Total hip Replacement

Introduction

A painful hip can severely affect your ability to lead a full active life.  Over the last twenty five years, major advancement in hip replacement have improved the outcome of the surgery greatly.  Hip replacement surgery is becoming more and more common as the population of the world.

Cause of hip replacement

There are many conditions that can result in degeneration of the hip joint

* Osteoarthritis is perhaps the most common cause for hip replacement surgery.

* A vascular necrosis is another cause of degeneration of the hip joint.

Abnormalities of hip joint function resulting from fracture of the hip and some types of hip conditions that appear in childhood can also lead to degeneration many years after an injury.

* The mechanical abnormal of the joint causes excessive wear and tear.

Symptoms

Symptoms usually begin as pain when bearing weight on the affected hip.The degeneration will lead to a reduction in the range of motion of the affected hip.

Diagnosis

The diagnosis of a degenerative hip joint starts with a complete history and physical examination by your doctor.

* X-ray will be taken to determine the extent of the degenerative process and suggest a cause for degeneration.

* Other tests may be required if there is reason to believe that other conditions are contributing to the degenerative process.

* MRI scanning may be necessary to determine whether a vascular necrosis is causing your hip condition.

* Blood test may be required to rate out systemic arthritis or infection in the hip.

Medical treatment

Not all hip condition requires a hip replacement as the initial treatment. Your doctor may suggest several alternatives treatments to put off replacing the hip as long as possible. Using a came may help alleviate some of your pain and allow you to walk more comfortably. Anti-inflammatory medications may reduce the inflammation from the arthritis and reduce your pain.

Surgery

Most degenerative problems will eventually require replacement of the painful hip joint with an artificial hip joint, called prosthesis. The decision to proceed with surgery should be made jointly by you, your family, and your doctor only after you feel that you understand as much about the procedure as possible

Once the decision to proceed with surgery is made, there are several things to be done. Your orthopedic surgeon may suggest a complete physical examination by your medical (or) family doctor.

This is to ensure that you are in the best possible condition to undergo the operation. You may also need to spend time with a physical therapist who will be managing your rehabilitation after the surgery.

The artificial hip joint called prosthesis

There are two major types of artificial hip joint.

* Cemented prosthesis

* Uncommented prosthesis

Both types are widely used. The types of prosthesis used for your surgery is usually decided upon by your surgeon based on your age, your life style and the surgeon past experience.

Each Prosthesis is made up of two components

* The acetabular component (or) socket portion, which replace the acetabulum.

* The femoral component, (or) stem portion, which replaces the femoral heads.

The femoral component is made of a metal stem with a metal ball on the end. Some prosthesis have a ceramic ball attached to the metal stem.The acetabular component is a metal small with a plastic inner socket liver that acts like a bearing.

Types of prosthesis

i. Cemented Prosthesis

It is held in place by a type of epoxy cement that attaches the metal to the bone

ii. Uncommented prosthesis

It has a fine mesh of holes on the surface area that-touches the bone. The much allow the bone to grow into the mesh and become part of the bone.

The operation

The steps for replacing the hip begin with making an incision about 8 inches long over the hip joint. There are several different approaches used to make the incision, usually based on your surgeon training and preferences.

Steps for the operation

Post operative course

Hospital stay

Immediately following surgery you will be taken to the recovery room where you will stay for 1-2 hours. Your B.P circulation, temperature, and wound drainage are carefully monitored.

After 1-2 hour post surgery you will transferred to an intensive care unite (ICU) for a day (or) two it epidural anesthesia is used of if close monitoring is needed. Other patient may be transferred directly to their own room.

Post operative physical therapy rehabilitation program

The duration of the physical therapy rehabilitation programmes depends upon types of operation was done and conditions of the patient.

Approximately the post operative physical therapy programme in minimum 1 weeks. (Walking, Stair Claimbing).