Hip is one of the greatest ball & socket type of joint in human body. Being a strong & stable weight-bearing joint, healthy hips support the entire body weight & allow people to move smoothly without pain. Due to its firm & large muscles, it cannot be easily damaged. According to reports, people between the ages of 50 & 75 years are most likely to suffer from damaged hips. Hips may be damaged by severe fractures or conditions like arthritis. Hip plays a major role in supporting basic activities like walking or sitting. When hip joint is injured, it becomes difficult to even perform basic tasks. When medications & use of walking supports fail to help this condition, a hip replacement surgery can be the best alternative.
What is a Hip Replacement Surgery?
Hip replacement surgery is also called as hip arthroplasty. Most common reason for people undergoing hip replacement surgery is damage caused due to arthritis. During hip replacement surgery, orthopedic surgeons extract damaged sections of patient’s hip joint & replace them with artificial parts generally made of very hard plastic & metal. This artificial joint is known as prosthesis & it helps improve function & reduce pain in hip. Hip replacement surgery is an effective & safe procedure for patients’ who are suffering from severe hip pain & which is interfering with daily activities.
There are various conditions that can damage a healthy hip joint & necessitate hip replacement surgery. Following list elaborates upon the most common causes of severe hip pain.
Hip replacement surgery may be helpful in treating these painful conditions. Patients should consult orthopedic surgeons in order to understand their treatment options & overall health condition of their hip.
Patients might consider hip replacement surgery if they are experiencing extreme hip pain. When patients are affected by following hip conditions, they are generally good candidate for hip replacement surgery.
- Rheumatoid Arthritis - It is generally caused by an overactive immune system. It produces a type of inflammation that can deteriorate cartilage & bone & thereby deform joints.
- Osteoarthritis - This is popularly known as wear-and-tear arthritis. It damages smooth cartilage that encloses ends of bones & helps joints move easily.
- Osteonecrosis - When there is an insufficientsupply of blood to ball of the hip joint, bone may deform &collapse.
- Childhood Hip Disease - Some children may have hip problems. Even after successful treatment in childhood, it may cause arthritis later on in life. Abnormal growth of hip is the major reason behind development of this condition.
A primary hip evaluation with an orthopedic surgeon basically consists of following tests.
- Failure of Pain Medications - When severe hip pain persists in patients’ hip joint despite pain medications
- No Results from Physiotherapy - When patients do not get any significant results from physiotherapy
- Severe Hip Pain - When hip pain worsens merely with simple activities like walking & even when a walker or cane is utilized
- Quality of Sleep - When harsh hip pain starts to interfere with sleep patterns of patients
- Inability to Climb Steps - When hip pain affects patient’s ability to go up or down stairs
- Sitting Problem - When hip pain makes it difficult for patients to rise from a seated position
Orthopedic surgeons will review outcomes of primary evaluation of patient’s health & then suggest appropriate options in order to relieve them from hip pain. Patients can freely discuss problems with orthopedic surgeons. In addition to this, patients should also discuss their smoking & drinking habits with surgeons.
There are two main types of hip replacement surgeries which are elaborated below. Orthopedic surgeons will decide which method is most appropriate for a given patient.
- Medical Status - Orthopedic surgeons will collect in-depth information about general health of patients in order to know about severity of hip pain & also will ask relevant questions.
- Physical Assessment - Surgeons will assess mobility of patient’s hip, its alignment & strength as well.
- X-ray Test - This will help orthopedic surgeons check damage in hip joints of patients.
- MRI Test - Magnetic resonance imaging scan may be done in order to evaluate condition of bone & delicate tissues of the patient’s hip.
Hip replacement is a surgical operation which is primarily designed to replace the damaged hip. Surgeons will explain various prosthetic designs & different types of materials which are available to perform a hip replacement surgery procedure. Several types of hip joint replacement materials are elaborated below.
- Total Hip Replacement Surgery - Total hip replacement involves removal of a part of femur including its head & fitted with a new artificial ball. Surface of current socket in pelvis area is creased to obtain a new socket component that will articulate with new ball.
