Faqs Hips

Who Should Have Hip Replacement Surgery?

People with hip joint damage that causes pain and interferes with daily activities despite treatment may be candidates for hip replacement surgery. Osteonecrosis (or avascular necrosis, which is the death of bone caused by insufficient blood supply) is the most common cause of this type of damage in India. However, other conditions, such as rheumatoid arthritis (a chronic inflammatory disease that causes joint pain, stiffness, and swelling), osteoarthritis, injury, fracture, and bone tumors also may lead to breakdown of the hip joint and the need for hip replacement surgery.

In the past, doctors reserved hip replacement surgery primarily for people over 60 years of age. The thinking was that older people typically are less active and put less stress on the artificial hip than do younger people. In more recent years, however, doctors have found that hip replacement surgery can be very successful in younger people as well. New technology has improved the artificial parts, allowing them to withstand more stress and strain and last longer.

Today, a person’s overall health and activity level are more important than age in predicting a hip replacement’s success. Hip replacement may be problematic for people with some health problems, regardless of their age. For example, people who have chronic disorders such as Parkinson’s disease, or conditions that result in severe muscle weakness, are more likely than people without chronic diseases to damage or dislocate an artificial hip. In such kind of people we prefer dual mobility cup. People who are at high risk for infections or in poor health are less likely to recover successfully. Therefore they may not be good candidates for this surgery. Recent studies also suggest that people who elect to have surgery before advanced joint deterioration occurs tend to recover more easily and have better outcomes.

Why Do People Have Hip Replacement Surgery?

For the majority of people who have hip replacement surgery, the procedure results in:

What Are Alternatives to Hip Replacement?

In early osteonecrosis i.e. Stage I / II Before considering a total hip replacement, we may try other methods of treatment, such as exercise, walking aids, medication and core decompression .

In Osteonecrosis or avascular necrosis, there is death of bone caused by insufficient blood supply so we drill holes in to the femoral head and inject stem cells into the femoral head which will help increase the blood supply. This may help to avoid or delay your surgery.

An exercise program can strengthen the muscles around the hip joint. Walking aids such as canes and walkers may alleviate some of the stress from painful, damaged hips and help you to avoid or delay surgery.

All medicines can have side effects. Some side effects may be more severe than others. You should review the package insert that comes with your medicine and ask your health care provider or pharmacist if you have any questions about the possible side effects.

For hip pain without inflammation, we usually recommend the analgesic the analgesic

For hip pain with inflammation, treatment usually consists of nonsteroidal anti-inflammatory drugs, or NSAIDs. When neither NSAIDs nor analgesics are sufficient to relieve pain, we sometimes recommend combining the two. Again, this should be done only under a doctor’s supervision.

Warning: NSAIDs can cause stomach irritation or, less often, they can affect kidney function.

Can we do Core decompression for stage III/ IV?

Core decompression is not effective for III/IV as there is already depression at weight bearing part of the femoral head. Core decompression with not help in improving mechanical symptoms caused by deformation of head.1

What is Hip Replacement Surgery

A total hip replacement is an operation that removes the arthritic ball of the upper thigh bone (femur) as well as damaged cartilage from the hip socket. The ball is replaced with a metal ball that is fixed solidly inside the femur. The socket is replaced with a plastic liner that is usually fixed inside a metal shell. This creates a smoothly functioning joint that does not hurt. The parts used to replace the joint are the same and come in two general varieties: cemented and uncemented.

Is a Cemented or Uncemented Prosthesis Better?

The answer to this question is different for different people. Because each person’s condition is unique, the doctor and you must weigh the advantages and disadvantages.

Cemented replacements are more frequently used for older, less active people and people with weak bones, such as those who have osteoporosis, while uncemented replacements are more frequently used for younger,more active people.

Studies show that cemented and uncemented prostheses have comparable rates of success. Studies also indicate that if you need an additional hip replacement, or revision, the rates of success for cemented and uncemented prostheses are comparable.

Am I too old for hip-replacement surgery?

Age is not a problem if you are in reasonable health and have the desire to continue living a productive, active life. You may be asked to see your personal physician for an opinion about your general health and readiness for surgery.

How long will my new hip last, and can a second replacement be done?

