Hip Replacement

Anatomy of Hip: Human body majorly has four types of joints:
  1. Synovial Joint
  2. Hinge Joint
  3. Pivot Joint
  4. Ball & Socket Joint

The Hip is the largest ball and socket joint present in the human body. The upper leg or the thigh bone Femur that also connects the thigh to the lower leg, is the rounded head bone that fixes itself in the socket of Acetabulum which is part of the pelvis. The surface of both the bones, femur & acetabulum are covered with articular cartilage, which supports the movement of the hip.

The hip is the second most flexible joint in the human body after Shoulder. The Hip joint is surrounded by synovial membranes. The synovial membrane has the fluid that reduces the friction and eases movement of the Hip in articular cartilage. It can move in front, back and sidewards. The hip can perform a wide range of motions. The Hip joint has ligaments that protect the hip capsule, providing it with a lot of stability.

Causes of Hip Pain: Here are the most common causes of Chronic Hip Pain that need medical attention:
  • Hip Diseases- Infants and children sometimes have hip diseases which left untreated affects the natural growth of the Hip. Even after receiving proper treatment, the child may face issues after growing up, and the joint surfaces may also suffer.
  • Rheumatoid Arthritis: The Synovial membrane that surrounds the Hip bone turns thick and inflamed. This further damages the surrounding cartilage resulting in pain and stiffness. Also known as “Inflammatory Arthritis”, this is an autoimmune disease.
  • Osteonecrosis: If a dislocation or fracture occurs, the blood supply to the femoral is reduced. This condition is referred to as “Avascular Necrosis”. It can also be a result of some diseases.
  • Osteoarthritis: It is the most common cause of pain and stiffness and almost inevitable with every human being. This type of arthritis occurs in people with age of 50 and above. The cartilage that reduces friction is worn down causing the bones to rub together

Hip Replacement Surgery: It is a complicated surgery because of the largeness of the joint. The affected bone and cartilage are removed from the body and prosthetic parts as required by the severity and affect on the bones and cartilage. This Surgery is also referred to as Arthroplasty.

The damaged rounded head of the femoral; is replaced with a ceramic or a plastic ball. Similarly the socket of the acetabulum is replaced with a metal socket with the help of cement and screws. A spacer made of metal is placed between the two prosthetic bones to help movement and remove friction.

Specialisation Required: Once the doctor suggests that the Surgery is the best option for the injury, the patient is required to meet the specialist who has the expertise to perform the actual process; the orthopaedic surgeons. Before a mutual decision is made by the doctor and patient, the orthopaedic surgeon will closely examine the patient’s joint and vital statistics.Taking into consideration all the points, overall health condition and intensity of injury, the surgeon and patient make the most suitable choice for treatment.

Why Surgery: An orthopaedic surgeon will advice the patient for surgery in following cases–
  • The patient faces problems in flexibility and movement in legs due to stiffness in Hip.
  • The anti-inflammatory and analgesic drugs cannot provide relief in the pain due to injury. The patient experiences pain even in the resting position.
  • The patient faces difficulty in carrying out daily tasks and the routine walking and bending is affected
Health Considerations: A specialist will take into account the following factors before taking up surgery-
  1. Medical History: The orthopaedic surgeon will collect maximum information about the patient’s injury, its cause, intensity of pain, any medical history for chronic ailment, like BP or Diabetes, previous surgery or Allergy.
  2. X-Rays: The specialist often asks the patient to get a few X-rays done. This helps the doctor to understand the anatomy of injury and plan the surgery ahead.
  3. Physical Check-Ups– The surgeon would check and examine the injury and range of movement of the leg.
  4. MRI : The patient is often asked to get other tests done like CBC, Dental evaluation, Urinary tests. ECG. etc.

The Surgical Process– The patient can be treated as an outpatient and may go home the same day or vice versa. The surgery often takes 60-120 minutes to take place. After the patient is admitted, he is given anaesthesia. It may be a general anaesthesia, epidural or regional nerve block anaesthesia. The damaged cartilage and bone is removed and the prosthetic parts are placed. After the surgery, the patient is moved to the post operative room and monitored for several hours before being discharged home.

Post -Operative care: There are big changes in day to day routine that need to be made post operation.The doctor prescribes analgesics, anti-inflammatory steroidal or non steroidal injectables. In extreme cases, narcotics may be given.

The patient has stitches or sutures at the injury area, which are removed after 15 days, till then they need proper care and management. They need to be supported with clothing and kept dry. Even long after, they cause a lot of irritation before they are completely healed.

A nutritious diet with iron supplements to help with tissue repair is suggested by the doctor. Movement is a big problem that needs to be addressed with care and precision. The patient requires support of some other person, cane or walker, initially for a few days. He can get back to his routine activities of daily life within 1-2 months. Although night time activities are still difficult to perform for a few more weeks. The patient is supposed to initiate walking, slowly and steadily; beginning from within the room to outside gradually. The range of flexibility and motion are also to be increased with proper support and care. It takes time to get back to activities like sitting, standing and walking.

Care of Replaced Hip: The Prosthetic Hip Joint needs to be taken care of consistently.
  • Regular visits to the surgeon for routine check- ups and X-Rays is important to ensure proper care of the joint.
  • Getting exercise sessions with a professional physiotherapist helps in proper healing of the injury.
  • Keeping the dentist well informed is important before proceeding for a dental procedure.

At The Cruciates, we have a team of specialists who can help you every step of treatment and guide with proper information whenever required. You can get in touch with us by clicking on the link-…., or you can call us at the number-…

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