What is Hip Replacement Surgery? When is Hip Replacement advised?
Hip replacement is a surgical procedure where the affected hip joint is replaced with an artificial structure known as the prosthetic implant.
Many patients who suffer from osteoarthritis or other conditions of the hip joint like rheumatoid arthritis, bone deformities, injuries, may present extreme hip pain and inability of movement, sleep troubles and restriction to day to day activities. When the condition is no longer manageable with medications, physical therapy or injections, hip replacement surgery is suggested. The objective of the surgery is to ultimately relieve a painful hip joint and make movements for walking easier
What is done in hip replacement surgery?
Hip replacement surgery may be carried out in two ways:
- Total hip replacement: In this procedure the whole of the joint is replaced with a hip prosthesis. It is also known as total hip arthroplasty.
- Hemi/half/partial hip replacement: Also known as hip hemiarthroplasty, in this procedure only the ball or the femoral head of the damaged hip joint is replaced.
Hip replacement surgery: Hip replacement surgery is a major operation done under general anaesthesia and can be performed either traditionally using the standard technique of a single 8 to 10 inch cut or incision along the side of the hip or by using a minimally-invasive technique consisting of one to two cuts from 2 to 5 inches long. The incision is made on the side of the hip to reach the hip joint. Once the joint is exposed, a saw is used to remove the ball form of the thighbone. An artificial joint or prosthesis is then fixed to the thighbone with the help of medical grade cement. Next, the surface of the hipbone is prepared with removal of any damaged cartilage and attached to the replacement socket part to the hipbone. The new ball part of the prosthesis in the thighbone is now inserted into the socket of the hip.
Hip arthroscopic surgery: Hip arthroscopy is a minimally invasive surgical procedure to diagnose and treat any hip injuries or deformities. Hip arthroscopic surgeries involve insertion of arthroscope through a small incision. The advantage of this method is reducedhip pain and scarring, faster recovery and delayed need for hip replacement. However, it only treats early hip conditions such as hip impingement, labral tears, removes loose fragments. It cannot replace partial or total hip replacement.
What can be expected from a hip replacement surgery?
- For many patients, deciding whether or not to go for a hip replacement surgery may be a difficult decision. Hence, it is beneficial and essential to discuss the options with orthopaedic surgeon to decide the right course of action.
- Each patient achieves recovery differently. After surgery, physical therapy is generally needed to increase hip strength and mobility gradually. Some people may go home soon after surgery, while others may need to stay back longer.
Hip arthroscopic surgery
What are the benefits and risks/complications of hip replacement surgery?
Generally, hip replacement is a part of a comprehensive care, which is focused towards management of pain, and discomfort, as well as improvement in movement and function. The potential benefits achieved with hip replacement are:
- Relief from pain
- Improved mobility
- Increased ability to pursue day-to-day activities like climbing stairs, squatting, walking etc
However, hip replacement is a major surgery that carries some risks or complications. Some of the possible risks are:
- Formation of blood clots in the veins of the leg, known as deep vein thrombosis. The clots may travel to the lungs and lead to a condition called pulmonary embolism.
- Infections in the site of surgery or within the joint
- Dislocation of the hip
- Loosening and wear of the joint
- Damage to nearby nerves and structures
- One leg becoming longer than the other, affecting gait
- Persistent discomfort
- Haematoma/bleeding of the surgical site
It’s very important to note that many of these complications may arise due to a poorly performed technique of implant placement. Hence the skills of the orthopaedic surgeon play a vital role.
What factors should be considered while choosing a hospital for hip replacement surgery?
Hip replacement is a major surgery that is highly dependent on the skills of the orthopedic surgeon. In addition, the hospital where the surgery is performed should have adequate infrastructure and trained team to fulfill the pre-operative and post-operative care. Some factors that should be considered while selecting a hospital include:
- Availability of skilled orthopedic surgeon who is specially trained or has expertise in performing hip replacement surgeries and leads the surgical team.
- Well-equipped operation theatre with sound infection control practices. Availability of specialized orthopedic surgical equipment in the operation theatre like ‘vacuum mixing’ of the cement, C-arm, pulse lavage etc.
- Post-operative care: Availability of a round the clock trained team of orthopaedic surgeons, anaesthetist, nursing and paramedical staff to support an uneventful and pain free post-operative recovery.
- Availability of physiotherapy personnel under the supervision of the orthopedic surgeon for after care for physiotherapy and to guide on post discharge exercises to be carried out.
- Round the clock support for diagnostics, dietary and pharmacy needs.
What factors govern the cost of hip replacement surgery?
The cost of surgery depends on many factors like:
- The type and brand of the implant.
- Orthopedic surgeon and team, expertise and experience.
- Underlying medical condition of the patient that can influence the hospital stay and requirement of additional tests and medicines.
- Room category availed; depending on the hospital’s billing policy.
How long does it take to recover from hip replacement surgery?
Recovery of patients with hip replacement is seen to be sooner than those with knee replacement. However it is also seen that recovery for a total hip replacement may differ considerably from patient to patient. There are many factors that govern the total recovery time such as, presence of any underlying medical conditions like diabetes, osteoporosis, and weight of the patient. While for some patients it may take 6 months to recover; for others it may just take a few weeks to recover. An average recovery time of 3-6 months is observed in patients with no underlying complications.