hip joint . Radiological and blood investigation are performed as per the requirements . An MRI and a CT scan ( with 3D reconstruction ) will provide the detailed anatomical extent of the disease and any associated loss of bony architecture . It ’ s very important to get as much information as possible before planning treatment options .
Patients presenting in the early stage of the disease are given a course of analgesics and physiotherapy for the hip joint . They ’ re also advised to do cycling or swimming . These measures help strengthen hip muscles and keep the joint mobile . Patients with advanced disease have minimal movement in their hip joints , hence they should opt for surgical options for their underlying arthritis .
Before surgery After surgery
What is the cause for hip joint arthritis in young patients ? It usually occurs due to trauma to the hip joint , avascular necrosis ( lack of blood supply to the ball of the femur ), infections ( tuberculosis / septic ), childhood hip problems ( congenital hip dislocation , Perthe ’ s disease , slipped capital femoral epiphysis , etc .), and inflammatory arthritis like rheumatoid arthritis or ankylosing spondylitis .
What problems can hip arthritis give patients ? A damaged hip can cause patients to experience pain in day-to-day activities . They have difficulty sitting crossed leg , squatting , or using stairs . As the disease progresses with time , the deformities appear in the hip joint leading to reduced mobility , and subsequently these patients become bedridden . Increasing deformity also produces changes in the spine and knee joints , if not treated on time . Few patients present with complaints of being unable to perform marital obligations .
How is hip arthritis diagnosed ? Your doctor will do a clinical examination of the hip joint , spine , and other joints of your body . A radiological examination ( X-rays and MRI ) and blood investigations will be performed based on clinical findings . This will vary from patient to patient depending on their underlying problem .
What is total hip replacement surgery ? In total hip replacement surgery , we remove the damaged femoral head ( ball ) and cartilage of acetabulum ( cup ) and replace it with metal implants . During surgery , the size of the acetabulum and femoral head are measured to optimise the size of the implant .
Is this surgery successful in young patients ? Yes , it is very successful . More and more young population are now undergoing total hip replacement surgery across the globe . This has been made possible due to : ( a ) better surgical techniques ( b ) advancements in implant designs ( c ) improvements in metal quality ( d ) improvements in ball-socket material
( e . g ., ceramics )
When should one undergo total hip replacement surgery ? Patients should seek surgery when their hip pain limits day-to-day activities , hip pain interferes with their sleep , there is no relief from any medications , or the deformity appears to set in .
How is the surgery planned after admission ? You will be admitted one day before surgery . You would already have seen the anesthesia team with your routine reports so that you get fit for surgery . Your anesthetist will make you numb at your operating area . You will remain awake throughout the procedure . You can listen to songs if you wish to . The surgeon will perform the surgery as per the protocol and insert a new hip joint which fits best in your joint . Once you ’ re transferred to the recovery room , you ’ ll be started on an oral diet .
When can one start walking after total hip replacement ? You can start to walk with the help of a walker once the effect of the anesthesia wears off completely . That can happen on the same day evening or the next day morning , depending on the time of your surgery . A physiotherapist will help you in walking and teach you a few exercises .
When do patients get discharged from the hospital ? Once you ’ ve completed the “ post-operative pathway ” as per the hip replacement surgery protocol , you ’ re fit to go home . It can vary from 2-4 days after surgery .
Do I need to take any special care after surgery ? Yes , you should be very careful and protect your new hip joint so that it lasts a long time with you . You should avoid sitting crossed leg , sitting on floor , squatting , high impact activities , and bending forward . These can cause damage to the ball and socket or may cause the ball to pop out of your socket .
Dr Deepak Kumar Mishra is a consultant in orthopaedics at Dr . L H Hiranandani Hospital in India .
Total Hip Replacement implants mainly fall into two categories – cemented and uncemented
GlobalHealthAndTravel . com OCTOBER 2021
61