Hip Replacement in India

A hip replacement surgery replaces a diseased hip joint with an artificial hip joint. The artificial joints can be of metal, ceramics, or high strength plastics.

Your hip joint has two bones, the femur or thigh bone, and the pelvic bone. Acetabulum, a part of your pelvic bone, acts as a socket for the head of the femur. The shape of the femoral head resembles a ball. So a hip joint is called a ball and socket joint.

The cartilage that lines the acetabulum and the synovial fluid gives lubrication to the joint. Due to the wear and tear of the cartilage, the bone ends tend to rub over each other. It creates a lot of friction.

You may feel severe pain when the bones rub against each other. It also limits your movements.

In the initial stages, medications may help to control the pain. As the disease progress, you will have pain even at rest. Once this happens, it is time for you to think of having hip replacement surgery. 

The surgery will relieve the pain and improve your ability to move around. It can be an open surgery or a minimally invasive one.

A total hip replacement replaces both your femoral head and the acetabulum with artificial joints. In a partial hip replacement, the surgeon will change only one of the two.

When to do a hip replacement surgery?

Osteoarthritis is the main reason for the degeneration of the hip joint. Some of the other main factors are 

• Rheumatoid arthritis
• Septic arthritis
• Ankylosing spondylitis
• Bone dysplasia, a condition characterized by an abnormal growth of bones

All these diseases cause a degeneration of the hip joint. You will need a hip replacement if it is severe. 

You may consider a hip replacement surgery if you have any of the following

• Severe pain during activity as well as rest
• Stiffness in the hip joint that reduces your movements 
• You are not able to lift your leg   
• You have problems doing routine stuff like walking, bending, etc
• The pain in the hip is so severe that it prevents you from sleeping
• You have a fracture in the hip bone 

Hip replacement surgery can improve the quality of your life. Being able to move around without pain and assistance can make you feel more independent.

Types of hip replacement surgery

There are two main types which are

Total Hip Replacement: In a total hip replacement surgery, the surgeon replaces both the femoral head and acetabulum with artificial implants.

Partial Hip Replacement: Here, the surgeon replaces only the femoral head. Those with a fracture in the femoral head are good candidates for this. The acetabulum is usually not replaced in such cases.

Surgeons use two different methods for hip replacement. They are 

Open Surgery: Here, the surgeon makes a 10-12-inch long incision on the side of the hip. It gives a clear view of the dislocated or injured hip after splitting the muscles. Then, the artificial implants replace the ball and socket with screws to hold it in place. 

Minimally Invasive Surgery: This surgery needs only two or three small cuts instead of a long incision. Recovery will be faster here, and there will be lesser issues. However, it may not be fit for all. The doctor will decide the right type as per your condition.

The hip replacement surgery procedure

You will be under general anesthesia during the surgery. In certain situations, you may have spinal or epidural anesthesia.

The surgeon will make an incision 10 to 12-inch-long, at the side or back of the hip to expose the hip joint. The surgeon will cut the head of the with a bone saw.

They will then prepare the acetabulum to receive the implant. This implant, containing a ceramic or plastic liner that facilitates the smooth movement of the joint, is then attached to the prepared socket.

The surgeon will then attach a prosthetic femoral stem to the end of the femur. A prosthetic ball that acts as the head of the femur is then attached to the prosthetic femoral stem. After this,they will check for the ease in various types of movements.  

The next step will be to check the length of both the legs for any disparity.  If everything is OK, the surgeon will close the incisions with the help of sutures or staples. Once the effects of anesthesia wear off, you will go back to your hospital room.

Recovery from hip-replacement surgery

In the first few days after the surgery, you may feel some amount of pain in the hip.

Pain associated with hip replacement surgery can last anywhere between 3-6 months after the surgery. In the first month, you may have strong pain killer medications to help reduce the pain.

After the first month, you can move on to over-the-counter pain medications. Physical therapy or physiotherapy can also help to control the pain.

You may be able to go back to your routine activities in eight to ten weeks of the surgery. But you should avoid lifting heavy objects as well as other strenuous activities. 

Regular exercises, having a strict and healthy diet, etc. can help you recover faster. You also need to be aware of the signs of blood clots forming in the veins of your legs. 

Once you are back home after surgery, you need to be physically active without exerting too much. You must follow the advice of your doctor and physical therapists regarding recovery. 

It may take 3-4 weeks before you can start putting weight on your leg. During this time, you will have to use a walker to move around.

You can start driving automatic cars after about two months from the date of your surgery. If you have a car with gears, you will have to wait a little longer.

Depending on your surgery, your doctor may recommend some sleeping positions. You also need to keep a pillow between your legs when you sleep.

While sitting down, make sure you sit on comfortable straight back chairs with armrests.

Avoid climbing stairs for as long as possible. Your physical therapist will show you the correct way to climb the stairs. 

Returning to work will depend on the kind of work you do. Usually, you will have to be at home for at least six weeks.

High impact activities such as cycling, swimming, jogging, etc. will have to wait till you recover totally.

Complications of hip replacement surgery 

Some of the risks and complications are 

• Pain in the hip joint
• Bleeding 
• Swelling of the joint 
• Injury to adjacent nerves or blood vessels
• Wound infections
• Formation of blood clots in the deep veins called deep vein thrombosis of the legs. Pulmonary embolism occurs when these clots move towards the heart. 
• A difference in the length of the legs after surgery. One leg may be longer or shorter than the other.

Things to remember after a hip replacement surgery

• The replaced hip will not last forever; they usually have a life span of 10-12 years
• Physical therapy is a must for recovery from the surgery
• You may have  to change certain things around the house for ease of movement
• You will need a cane or a walker during the initial healing period
• If you live alone, then arrangements should be made to have someone come over and live with you during the recovery period. You may need help with most of the household chores