Hip Replacement Surgery
Hip Replacement in India helps patient in their Orthopaedics related treatments by packaging their medical trip to India and it also offers a full complement of surgical as well as physiotherapy services exclusively to International Patients combined with their post - discharge recuperative holidays.
Hip replacement surgery, also called total hip arthroplasty, involves removing a diseased hip joint and replacing it with an artificial joint, called a prosthesis. Hip prostheses consist of a ball component, made of metal or ceramic, and a socket, which has an insert or liner made of plastic, ceramic or metal. The implants used in hip replacement are biocompatible — meaning they're designed to be accepted by your body — and they're made to resist corrosion, degradation and wear.
Hip replacement is surgery for people with severe hip damage. When you have a hip replacement, the surgeon removes damaged cartilage and bone from your hip joint and replaces them with new, man-made parts. This can relieve pain, help your hip joint work better, and improve your walking and other movements. Your doctor may recommend it if you have hip damage and pain, and physical therapy, medicines and exercise don't help.
Hip replacement is typically used for people with hip joint damage from arthritis or an injury. Followed by rehabilitation, hip replacement can relieve pain and restore range of motion and function of your hip joint.
The most common problem after surgery is hip dislocation. Because a man-made hip is smaller than the original joint, the ball can come out of its socket. The surgery can also cause blood clots and infections. After a hip replacement, you might need to avoid certain activities, such as jogging and high-impact sports.
Your Hip Surgery
The hip is a ball and socket joint. The ball portion of the joint is called the femoral head, and is part of the upper leg bone (femur). The socket portion is called the acetabulum, and is part of the pelvic bone. The femoral head (ball) fits into the acetabulum (socket) and moves within its natural fluid, called synovial fluid, which helps to lubricate the joint during motion
In a healthy hip joint, the surfaces of these bones where the ball and socket rub together are very smooth and covered with a tough protective tissue called cartilage. Arthritis causes damage to the bone surfaces and cartilage. These damaged surfaces eventually become painful as they wear.
There are many ways to treat the pain caused by arthritis. One way is total hip replacement surgery. The decision to have total hip replacement surgery should be made very carefully after consulting your doctor and learning as much as you can about the hip joint, arthritis, and the surgery.
In total hip replacement surgery, the ball and socket that have been damaged by arthritis are removed and replaced with artificial parts made of metal and a durable plastic material. We call these artificial parts "implants," or "prostheses."
Two Types of Hip Fixation
There are two main types of fixation philosophies-cemented and porous. Both can be effective in the replacement of hip joints.` The physician (and the patient) will choose the best solution that is specific to the patient's needs.
Cemented Hip Implants
The cemented hip implant is designed to be implanted using bone cement (a grout that helps position the implant within the bone). Bone cement is injected into the prepared femoral canal. The surgeon then positions the implant within the canal and the grout helps to hold it in the desired position.
Porous Hip Implants
The porous hip implant is designed to be inserted into he prepared femoral canal without the use of bone cement. Initially, the femoral canal is prepared so that the implant fits tightly within it. The porous surfaces on the hip implant are designed to engage the bone within the canal and permit bone to grow into the porous surface. Eventually, this bone ingrowth can provide additional fixation to hold the implant in the desired position.
What to Bring to the Hospital ?
Below is a list of things you may want to bring with you to the hospital in preparation for your surgery. Talk with your physician, as he/she may have additional information about preparing for your hospital stay.
- Your personal belongings should be left in the car until after surgery. Tell your family that your room will be assigned when you are in surgery or in recovery, at which point they can bring your personal items to your room.
- Personal grooming items that you may want to pack include a toothbrush, toothpaste, hairbrush, eyeglasses/contacts, comb, deodorant, shaving cream/electric razor, shampoo, lotion, undergarments, and a robe.
- Bring slippers or flat rubber-soled shoes for walking in the hallways.
- Bring loose-fitting clothing for your trip home.
- Bring any medications you are currently taking. You should also write down your medication information to be given to the hospital staff. Be sure to include the name, strength, and how often you take the medications. Please communicate any allergies you might have to your doctors and the nursing staff.
- If you use a breathing exerciser (IBE), be sure to bring it with you from home, as you will probably need this right after surgery.
- Leave jewelry, credit cards, car and house keys, checkbooks, and items of personal value at home. Bring only enough pocket money for items such as newspapers, magazines, etc.
The patient is first taken into the operating room and given anesthesia. After the anesthesia has taken effect, the skin around the upper thigh is thoroughly scrubbed with an antiseptic liquid. An incision of appropriate size is then made over the hip joint.
Replacing the Socket Portion of the Joint
One type of implant that replaces the socket consists of a metal shell that is lined with a strong plastic liner.
Inserting the Implant
The shell portion of the socket implant may be attached either by using a special kind of epoxy cement for bones, or by pressing the implant into the socket so that it fits very tightly and is held in place by friction. Some implants may have special surfaces with pores that allow bone to grow into them to help hold the implant in place. Depending on the condition of the patient's bone, the surgeon may also decide to use screws to help hold the implant in place.
When the shell portion of the socket implant is in place, the plastic liner is locked into place inside the shell.
Removing the Ball
A special power saw is used to remove the damaged femoral head
Replacing the Ball Portion of the Joint
The implant that replaces the ball consists of a long metal stem that fits down into the femur. The metal ball is mounted on top of this stem.
