Are you diagnosed with hip arthritis? Do the symptoms get in your way while doing the thing you love? Lifestyle changes, regular medications, and assistive devices for walking are of no use?
Hip replacement – a life-changing procedure is a right solution for everyone with a damaged hip joint.
Total hip replacement surgery (also called total hip arthroplasty) is a surgical procedure that involves the replacement of a damaged or worn-out hip joint with a new one (hip prosthesis). These prostheses are made up of either metal, tough and sturdy plastic or ceramic. The hip joint may have been damaged due to arthritis, fracture, injuries, chronic illness or gradual wear and tear over the years.
The hip can be compared to a ball and socket, where the head of the thigh bone (femur) is the ball which fits into the socket of the pelvic bone. In a total hip replacement surgery, both the ball and the socket of the hip joint are replaced with a prosthesis.
The goal of total hip replacement surgery is to relieve pain, improve basic body movements and help the hip joint to support our daily activities.
Typically, total hip replacement is done as the final option for an individual with severe pain due to an extensively damaged hip, as other methods of treatment did not succeed. Total arthroplasty has no age or weight limitations, but most individuals who choose hip replacement belong to age the group of 50 to 80. Anybody with severe pain, stiffness and disability of the hip joint can undergo a total hip replacement.
PREPARATION BEFORE PROCEDURE
The doctor will perform a physical exam following a medical history evaluation. This is important to make sure the individual is fit for the surgery. Several tests such as blood tests, urine tests, electrocardiogram test, chest X-rays, etc. may be performed to help plan the surgery. Depending on the individual’s condition, additional tests may also be recommended.
The doctor will explain the benefits and risks of the surgery. Inform the doctor about any allergies or infections to help guide and plan the surgery.
The patient must not eat anything for six to eight hours before the surgery. Some conditioning exercises may be recommended to strengthen the hip muscles. Stop smoking at least two weeks before the procedure, as tobacco delays the healing, thereby slowing the recovery process.
The artificial hip prosthesis is of two types:
Cemented prosthesis: A surgical cement material is used to attach the cemented prosthesis to the bone.
Uncemented prosthesis: This type of prosthesis is attached to the bone with porous surface material.
General anaesthesia or spinal anaesthesia will be given to relax the body. An intravenous (IV) line and a urine catheter will be placed. The doctor will continuously monitor all the vitals throughout the procedure.
An incision is made in the hip region to remove all the damaged bone and cartilages of the hip joint. It will be replaced by a suitable hip prosthesis. The prosthesis includes:
- A stem which fits into the thighbone (femur),
- A ball which attaches to the stem,
- A cup which is placed into the socket of the hip joint.
The ball part of the prosthesis is made up of a highly polished ceramic or strong metal. While, the socket is composed of either durable plastic, metal or ceramic, which may also have an outer metal shell.
In both implant cases, the bone grows onto the surfaces and attaches itself to the artificial prosthesis. In some individuals, a combination of these two types of artificial hip prosthesis may be used.
The incisions are closed with stitches and staples. A surgical drain is attached in the incision site, to drain fluids. A sterile adhesive bandage is placed on the stitches and drain to keep them in place.
After the procedure, the individual will be shifted to a recovery room, where the vitals and the condition is monitored. Once the anaesthesia wears off, and the vitals stabilize, the individual is moved to the general ward. Medications prescribed by the doctor will be administered.
A physical therapist will be assigned, who will recommend certain exercises that will help move the new hip after surgery. This exercise schedule prescribed should be followed during hospitalisation and after discharge.
A few tips which will help in faster recovery include:
- It is important to take special precautions while sitting, climbing the stairs, bending or standing.
- Make a few necessary changes in the house that help reduce the strain on the new hip, such as elevate the toilet seats, install safety handrails in the shower, use a stable chair with a soft cushion. Also, use a firm pillow to help raise the hip while sitting.
- Keep the surgical site clean and dry.
- Employ appropriate measures to prevent injuries and trauma to the hip joint.
- Avoid climbing up or down the stairs for a few weeks until the hip is strong.
- Include rehabilitation and physical exercise, as recommended by the doctor.
- While sleeping, lie on the non-operated site for four to six weeks after surgery.
- Keep a pillow between the legs and another pillow to support the feet and ankles while sleeping.
- Use walker, cane or crutches, as recommended by the doctor.
- Consume a well-balanced diet.
- Perform the physical exercise recommended by the therapist for at least three times a day.
FACTORS AFFECTING COST
The cost of the treatment depends upon:
- One side or both side replacement
- Anaesthesia involved
- Type of approach- open vs laparoscopic
- Other co-morbidities
- Other treatment needed