, called the femoral head that fits in a socket (the acetabulum) in the pelvis to allow a wide range of motion.
Hip replacement surgery involves 4-6-inches incision over the side of the hip through the muscles and removes the diseased bone tissue and cartilage from the hip joint, while leaving the healthy parts of the joint intact. Then the surgeon replaces the head of the femur and acetabulum with new, artificial parts. The new hip is made of materials that allow a natural gliding motion of the joint.
The parts used to replace the joint are the same and come in two general varieties: cemented and uncemented.
Cemented parts are fastened to existing, healthy bone with a special glue or cement. Hip replacement using these parts is referred to as a “cemented” procedure. Uncemented parts rely on a process called biologic fixation, which holds them in place. This means that the parts are made with a porous surface that allows your own bone to grow into the pores and hold the new parts in place. Sometimes a doctor will use a cemented femur part and uncemented acetabular part. This combination is referred to as a hybrid replacement.
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.
What Can Be Expected Immediately After Surgery?
On the day after surgery or sometimes on the day of surgery, therapists will teach you exercises to improve recovery. A respiratory therapist may ask you to breathe deeply, cough, or blow into a simple device that measures lung capacity. As early as 1 to 2 days after surgery, you may be able to sit on the edge of the bed, stand, and walk with assistance. While you are still in the hospital, a physical therapist may teach you exercises such as contracting and relaxing certain muscles, which can strengthen the hip.
How Long Are Recovery and Rehabilitation?
Usually, people do not spend more than 5 days in the hospital after hip replacement surgery. Full recovery from the surgery takes about 2-3 months, depending on the type of surgery, your overall health, and the success of your rehabilitation. It is important to get instructions from your doctor before leaving the hospital and to follow them carefully once you get home.
What Are Possible Complications of Hip Replacement Surgery?
New technology and advances in surgical techniques have greatly reduced the risks involved with hip replacements.
The most common problem that may arise soon after hip replacement surgery is hip dislocation. Because the artificial ball and socket are smaller than the normal ones, the ball can dislodged from the socket if the hip is placed in certain positions. The most dangerous position usually is pulling the knees up to the chest. Now to tackle with these problems surgeons are using larger head with larger socket which not only reduces the chances of dislocation but also guarantees greater range of motion. To minimize the risk of complications, it’s important to know how to prevent problems and to recognize signs of potential problems early and contact your doctor
When Is Revision Surgery Necessary?
Hip replacement is one of the most successful orthopaedic surgeries performed. However, because more people are having hip replacements at a younger age, and wearing away of the joint surface becomes a problem after 15 to 20 years, replacement of an artificial joint, which is also known as revision surgery. But with the modern technology, there are hips with ceramic and ceramic bearing (delta motion) that can remain for life time.
What Types of Exercise Are Most Suitable for Someone With a Total Hip Replacement?
Proper exercise can reduce stiffness and increase flexibility and muscle strength. People who have an artificial hip should talk to their doctor or physical therapist about developing an appropriate exercise program. Most of these programs begin with safe range-of-motion activities and muscle-strengthening exercises. Many doctors recommend avoiding high-impact activities, such as basketball, jogging, and tennis. These activities can damage the new hip or cause loosening of its parts. However exercises like, walking, stationary bicycling and swimming are encouraged. These exercises can increase muscle strength and cardiovascular fitness without injuring the new hip.
(The author is Consultant Orthopaedics, SDDM Hositpal, Jammu)
Follow our WhatsApp channel
