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Total Hip Replacement Surgery: A Comprehensive Guide

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Total hip replacement refers to the replacement of the damaged hip joint with a prosthetic joint made up of metal or plastic. The hip joint may get damaged because of several reasons, including age-related degeneration of the hip bone, osteoarthritis of the hip and injury due to accident or fall.

Hip replacement surgery can be conducted in adults of any age group. However, it is most commonly performed in patients aged between 60 and 80, with most of them surviving hip injury because of fall or damage due to osteoarthritis.

Hip pain is one of the major reasons behind the need to conduct hip replacement surgery. Chronic hip pain severely affects the day to day life of people and limits their movement. They are not able to walk, sit, stand up and climb stairs and a serious medical attention is needed if the pain is not controlled with medications or if it deteriorates over a period of time.

Total hip replacement is also known as hip arthroplasty. It is a common orthopaedic procedure which is now being conducted on thousands of patients around the world. In fact, the number of hip replacement surgeries conducted in a year has ‘sky-rocketed’ from 2000 to 2010, according to a survey conducted by CDC’s National Centre for Health Statistics (NCHS).

Hip replacement surgery in India is a common orthopaedic procedure, not only preferred by patients in India but those from abroad as well. Hip replacement cost in India is just a fraction of what it costs in other Western countries, including the US and UK.

This is the major reason why India has emerged as a hub for orthopaedic surgeries for the medical tourists. On an average, a medical tourist ends up spending 50 to 70 percent less amount when they decide to travel to India for hip replacement or for that matter any other orthopaedic surgery.

The difference in the cost of total hip replacement in India and any other country remains significant even when additional costs such as that of boarding, lodging, local transport, telephone and internet are taken into account.

Total hip replacement cost in the US is around $39,000. On the other hand, the cost of hip replacement surgery in India is just around $6,000. The total cost may depend on several other factors such as the duration of stay, choice of hospital and choice of city for treatment.

There are several questions that a patient may have about undergoing total hip replacement. This article talks about these common notions and other considerations to make while making the decision to undergo hip replacement surgery.

Hip Pain Causes

Hip pain is a common problem, especially among the elderly. The exact location or the point from where hip pain is emerging may help doctors understand the exact cause.
There are many reasons that may contribute to hip pain. For example, it may result because of a problem with the surrounding muscles, ligaments or tendons, or it may result because of certain diseases affecting the hip bone or the lower back.

The causes of hip pain are divided into several categories, including the following:

Injuries

  • Dislocation or Fracture of Hip Bone
  • Inguinal Hernia
  • Tendinitis
  • Bursitis
  • Hip Labral Tear

Cancer

  • Bone Cancer
  • Leukaemia

Arthritis

  • Rheumatoid Arthritis
  • Septic Arthritis
  • Osteoarthritis
  • Psoriatic Arthritis

Other reasons for hip pain include sciatica, osteoporosis, osteonecrosis, osteomyelitis, synovitis and sacroiliitis. Depending on the exact cause of hip pain, the patient may experience pain in the thigh, buttocks, groin or inside or outside of the hip joint. Sometimes, the pain may radiate from the groin to the hip.

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Best Candidates for Total Hip Replacement

Most often, people who suffer from chronic hip pain because of any of the reasons described previously are the ones who are recommended to undergo total hip replacement. The pain, however, should be severe enough to interfere with the daily routine of the patient.

Moreover, hip replacement surgery is recommended only when other treatment options fail to work, including medications, physical therapy and change of lifestyle.

A few years back, total hip replacement was recommended only to people aged above 60. However, the doctors now believe that the hip replacement surgery can prove to be highly successful in young patients as well.

Therefore, the best candidates for hip replacement surgery include any adult with persistent chronic hip pain that interferes with day-to-day life and also decreases the quality of life. Total hip replacement helps improve motility, quality of life and day-to-day functioning while eliminating pain altogether.

Hip Replacement Surgery: Risks and Complications

The advances made in the field of medical technology have greatly reduced the number of complications that the patients used to experience right after hip replacement surgery. However, there are still some risks and complications of total hip replacement that a patient may suffer from after the surgery, even though the chances are minimal.

The following are some of the hip replacement surgery risks and complications:

  • Hip Dislocation
  • Infection
  • Reaction to Artificial Hip Joint
  • Need for Revision Surgery
  • Blood Clots
  • Heterotopic Bone Formation
  • Redness, Swelling and Inflammation

Types of Hip Replacement Surgeries

There are different types of hip replacement surgery, categorized according to the type of material used, the method of fixation and the extent of joint replaced.

For example, a patient may be made to undergo cemented hip replacement or uncemented hip replacement. In case of cemented replacement, the artificial joint parts are attached to the adjoining tissues, ligaments and tendons with the help of a special glue called cement. In case of uncemented fixation, the prosthetic component is made to attach naturally or biologically.

The surgery can also be conducted using the traditional approach or in minimally invasive manner. In the first approach, the entire hip area is cut open to expose the damaged tissue and then replaced with artificial joint. In minimally invasive hip replacement, a short incision is made and special tools and devices are used to replace the damaged joint parts.

The surgery may also vary depending on the type of implant used for the surgery. The implant can be made up of ceramic, metal, plastic or a combination of two types of material.

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Hip Replacement Procedure

Before the surgery, the patient is administered general anaesthesia to put them into an unconscious state. It puts them into deep sleep and relaxes their muscles completely. As a result, they do not experience any pain during the procedure.

Once the patient is in deep sleep mode, the surgeon makes an incision along the side of the hip and then moves the muscles connected to the hip bone. This exposes the hip joint and the surgeon then removes the hip ball by cutting the thigh bone with a saw.

The artificial joint is then placed in place of the hip ball and attached to the thigh bone in uncemented or cemented fashion. The hip bone is then prepared for its attachment to the artificial socket by removing and damaged tissues.

The artificial ball attached to the thigh bone is then connected with the hip socket. The incision is closed after reattaching the muscles and draining extra fluid, if any.

Recovery after Knee Replacement Surgery: What To Expect?

After hip replacement surgery, a patient is expected to stay in the hospital for at least four to five days. Hip replacement recovery time may vary from one patient to another, but it may last anywhere between three to six months. It depends on the overall health of the patient, the success of the surgery and the type of surgery that the patient is made to undergo.

Recovery after total hip replacement surgery also depends on whether the patient has followed the guidelines given by the doctor or not. The patient must carefully follow all the precautions and guidelines to faster their rate of recovery.

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Frequently Asked Questions

Q: Which activities should I avoid after hip replacement surgery?
A: You should avoid performing high strength and high impact exercises such as jogging, tennis and basketball. In fact, any activity that involves long range of motion should be avoided initially.

Q: Which exercises should I perform for better recovery after hip replacement surgery?
A: Exercising is a must after hip replacement surgery. It helps improve the flexibility of the muscles and their strength. Ask the physical therapist or the doctor about muscle-strengthening exercises. Walking, stationary cycling, skiing and swimming are some of the recommended exercises.

Q: How long will the new hip joint last after surgery?
A: Nearly three decades back, the life of the hip implant was just 10 years. However, advances in the field of medical technology have now increased the life of hip implants to almost 25 years. In some cases, the implants last over a lifetime of the patient.

Q: Can I avoid undergoing hip replacement?
A: Hip replacement surgery in inevitable in case the medications or topical ointment don’t work, physical therapy is not effective and the pain is getting deteriorated day by day. The medications prescribed to individuals who do not want to undergo hip replacement include anti-inflammatory drugs, NSAIDs, corticosteroids and other topical ointments.

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