- Metal-on-Metal Hip Resurfacing - Resurfacing natural ball & socket of thigh bone is a latest form of hip replacement surgery. Instead of eliminating head of femur & then substituting it with an artificial ball, a metal cap is adjusted over the head of femur. Socket is also fixed up with a metal component. Patients undergoing this type of hip surgery procedure have lower risk of dislocation. Metal-on-metal resurfacing is not appropriate for patients with weakened bones or low bone density.
These are the most commonly used materials in hip replacement surgeries. Orthopedic surgeons will decide which is the most suitable after discussing it with patients.
A significant factor in determining whether to undergo hip replacement surgery is accepting what this surgery can & cannot do. Generally, patients however achieve great results after hip replacement surgery.
- Metal on Metal - Ball & socket is made of stainless steel, chromium titanium, cobalt or a combination of these materials.
- Polyethylene & Metal on Polyethylene - Basically, polyethylene is plastic, so these hip replacements generally have a plastic liner & metal structural pieces. They may also consist a metal ball intersecting a plastic socket liner.
- Ceramic - Ceramic hips are made of functional & durable versions of similar type of materials that bowls & plates are made from. There are mostly ceramic on ceramic, ceramic on metal & ceramic on polyethylene versions. Even though they are long-lasting, still they are vulnerable to fractures & breaking under heavy stresses.
Below are some important questions that patients may want to ask orthopedic surgeons. These are meant to help patients prepare themselves for hip replacement surgery.
- Health Evaluation - When patients have decided to undergo hip replacement surgery, the orthopedic surgeon may ask them to undergo a complete physical test. Ideal patients should be in a good healthy condition in order to have smooth recovery following surgery.
- Healthy Skin - Patients should not have any skin infections or irritations before hip replacement surgery. If it is present, patients should contact the orthopedic surgeon for some treatment to improve the skin condition.
- Blood & Urine Tests - Blood & urine samples should be tested prior to surgery in order to ensure a healthy body status.
- Blood Donation - Patients may be advised to donate their own blood prior to surgery. It will be helpful in case they require blood transfusion after hip replacement surgery.
- Weight Loss – When a patient is overweight, doctors may ask them to shed some weight before undergoing hip replacement surgery in order to reduce stress on the new hip.
- Home Planning - If a patient is living alone, they should make advance arrangements to have a friend or family member to assist them at home during the recovery phase.
Orthopedic surgeons suggest surgery for patients with pain so severe that, despite medications, it causes a loss of range of motion. Hip replacement surgery takes few hours to complete, during which orthopedic surgeons perform the following steps.
- Is hip replacement surgery the best treatment for me?
- Will I be able to walk freely without pain after surgery? If so how far?
- How well does hip replacement surgery work for someone of my age-group?
- Are there any specific exercises that I can do before my hip replacement surgery so it will be more successful?
- Do I need to shed some weight before surgery?
- How long will my hip replacement surgery last?
- What help will I require when I come home after surgery?
- How can I make it simpler for myself in the shower & bathroom?
- Are there any significant risks or complications of hip replacement surgery?
- What can I do before my hip replacement surgery in order to lower these risks?
- Will I experience a lot of pain after my hip replacement surgery? What can be done to relieve pain?
- Will you be able to provide physical therapy to me in hospital?
- Do I need to bathe with any specific soap?
- When will I completely recover after my hip replacement surgery?
Average recovery time of hip replacement surgery for patients is around eight weeks. However, healing time can take few weeks or even months, depending upon health of the patient & also the age factor. Within 2 months, most patients are able to reach their level of activity which they had prior to undergoing hip replacement surgery. Patients concerned about post-surgery care may invite a friend or a family member to assist them with bathing, dressing, exercising & sitting for few days after surgery. Physical therapists will also be able to help patients in re-attaining range of motion & canes or walkers will be required until the new hip joint eventually strengthens.
There are several possible risks & complications that a patient may face during hip replacement surgery. General list of potential complications include the following.
