This is a surgery where both the ball and socket of the hip joint are replaced with artificial materials.
The normal hip joint consists of a cup called the acetabulum into which
articulates a head of the thigh bone called the femur.
This joint may become damaged due to a variety of conditions. The common causes are rheumatoid arthritis, ankylosing spondylitis, childhood diseases like perthe's, injury to the hip joint etc. There is loss of articular cartilage, a smooth lining of the ends of the bone in a joint. The result is that raw bones rub against each other causing pain. This condition where the articular cartilage is damaged, is collectively called arthritis.
Damage to hip joint can occur at any age. Total hip replacement can be done after the age of 20 years.
There are three basic components in a total hip system. The stem which is
into the medullary cavity of the femur bone. The head which is fixed to the
stem and cup which is fixed to the acetabulum. The acetabular component may be only of polythene material or a titanium shell which holds the polythene cup.
There are two basic types of total hip system, the cemented and the un
cemented. In the cemented system, the components are fixed to the bone
by a material called bone cement which firmly fixes the components to the bone. The un cemented total hip system does not use cement for fixation, instead rely on firm fixation by scratch fit.
There are various materials by which the head and the cup are made of. The older version is a stainless steel head articulating with a polyethylene cup. In this type of articulation, the head rubs against the polyethylene cup and gets worn out faster. The particles so generated by the wear of polyethylene will cause damage to the bone which can cause loosening of the components from the bone, a condition called aseptic loosening. To avoid this, complication, various other material combinations are available. Ceramic is a promising material. The ceramic cup with ceramic head is long lasting. Ceramic head can also be coupled with polyethylene cup which also gives comparable long term results. On an average, these materials are designed to last for more than 20 years.
The surgery is done usually under spinal anaesthesia. Through a surgical
exposure, the damaged head of femur is removed, the acetabulum is reamed to make the surface rough so that the hold of the artificial cup is better. After the cup and stem with the head are implanted, the patient is kept under observation for a day or two in the post operative ward. A drain may be inserted in the wound during surgery to drain the blood that may collect in the wound. This step is an attempt to prevent infection. The drain is usually removed on the 2nd post operative day. The patient may be given some antibiotics and blood thinning agents. In the normal course, the patient can start standing and walking with support by the end of 4th post operative day. In the first few days, pain relievers are given. He is usually discharged on the 5th post operative day. He comes back after 10 days for suture removal.
There are a few potential complications in total hip replacement surgery. In the first two or three days after surgery, patient may develop clotting of blood in the leg veins. Occasionally, this blood clot may travel in the blood to get lodged in the lungs. The patients are given blood thinning agents to prevent this complication. DVT stocking and calf muscle pumps can also prevent this complication.
Post operative Infection is another complication. Every step is taken to
prevent this. At KKOH, strict sterilisation and aseptic procedures are carried out. Our infection rate is very low compared to International standards. Total hip replacement is usually a promising surgery if done by an experienced surgeon taking adequate precautions.
Our state-of-the-art facility combines advanced medical technology with compassionate care, making us the preferred choice for patients seeking specialized bone and joint treatment.
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