Clearing and Shaping the Canal
The upper leg bone has relatively soft, porous bone tissue around the center. This part of the bone is called cancellous bone. It surrounds the canal, which mainly contains blood vessels and fatty tissue.
Special instruments are used to clear some of the cancellous bone from the canal, and then to mold the inside walls of the canal to fit the shape of the implant stem.
Inserting the Implant
The stem implant may be held in place by either using the special cement for bones, or by making it fit very tightly in the canal. If cement is used, it is injected into the canal first, and then the implant is inserted into the canal. If cement is not used, the implant is simply inserted into the canal. Like the socket implant, the stem implant may have a special surface with pores that allow bone to grow into them.
On some implants, the stem and ball are one piece. On others, they may be two separate pieces. If the ball is a separate piece, it is usually secured to the top of the stem after the stem has been inserted.
The Following are the Types of Hip Surgeries performed at We Care India partner Hospitals :
Frequently Asked Hip Replacement Questions
This page provides a brief introduction to hip replacement. It can help you make a list of questions to ask your doctor, but it is not meant to provide complete information. Check with your surgeon's office about more comprehensive resources and patient education materials.
What causes hip pain?
- Rheumatoid arthritis
- Aseptic bone necrosis / Avascular necrosis
Is there a cure?
Since hip pain results from damage to the joint, there is no “cure.” However there are a variety of treatment options available, ranging from rehabilitation to total hip replacement surgery.
How do I know if I need a hip replacement?
If you have difficulty walking or performing everyday activities such as getting dressed, it may be time to consider hip replacement surgery.
Doctors generally try to delay total hip replacement for as long as possible in favor of less invasive treatments. However in patients with advanced joint disease, hip replacement offers the chance for relief from pain and a return to normal activities.
How do I prepare for hip replacement surgery?
If you and your surgeon decide that total hip replacement is right for you, a date will be scheduled for your surgery. Several things may be necessary to prepare for surgery. For example, your surgeon might ask you to have a physical examination by your primary care physician. This will help to ensure that other health problems you may have, such as diabetes or high blood pressure, will be identified and treated before surgery.
What happens during hip replacement surgery?
On the day of surgery, an intravenous tube will be inserted into your arm to administer necessary medications and fluids during surgery. You will then be taken to the operating room and given anesthesia.
The surgery usually takes two to four hours, although this is dependent upon the severity of the arthritis in your hip. In the operating room, a urinary catheter will be inserted and left in place for one or two days. Compression stockings and pneumatic sleeves will be put on both legs. The procedure is performed through an incision over the side of the hip. The ball-end of the thighbone (femur) is cut and replaced with the new metal ball and stem component.
It may be stabilized with or without cement. The damaged surface of the socket is smoothed in preparation for the insertion of the new socket. The ball and socket are then joined. When the surgeon is satisfied with the fit and function, the incision will be cleaned and covered with dressings. You will also find small drainage tubes coming out of the hip to drain fluid from the wound.
You will be sent to the recovery room and as the anesthesia wears off you will slowly regain consciousness. A nurse will be with you, and may encourage you to cough or breathe deeply to help clear your lungs. You will also be given pain medication and will find a foam wedge or pillows placed between your legs to help hold your joint in place. When you are fully conscious, you will be taken back to your hospital room.
How long does the surgery take? What is the recovery time?
In the weeks immediately following surgery, you may need walking aids such as a cane or crutches. Within a few months, however, you should be able to return to normal activities.
For more information, please read, Your Hip Surgery and After Hip Surgery.
How is the implant affixed in the body?
- Bone Cement : - A special type of bone acrylic cement may be used to secure some or all of the implant components to the bone. If used, the bone cement takes about 15 minute to set.
- Press-Fit : - In other cases, the implants may be “press-fit” into the bone. Press-fit components may have a special porous coating that allows tissue to grow up to it for fixation.
- Combination : - In some cases, your surgeon may choose a combination of cement and press-fit attachment, depending upon the implant components and condition of the pelvic and thigh bone.
The decision as to whether to use a cemented or press-fit component depends upon many factors, including the manufacturer’s intended use of the product, surgeon philosophy and the patient’s condition.
What can I expect after surgery?
When you are back in your hospital room you will begin a gentle rehabilitation program to help strengthen the muscles around your new hip and regain your range of motion. On the day of surgery you may be asked to sit on the edge of the bed and dangle your feet. You will also learn how to protect your new hip while doing daily activities.
As soon as possible, usually within the next 24 hours, your physical therapist will help you start walking a few steps at a time. As you heal you will progress from walker to crutches and then a cane. Before you are dismissed from the hospital, an occupational therapist will also show you how to perform daily tasks at home with your new hip. For example, he or she will instruct you on how to go to the bathroom, how to dress yourself, how to sit or stand, how to pick up objects and many others.
After about two to four days, or when your surgeon determines that you have recovered sufficiently, you will be discharged. You may be transferred to a rehabilitation facility for a few more days, as determined by your surgeon. Upon returning to your home, you will need to continue taking your regular medications and continue exercising as directed by your surgeon or physical therapist. Walking, remaining active and practicing the required exercise are the quickest ways to full recovery. Read the Surgery Calendar to learn more on what to expect after surgery.
The Following are the Types of Hip Replacement performed at We Care India partner Hospitals :
What about sex?
Doctors generally allow patients to resume sexual activities as soon as they feel able. In the months following surgery, patients are generally advised to take it easy and modify their positioning to keep pressure off of the joint while it’s healing. As always, it is best to consult with your doctor about what’s safe for your particular condition.
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