Hip Replacement

A hip replacement surgery, also known as hip arthroplasty, is a procedure by which a part or all of the hip joint is removed and replaced with an artificial joint or prosthesis.

The hip joint is where the femur (thigh bone) and the pelvis (hip bone) meet. This is known as a ball and socket joint, in which the ball-shaped portion of the femur fits into the socket-shaped portion in the pelvis. The hip joint also consists of tendons, ligaments, cartilage, and lubricating fluid.

Hip replacement surgery involves the removal and replacement of one or both sides of the hip joint by an artificial joint. The artificial joint or prosthesis is usually made up of metal, ceramic, and very hard plastic, and it helps in reducing pain and improving function.
Hip replacement surgery is usually performed when your hip pain interferes with your daily activities and non-surgical treatment options have either failed or are no longer effective.

Types:
The different types of hip replacement surgeries include:

1. Total hip replacement: The surgery involves the removal and replacement of both the sides of the joint, the ball and the socket.
2. Partial hip replacement (hemiarthroplasty): This type of surgery involves the removal of the ball of the femur. This type of hip replacement procedure is usually performed in older people.
3. Hip resurfacing: This type of surgery involves the replacement of the socket of the joint. It also involves trimming the ball of the femur and then capping it using a metal covering.

Symptoms

Purpose:
A hip replacement surgery is usually required in the following cases of hip joint damage and pain:
1. Osteoarthritis: It is a degenerative type of joint disease. The breakdown of the bones and cartilage within the joint causes pain, stiffness, and swelling. It is the most common cause of hip replacement surgery.
2. Osteonecrosis: This is a rare type of disease that involves the death of the bone tissue.
Rheumatoid arthritis: This is an autoimmune condition (in which the body’s immune or disease-fighting system attacks its own tissues and organs) leading to joint inflammation.
3. Hip dysplasia: This is a condition in which the hip bones fail to align correctly. It is normally a congenital condition (condition present at birth).
4. Hip joint infections: Infections of the hip joint, like septic arthritis, may need hip replacement surgery.
5. Hip joint injuries: Injuries of the hip joint may include fractures, torn cartilage, and torn ligaments, that may cause irreversible hip joint damage.

Hip joint replacement surgery is usually performed when:

• other treatment options are not working
• if there is pain at rest
• stiffness or pain is limiting your daily activities

Symptoms:
The following symptoms may indicate the need for a hip replacement surgery:

• Severe chronic (long-term) hip pain
• Stiffness in the hip region
• Pain that leads to difficulty in everyday activities like walking or bending
• Inability to lift the leg or move
• Severe pain that does not go away even after the use of medications or therapy
• Hip joint fracture
• Avascular necrosis (death of the bone tissue due to less blood supply)

Diagnosis

1. Physical examination: The physical health status of the patient is determined. The symptoms, medical history, and family history of the patient are noted. The doctor also checks for the alignment, strength, and stiffness in the hip joint. The range of motion and mobility of the hip joint is also checked.
2. Blood tests and urine tests: These tests help in detecting a medical condition or infection that may be present.
3. Electrocardiogram (ECG): This test helps in measuring the electrical activity of the heart and checking the heart condition.
4. X-rays of the hip region: The x-ray helps the doctor in determining the extent of deformity or damage at the hip joint by looking for changes in structure, signs of joint erosion, inflammation, tissue tear, or cartilage loss.
5. MRI scan: It is an imaging test that helps in obtaining a clear image of the bone and soft tissue near the hip region.

Treatment

A hip replacement surgery can be performed under general anesthesia (the patient is put to sleep during the procedure) or by giving a nerve block (injecting an anesthetic around the nerves). It can be performed in the following ways:

1. Open hip replacement surgery:

• It involves making a 10-to-12-inch cut or incision in the hip region through the layers of the tissue.
• This allows the surgeon to directly view and access the surgical site.
• The damaged bone and cartilage are removed, leaving the healthy bone intact.
• A prosthetic socket is implanted into the pelvic bone to replace the damaged socket.
• The round ball on the top of the femur is replaced by a prosthetic ball, that is attached to a stem that fits into the thighbone.
• The procedure involves more cutting and damage to the muscles and tissues causing delayed recovery and more pain than a minimally-invasive procedure.

2. Minimally-invasive hip replacement surgery:

• The procedure involves the orthopedic surgeon making a 3-to-6-inch cut or incision or two 2-to-3-inch cuts or incisions in the hip region.
• Special surgical instruments are used to perform the surgery through these incisions.
• This procedure is less painful and has a quicker recovery than open surgery.
• However, it has an increased risk of injury to the blood vessels and nerves, along with an increased risk of bone fracture, breakdown of the wound, and improper implant positioning.

The different types of hip replacements that can be used include:
1. Cemented replacement: A surgical cement is used to attach the prosthesis to the bone.
2. Uncemented replacement: A prosthesis with a special coating that promotes bone growth into the prosthesis is used in this method. Recovery includes time for the bone to grow and securely attach to the prosthesis. This method also causes more thigh pain following surgery.
3. Hybrid replacement: A cemented femoral stem and an uncemented socket is used in this method.

Risks

The following complications may be associated with a hip replacement surgery:

• Blood clot formation
• Infection
• Bleeding
• Allergic reaction to an anesthetic agent
• Hip joint fracture
• Dislocation of new the hip joint
• Change in the length of a leg
• Joint stiffness
• Loosening of the new hip joint, leading to pain and the need for another surgery to secure the new hip joint
• Nerve, blood vessel, or muscle damage
• Wear and tear of the new hip joint that may require another replacement

After Procedure

• For some types of hip replacement surgeries, you may go home on the same day of the surgery.
• In the case of a total hip replacement surgery, you will be staying in the hospital for one or two days after the procedure.
• A physiotherapist will help you to start walking a day after the surgery.
• You will need a walker or crutches for many days after the surgery.
• The physiotherapist will also teach you certain exercises to strengthen the hip joint and guide you on how to use your new hip joint.
• Physiotherapy will continue for six to eight weeks after the procedure.
• Complete recovery following a hip replacement surgery may take a few months, after which you can resume your normal daily activities.
• Avoid high-impact sports, like tennis and running, and contact sports after the surgery.
• Tell your dentist if you have had hip replacement surgery, as the dentist may recommend antibiotics to prevent infection before any dental procedure.
• Take precautions to avoid injuries and falls.
• Low impact sports like walking, swimming, and stationary biking are recommended.

Seek immediate medical care if you notice any of the following symptoms after a hip replacement surgery:

• Fever
• Shortness of breath
• Breathing problems
• Confusion
• Chest pain, tightness, or pressure
• Inability to pass bowels or urinate
• Swelling, redness, or pus drainage
• Bleeding
• Leg pain, swelling, or redness

Cost of Hip Replacement Surgery in India- 

Cost of Hip Replacement Surgery in Mumbai is 350000 INR to 400000 INR

Cost of Hip Replacement Surgery in Bangalore is 300000 INR to 350000 INR

Cost of Hip Replacement Surgery in Delhi is 300000 INR to 350000 INR

Cost of Hip Replacement Surgery in Chennai is 300000 INR to 350000 INR