Thursday, 22 March 2012

Hip Replacement Surgeries

HIP ARTHRITIS
Arthritis of the hip is a disease condition where in the normal smooth bearing surface of the hip-joint (articular cartilage) is damaged or lost, causing pain, sometimes deformity that leads to loss of function and disability. The various causes that can lead to arthritis include age related wear & tear (osteo arthritis), wear & tear due to extra demand or injury to the hip joint, inflammation (rheumatoid arthritis) and other causes.
AVASCULAR NECROSIS OF THE HIP
Hip arthritis is also caused by an important condition called as ‘avascular necrosis’ which means death of femoral head because of loss of blood supply. Loss of blood supply can be caused by alcohol abuse, blood diseases like sickle cell disease, fracture of the hip, long term use of medicines called as steroids as well as some rare & unknown causes.
SYMPTOMS
Pain, loss of motion, restriction of activity, difficulty in walking, unequal leg lengths. Dependence on others, permanent disability, loss of confidence are other outcomes of this disease process.
SURGICAL TREATMENT
Depending on the patient’s age, gender, activity level, bone quality and stage of arthritis the surgical options are decided.
TOTAL HIP REPLACEMENT (THR)
WHEN TO THINK OF SURGERY?
  • Pain not controlled
  • Stiffness (loss of motion)
  • Disability
  • Restriction of day to day activities
Hip replacement surgery is performed principally for pain relief and also to regain independence and ability to do day to day work.
SURGICAL PROCEDURE
The hip joint consists of femoral head (ball) inside the acetabulum (socket). In a hip replacement, the femoral head is either resurfaced or removed and replaced with a ball attached to a stem which is inserted into the shaft of the femur (thigh bone). The acetabulum is then enlarged and a new socket inserted.
There are a variety of bearing surfaces that can be used depending on patient’s age, activity & bone quality.
The components can be fixed with or without bone cement.

Uncemented hip replacement

Cemented Hip Replacement
A decision is made as to the most appropriate combination of bearing surfaces and type of fixation for a particular patient.
RISKS
Total hip replacement is a major surgical procedure with very high success rates. However, like any other surgical procedure it is also associated with some risks, which are uncommon, but must be kept in the mind. These risks include:
  • Dislocation of the hip
  • Wear & loosening
  • Venous blood clots
  • Infection
  • Leg length inequality
  • Despite all these potential problems, the vast majority of patients are very happy with this procedure.
RECOVERY
The patients are hospitalized for less than 1 week after surgery. Most patients recover quite quickly from surgery. The recovery is much faster in thinner and hard working patients and those who are motivated to participate in active rehabilitation.

X ray of a patient who has undergone
both side hip replacement 7 years ago

X ray of a patient who has undergone
'Hip Resurfacing' surgery
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