DR. KIRTHI PALADUGU ARTICLE IN TIMES OF INDIA SRIKARA HOSPITALS
Hip
Joint is the largest and the most stable joint in the human body. It is the
largest ball socket joint. Socket - cup formed by the Acetabulum, which is the
part of pelvic bone and the ball is formed by the upper end of the thigh bone
(Femur). The ligaments and the hip provide stability, acting in coordination
during each and every degree of mobility in our day to day activities.
Common Causes Of Hip Pain
OSTEOARTHRITIS
: Age related wear and tear seen in people of 50 years and beyond
where bones rub against each other causing pain and stiffness.
Rheumatoid
ARTHRITIS : An autoimmune disease in which the
synoviuim in the joint destroys the cartilage. It is also termed as
Inflammatory Arthritis.
AVASUCLAR
NECROSIS (AVN) Any injury to the hip,
previous dislocation, childhood disease, long term use of steroids smoking and
alcoholism may result in lack of blood supply, leading to the collapse, deformation
and arthritis of the Hip.
Past
traumatic arthritis : Any major injury to
the hip followed by surgery and its failure can lead to arthritis
causing pain and deformity.
In
Total Hip Replacement surgery, the damaged bone and cartilage is removed and
replaced with prosthetic components.
The
damaged femoral head is removed and replaced with a metallic stem that is
placed in to the hollow center of the femur, can be either Cemented or Press
fit.
A metal
or ceramic ball is placed on the upper part of the stem.
The
damaged cartilage surface of the socket (Acetabulum) is removed and replaced
with metal socket and a Plastic or Ceramic liner is inserted between the new
ball and the Socket, to allow for a smooth gliding surface.
The
decision to undergo hip replacement is made by you, your family and the
treating Joint Replacement surgeon.
Candidates
for surgery
There
is no age or weight restrictions for Hip replacement and is based on patient
pain & Disability.
- Hip
pain that limits everyday activities like walking stairs, bending etc.
- Pain
at rest – day or night
- Stiffness
- Inadequate
relief from medication, physiotherapy and walking aids.
Surgeon
Evaluation
Medical
history of the patient is first checked. Physical examination includes hip
mobility, pain score strength alignment. X-rays show degeneration/deformation
while MRI is helpful in soft tissues condition and early stages of AVN.
Realistic
Expectations
Most
patients who undergo Hip replacements experience dramatic pain relief and
improvement in the ability to perform daily activities. With aging, the
prosthesis, material between the head & the socket (liner) begins to wear.
Patients can do unlimited Walking, swimming, driving, biking, stairs & low
impact sports. With appropriate activity and lifestyle modification, hip
replacements can last for years.
Surgical
Protocol
Once
the need for surgery has been decided, the patient will undergo a set of
surgical profile, medical /cardiology clearance and pre anesthetic evaluation.
The implant to be used will be chosen according to the patient requirements and
is based on the quality and strength of the bone.
Patient
will be staying in the hospital for 2-3 days initially for pain management.
Wound heals after approximately 2 weeks of surgery.
Post
Operative Care
There
has to be a graduated walking program followed by normal activities such as
sitting, standing and climbing stairs in 3-4 weeks, can be back to work,
driving and all in 4-6 weeks.
Possible
Complications of Surgery
The
rate of complications in hip replacements in as low as 2% world wide. These
include infections, blood cots, limb length inequality, dislocation etc, all
mentioned do have treatment protocols and with the advent of Dual Mobility cups
the chances of dislocation has been rare.
Hip
replacement in a boon for the patients with severe hip pains impacting the day
to day activity. The success of the surgery is based on the selection of the
patient, education of the patient before and after surgery, necessary
evaluation and right expert intervention.
We
believe in
MOBILITY IS/FOR LIFE.
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