Hip Joint and Its Diseases
Hip Replacement is a very common joint replacement procedure done in India. In terms of numbers it is second to knee replacement surgeries. The hip joint is a ball and socket joint, formed by an articulation between the pelvic acetabulum and the head of the femur. It forms a connection from the lower limb to the pelvic girdle, and thus is designed for stability and weight-bearing – rather than a large range of movement. Femur is the bone in the thigh and is one of the strongest bones of our body capable of bearing the maximum weight. The head of the femur bone is in the form of a ball which fits into the hip socket and allows for movement at the hip joint which is so important for most of the functions like walking and sitting.
Conditions that can damage the hip joint, sometimes making hip replacement surgery necessary, include:
Osteoarthritis. Commonly known as wear-and-tear arthritis, osteoarthritis damages the slick cartilage that covers the ends of bones and helps joints move smoothly.
Rheumatoid arthritis. Caused by an overactive immune system, rheumatoid arthritis produces a type of inflammation that can erode cartilage and occasionally underlying bone, resulting in damaged and deformed joints.
Osteonecrosis. If there isn’t enough blood supplied to the ball portion of the hip joint, such as might result from a dislocation or fracture, the bone might collapse and deform.
The progressively intense chronic pain together with impairment of daily function including walking, climbing stairs, and even arising from a sitting position eventually become reasons to consider a hip replacement surgery.
Hip Replacement Surgery
Hip replacement is a surgical procedure in which the diseased cartilage and bone of the hip joint is surgically replaced with artificial materials. Total hip joint replacement involves surgical removal of the diseased ball and socket and replacing them with a metal ball and stem inserted into the femur bone and an artificial plastic cup socket.
Types of Hip Replacement Surgeries
Partial Hip Replacement Surgery – In this surgery which is also known as hemiarthroplasty only the femoral head is replaced with a metal implant. This kind of surgery is suited for those patients whose acetabular socket and the stem are in reasonably good condition and only the femoral head has degenerated or damaged. However recent studies have shown that Total Hip Replacement is the Gold Standard for most of the patients.
Total Hip Replacement – Total hip joint replacement involves surgical removal of the diseased ball and socket and replacing them with a metal or ceremic ball and stem inserted into the femur bone and an artificial plastic (or ceramic) cup socket. The metallic artificial ball and stem are referred to as the “femoral prosthesis” and the plastic cup socket is the “acetabular prosthesis.” Upon inserting the prosthesis into the central core of the femur, it is fixed with a bony cement called methylmethacrylate. Alternatively, a “cementless” prosthesis is used that has microscopic pores which allow bony ingrowth from the normal femur into the prosthesis stem. This “cementless” hip is felt to have a longer life and has less chances of bone cement reaction in the patient. Total hip replacement is also referred to as total hip arthroplasty.
Revision Hip Replacement – The patient who has undergone Partial or Total Hip Replacement at a younger age needs to get the implants replaced after 15-20 years. This surgery which involves removal of the previous implant and replacing it with new implant is called Revision Hip Replacement. While many orthpaedic surgeons are good at doing Total Hip Replacement, very few of them are doing Revision Hip Replacement Surgeries.
Post Hip Replacement Surgey
After the surgery which generally lasts for two to four hours, both lower limbs will be observed for adequate sensation and circulation. Besides starting pain killers and antibiotics, compression stockings are applied to prevent blood clotting in the lower limbs. Physical Therapy will begin in 48 hrs.
The therapist will help the patient in walking and reinstating the movement of the knee. The knee will be in an immoboliser which will be removed after the inspection by the surgeon. Patients will start walking using a walker and crutches. Eventually, patients will learn to walk up and down stairs and grades. Patients are given home exercise programs to strengthen the muscles around the buttock and thigh.
Best Doctors and Cost
Dr Anubhav Jain and Dr Subhash Jangid are two of the best orthopaedic surgeons in India for doing all the 3 types of Hip Replacement Surgeries – Partial, Total and Revision Hip Replacement.
The cost of Partial Hip Replacement is USD 3000 while that of Total Hip Replacement is USD 4000 and Revision Hip Replacement is USD 5000. The difference in the costing is due to the difference in the cost of the implants and also the complexity of the surgery.
It is important for patients to continue in an outpatient physical-therapy program along with home exercises for optimal outcome of the replacement surgery. Excercising and maintaining mobility will help prevent the scarring of the replaced joint and improve muscle strength around the joint.