Total Hip Replacement
What is Hip Replacement?
Total Hip Replacement, also known as Total Hip Arthroplasty, is one of the most successful orthopedic interventions,and it is coined as ‘The Operation of the 20th Century’. Total Hip Replacement is for those with severe pain in their hip joints and a variety of arthritic and related conditions. There are various types of hip replacement surgeries that have been performed over the years. The goal is to relieve pain and increase mobility, over and above, perform day to day activities with ease.
Why Total Hip Replacement Surgery?
Hip joint cartilages are damaged in most of the diseases. Cartilage damage can cause severe pain, it affects daily activities. The patient has to undergo a hip replacement surgery.The replaced hips can be in good condition for about 20 years. Total hip replacement is preferred in patients older than 60 years. Replaced hip surgery increases the life expectancy of the patient.
Total Hip Replacement is only advised when one is suffering from one or more conditions mentioned below:
- Aged above 60 years.
- Unbearable hip pain.
- Impaired daily activities.
- Experiencing severe pain in the night.
- Failure of other joint treatments.
The most common medical conditions that requires hip replacement surgery are:
- Rheumatoid arthritis
- Secondary osteoarthritis
- Paget’s disease
- Avascular necrosis of the hip
- Ankylosing spondylitis
The conditions when you can't have Hip Replacement?
In case of medical contradictions, it is not advisable for a patient to undergo surgery.
- In case, if you are suffering from an infection.
- In case, if you are suffering from an infection anywhere else in the body.
- If the muscles of that particular joint are weak due to Poliomyelitis or other paralytic conditions.
- If you are suffering from decreased blood supply to the affected joint or may be suffering from a severe illness, healing of the surgical wound may be impaired.
The goal is to make you perform day-to-day activities without experiencing any pain.
What happens pre and during the surgery?
- Usually, the patient is admitted a day or a week before(based on a specially designed preoperative assessment clinic) the surgery for general evaluation.
- Then based on the assessment, the patient can get admitted on the same day of the surgery, if found fit.
- Before surgery, a general physician, an anesthetist and a cardiologist might assess the patient.
- Few reports like a batch of blood tests, an ECG, an Echocardiogram, and a chest X-ray is also required.
During the Total Hip Replacement surgery procedure
- After the general assessment, an anesthesia is given, depending on your general health, it might be general or spinal.
- After the desired preparations, surgery is performed with a midline longitudinal cut of about 8 cm to 10 cm on your Hip.
- The size of the cut depends on the surgical approach. Doctors visualize the hip joint using incision.
- The ball of the joint is visualized through the incision.
- Surgeons remove the ball by making a cut at an appropriate angle and length using a surgical saw.
- Soft tissues and debris are removed from the socket for proceeding further.
- Special instruments called reamers are used to prepare the new socket and a trial; of new prosthesis is done.
- If the size of the prosthesis is the same, then the socket is fixed using the bone cement or screws or simply a press-fit depending on the technique employed.
- The upper end of the thigh bone is prepared using specific instruments.
- During the procedure, the hollow bone is scraped to shape the center of the thigh bone to accommodate the femoral stem.
- A trial stem with a ball on its top end is placed in the thigh bone, and surgeons maneuver it into the socket.
- He confirms the length of the adjoining part like the length of the leg, stability and movement of the hip joint. Other changes, if required, are made.
- Once all the components are confirmed, all the parts are placed back.
- The surgical wounds are stitched and the patient is shifted to the recovery area. In case of special medical conditions, the patient is shifted to the ICU.
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