We expect most hips to last more than 10–15 years. However, there is no guarantee, and 5–10 percent may not last that long. A second replacement may be necessary.

What are the major risks?

Most surgeries go well without any complications. Infection and blood clots are two serious complications that concern us the most. To avoid these complications, we use antibiotics and blood thinners. We also take special precautions in the operating room to reduce risk of infections. The chances of this happening in your lifetime are 1 percent or less. Dislocation of the hip after surgery is a risk.

Should I exercise before the surgery?

Yes. You should discuss preoperative physical therapy . Exercises should begin as soon as possible.

Will I need blood?

You may need blood after the surgery. You may donate your own blood, if able, or use thecommunity-blood-bank supply.

How should I prepare for the surgery?

Once DR Ramesh Sen has ordered a hip replacement surgery, the patient will need to schedule an appointment with general physician to get medical clearance if require. The patient will need to meet with the anesthesiologist to review their medical history, receive a physical exam and have their blood taken. Patient would be taught pre op exercises by your physiotherapist. Once the anesthesia clearance is done patient would be given date for surgery. Patient would be admitted a day prior to surgery.

How long will I be in the hospital?

Most hip-replacement patients are hospitalized for five days after surgery. If you need more time for rehabilitation, other options might be available to you. Make arrangements before your surgery to have someone stay with you after you are discharged.

What are my anesthesia options?

You may have a general anesthetic, which most people call “being put to sleep,” or a spinal anesthetic. The choice is between you and the anesthesiologist.

Will I have pain after surgery?

Yes, but we will keep you comfortable with appropriate medication. Generally most patients are able to stop very strong medication within two days. The day of surgery, most patients control their own medicine with a special pump that delivers the drug directly into their epidural. Our anesthetist will discuss with you what pain control option is best for you.

Will I need a walker, crutches or cane?

Yes. Until your muscle strength returns after surgery, you will need a walker, a cane or crutches. Your equipment needs will be determined by the physical therapist.

Will I need any other equipment?

After hip-replacement surgery, you will need a high toilet seat for about three months. If needed, you will also be taught by the physical therapist to use adaptive equipment to help you with lower body dressing and bathing. You might also benefit from a bath seat or grab bars in the bathroom.

Where will I go after discharge from the hospital?

Many patients go directly home when discharged. You can even go to Fortis INN if required.

Will I need help at home?

Yes. In the first several days or weeks after surgery, depending on your progress, you will need someone to assist you with meal preparation, housekeeping, etc. Family members or friends must be available to help. Preparing ahead of time, before your surgery, can minimize the amount of help required.

Will I need physical therapy when I go home?

Yes. Physical therapy will continue after you go home with a therapist in your home or at an outpatient physical-therapy facility. The length of time required for this type of therapy varies with each patient. We will help you with these arrangements before you go home.

How soon after surgery will i be able to drive?

The ability to drive depends on whether surgery was on your right hip or your left hip and the type of car you have. If the surgery was on your left hip and you have an automatic transmission, you could be driving within two weeks. If the surgery was on your right hip, your driving could be restricted as long as six weeks

When will I be able to get back to work?

We recommend that most people take at least one month off from work, even if your job allows you to sit frequently. More strenuous jobs will require a longer absence from work.

How often will I need to see my doctor following the surgery?

Ten days discharge for suture remmoval. The frequency of follow-up visits will depend on your progress.

How will my physical activity be restricted after surgery?

High-impact activities such as contact sports, running, singles tennis and basketball are not recommended. Injury-prone sports are dangerous for your new joint. You will be restricted from crossing your legs. Your surgeon and therapist will discuss further limitations with you following surgery. You are encouraged to participate in low-impact activities such as walking, dancing, golfing, hiking, swimming, and gardening.

Will I notice anything different about my hip?

In many cases, patients with hip replacements think that the new joint feels completely natural. However, we recommend always avoiding extreme positions or high-impact physical activity. The leg with the new hip may be longer than it was before, either because of previous shortening due to the hip disease, or because of a need to lengthen the hip to avoid dislocation. Most patients get used to this feeling in time or can use a small lift in the other shoe. Some patients have aching in the thigh when bearing weight for a few months after surgery.