- Incision - An incision is done on the front, back or side of upper leg, pointing through delicate tissue & muscle to evaluate the hip joint. Orthopedic surgeons may administer general or regional anesthesia for hip replacement surgery. Types of regional anesthesia consist of epidural, spinal & peripheral nerve blocks.
- Dislocation - Surgeons displace femur from socket & pull out head of femur with an appropriate tool. Socket is then adjusted so that it matches shape of new hip implant.
- Positioning - New hip cup is positioned & locked in appropriate place with bone cement. Quality of patient’s bone will decide whether cement is suitable to secure the new cup.
- Fitting - Vacant space of femur bone is elaborated using suitable tools so the implant stem fits properly.
- Evaluation - A temporary ball is fixed on top of stem & hip joint is judged on range of motion & stability to ensure the ball stays firm & does not shift anywhere from socket.
- Completion - A permanent ball is finally attached on top of stem & the hip joint is judged again for stability & mobility. Surgeons will also verify length of the leg before closing the incisions with stitches.
Most patients experience considerable reduction in hip pain that they felt before undergoing hip replacement surgery. Increased range of motion & strength in the hip joint is observed. Very high-impact activities like playing basketball or running may be too stressful on the new artificial hip joint. But as time goes by, patients may be able to perform activities like swimming, playing golf, hiking or riding a bike quite comfortably. Following orthopedic surgeons’ instruction is very important in order to maintain the new hip implant for a longer period of time. In case of any problem, patients must undergo a post-operative check-up & stay in touch with the orthopedic surgeons. These factors will eventually result in a successful hip replacement surgery.
- Blood Clots - Clots can be formed in patient’s leg veins after hip replacement surgery. This is dangerous because a piece of clot can break causing damage & may travel to the patient’s heart, lung or rarely their brain.
- Fracture - During hip replacement surgery, healthy parts of the patient’s hip joint may sometimes get damaged & cause a fracture to happen. Sometimes, fractures are not serious & they may heal on their own but significant fractures may need to be rectified with pins, wires & possibly bone grafts as well.
- Infection -There is high chance of occurrence of infection at the site of incision & delicate tissues near the new hip. Surgeons will treat these kind of infections with antibiotics but a severe infection may need an additional surgery.
- Dislocation - Some positions can cause replacement of the ball in patients. This can also dislodge the new artificial hip joint. This can however be avoided by taking proper care & it is suggested that patients should not bend more than 90 degrees at the hip joint. In case of hip dislocation, surgeons may fit patients with a brace to maintain correct position of hip. When hips of patients still keep dislocating, another surgery is often needed to stabilize this problem.
- Change in Length of Leg - Orthopedic surgeons will definitely take certain steps to avoid this problem, but occasionally hip replacement surgery makes a leg shorter or longer than the other. It can also be caused by weakness in muscles around the hip. In such a condition progressive stretching & strengthening of these muscles may help.
- Loosening - This complication is very rare with newer hip implants, but the patient’s new replaced hip joint may not become utterly fixed to hip bone or may get loose over time so as to cause serious pain in hip. Many a times, another surgery might be required to fix this condition.
Medical Tourism in India for Highly Reliable Hip Replacement Surgery
India is considered to be one of the favorite countries promoting medical tourism, because of its top-notch facilities, compassionate medical professionals & easily accessible locations. Success of Indian medical tourism however depends mostly on excellent orthopedic surgeries which are provided to international patients at surprisingly low rates. Cost of orthopedic surgeries like hip replacement surgery in India is comparatively 10 to 20 times lesser than the price in other countries like Canada & United States. Travcure Medical Tourism associates with multi-super specialty hospitals & healthcare centers across India & which is backed by highly sophisticated technology when it comes to providing best orthopedic surgeries. Orthopedic surgeons in India are certified by prestigious medical institutions & have great expertise & experience in handling even the most complicated hip replacement surgery. Healthcare services with Travcure are specifically designed to cater to requirements of international patients. Travcure maintains integrity, honesty & transparency at every step of the patient’s medical journey. Additionally, holiday packages may also be provided to international patients for rejuvenating their mental health after hip replacement surgery.