Total Hip Replacement surgery

Total hip replacement surgery is renowned treatment for hip pain with restricted mobility and movement hampering daily activities. This information helps you to understand when and why one require or should go for hip replacement surgery.

Dr. Amir Sanghavi

Comeback Stories

What Is Total Hip Replacement surgery

Total hip replacement surgery is renowned treatment for hip pain with restricted mobility and movement hampering daily activities. This information helps you to understand when and why one require or should go for hip replacement surgery.

Hip joint anatomy

Hip is a ball and socket type of joint which is the largest joint of body. Socket formed by acetabulum (part of pelvis bone) and ball is formed by head of femure(thigh bone) . joint surface id made of smooth cartilage covered with joint capsule and synovial membrane. In joint cavity there is synovial fluid with lubricate the joint. Joint stability provided by ligaments which connects hipball and acetabulum together.

Causes of hip pain

Hip pain occure due to bony or secondary to surrounding soft tissue condition which lead to damage of joint surface includes:

  • Arthritis :
    osteoarthritis , rheumatoid arthritis ,arthritis secondary to pelvis or femoral head fracture in which joint cartilage is damaged causing pain.
  • Avascular necrosis of femoral head in which bone of head of femure become necrosed due to lack of blood supply leads to damage to joint surface
  • Hip infection causes cartilage damage which roughened joint surface.
  • Soft tissue including joint capsule and synovial membrane disease causes joint surface damage and cause hip pain.

Conditions require Hip Replacement surgeries

Hip pain occure due to bony or secondary to surrounding soft tissue condition which lead to damage of joint surface includes:

  • Avascular Necrosis of Hip

    Head of femure necrosis due to compromised blood supply due to which there is loss of subchondral bone and joint surface damage which damages acetabulum cartilage at the end.

  • There are so many causes of AVN but including long term steroid intact, smoking, alcohol and coagulopathy disorder.

  • Most commonly age group involved is younger between 30 – 50 years.

Arthritis

  • Osteoarthritis

    mainly due to age related in which femoral head and acetabular cartilage damage which causing pain.

  • Rheumatoid Arthritis

    in which synovial inflammation causing secondary damage to hip joint cartilage and arthritis.

  • Secondary Arthritis

    mainly due to hip joint fracture or fracture of acetabulum which causes joint arthritis

  • Hip replacement surgeries required in painful damaged joint with loss of functional movement to restore normal function and walk and to restore day to day activity.

Who requires hip replacement surgery?

It not depends on age criteria rather it depends on criteria of pain and disability to perform day to day activities

When hip replacement surgery require?

  • Hip pain persists due to which one can’t perform day to day activities
  • Hip range of movement restricted and even can able to normal walk.
  • Increase night pain with distorted sleep.
  • Increase deformity at hip joint due to pain and disturbed joint anatomy.
  • Muscle weakness and reduced strength due to not able to walk for long time.

For replacement surgery patient evaluation require

  • Detail history with old past surgeries and other history regarding drug addiction / tobacco/smoking.
  • History of recent infection should be taken especially and dental or urinary infection.
  • Physician check up for pre operative fitness and cardiac status.
  • Local examination to check local condition of skin at surgical sight to prevent post operative wound complication.
  • Assessment of both lower limb for limb length discrepancy.

Investigation require before surgery

  • Blood hemogram with coagulation profile
  • Urine analysis to check any urine infection
  • X-ray:
    Ap & frog leg lateral view if possible which shows reduce joint space with roughened joint surface of both femoral head and acetabulum.
  • MRI: it is gold standard in diagnosis and staging when there is avascular necrosis of hip. It also helpful to assess condition of soft tissue and muscles surrounding hip joint

How its done

  • Damaged joint including head of femure and acetabulum cup replaced by prosthetic joint.
  • Damaged femoral head removed and replaced with prosthetic stem made of metal placed into the femoral canal. Femoral stem either uncemented(press fit) or cemented.
  • On the stem metal or ceramic ball placed which replaces the damaged head of femure
  • Damaged cartilage of socket removed and metal cup placed which is fixed to the pelvis bone socket with screws or sometimes cement.
  • Spacer is placed between new ball and socket to provide smooth gliding which made of plastic , ceramic or metal

Prognosis of replacement surgery depends on:

Multiple factors affect prognosis in which patient factors include weight, systemic disease like diabetes, cardiac or kidney related , drug addiction/tobacco/smoking as there is high chance of postoperative wound complication, infection or deep vein thrombosis (clotting of blood in blood vessels) in these patients, neurological status of both lower limb .

Prognosis and better outcome also depends on the skill of surgeon , operation theater environment , usage of advance instruments and techniques , quality of implants.

Post operative protocols and recovery:

Patient is made walk from the same day or 2nd day of surgery. Normal range of motion exercise started from 2nd day of surgery according to patient comfortness. Urine catheter removed on 2nd or 3rd day of surgery and toilet training started while patient is admitted in hospital. Suture removal on 14th-15th day of surgery. Other normal household activities including stairs climbing should be started as far as patient comfortable as eventually all patients resumes normal activity after 5-6 weeks of surgery.

Benefits of hip replacement surgery:

  • Painless range of movement
  • Patient can resume walking from the day or next day of surgeries
  • Correction of deformity
  • Enhance quality of life

Some facts about new metal joint in body:

Due to metal in body some may feel foreign material and sometimes may get feeling of clunk at hip joint which is very normal and get wear off as time passes and as patient get used to it. Prosthetic joint may detected by metal detector at airports or any other security check out point for that you need to ask your doctor to make implant card or get certificate of implant in body from your operating surgeon

How longevity of implant can be increased?

As joint is made off metal and plastic component it can be wear and tear of joint after sometime which should be prevented by

  • Regular hip muscle strengthening exercise which causes less stress to joint
  • Weight reduction exercise in obese patients and diet control
  • Avoiding activities causes stress to hip joint especially sports activities.
  • Regular visit to your operating surgeon and assessment with including x ray to check joint condition

Request an Appointment

Please complete the form below to request an appointment. A member of our intake team will follow up with you.

Other Expertise Areas