Total Hip Replacement
What is Total Hip Replacement?
The hip joint is a ball and socket joint made up of the upper end of the thighbone (femur), which fits into the hip socket (acetabulum) in the pelvis with articular cartilage present between the bones that provide cushioning and allows smooth joint movement. Total hip replacement is a surgical procedure in which a painful or poorly functioning hip joint is replaced with prosthetic components to help reduce symptoms and restore mobility in the joint.
Parts of the Hip Prosthesis
The prosthetic hip is a mechanical device that is designed to replace the patient’s hip joint. It is made of the following components:
- Acetabular component: This replaces the acetabulum of the hip. It is shaped like a cup and is made of metal shell with a polyethylene or ceramic inner liner.
- Femoral component: This replaces the top end or head of the femur. It is shaped in the form of a stem and ball. The stem is made of metal and the ball is made of metal or ceramic.
When should Total Hip Replacement be considered?
A hip that is painful as a result of osteoarthritis ,injury or chronic and inflammatory desease can severely affect your ability to lead an active life. Total hip replacement should be considered when non-surgical treatments do not provide adequate pain relief and your symptoms interfere with your ability to perform routine activities.
Preparing for Total Hip Replacement
In preparation for the surgery, you may be recommended to:
- Undergo tests to ensure you are fit for the surgery
- Inform Dr. Laxman of your current medications and allergies
- Temporarily stop certain medications before surgery
- Avoid smoking and alcohol as it slows down healing
- Stop eating and drinking 8 to 12 hours prior to the surgery
What to expect during Total Hip Replacement Surgery?
The operation is performed under general or local anaesthesia. There are several different ways of accessing the hip joint to perform surgery on the hip. The anterior approach is considered less invasive. A 4 to 6 inch incision is made along the side of the thigh. Underlying muscles and soft tissues are carefully separated. The blood vessels and nerves are protected with special retractors. An incision is made in the front part of the hip capsule. The femur is dislocated from the acetabulum. The head of the femur is then cut with a surgical saw. A reamer is used to shape the hip socket so the acetabular component can fit inside the socket properly. A surgical drill is used to create a canal within the femur. The canal is shaped with filing tools so that the stem of the femoral component fits properly within the canal. The prosthetic components are placed in position and the hip is relocated. Stability and mobility of the joint is assessed. The incision is then closed in layers with sutures. A bandage is then applied and you will be transferred to the recovery room.
Recovery after Total Hip Replacement
Hospital stay after the procedure varies between 1-4 days. You will be discharged home when can safely get out of bed, walk with the assistance of a walker or crutches and use the stairs safely. You will be instructed on physical therapy exercises to help you recover quickly. Full recovery from total hip replacement may take about 3 months.
Risks of Total Hip Replacement
Total hip replacement is a very safe procedure that improves hip stability and function. Of note, there are minimal risks with the surgery, which include infection, bleeding and delayed healing.
Longevity and long term functional returns
Most of the functions expected by Indian patients like sitting crosslegged and sintting on the floor ascending & descending stairs are easily performed by most of the patients. Dr Laxman Advises to use ceramic bearing surface in young patients,Ceramic on poly bearing surface in old patients,Metal on poly bearing surface in patients over the age of 75 years.Most of the Replaced Hips perform well for 20-25 years if instructions are followed & lifestyle modifications are applied.
Why Would Someone Need Total Hip Replacement?
Total hip replacement is often necessary after the cartilage between a patient’s femur HEAD(ball) and ACETABULUM (cup)wears out. Severe arthritis often results from the lack of cartilage and leaves patients with severe pain and immobility. Typically, a hip replacement is performed WHEN nonsurgical methods fail to relieve hip pain.
What Happens During a Total Hip Replacement?
While the patient is under anesthesia, the hip is cut open and the arthritic bone in the socket of the joint is cleaned out. The surgeon also removes arthritic bone from the femoral head, then inserts an artificial femoral head down into the femur.Stability of the hip jopint is assessed. Wound is closed in Layers.
Will I Be Pain-Free After My Surgery?
Total Hip Replacement is a very happy surgery. There is tremendous pain relief immediately after surgery.there might be mild surgical site pain for which medicines will be given on inpatient basis.
By the time you are ready to go home almost all the pain will disappear.
How Long Will I Have to Stay in the Medical Facility?
Avelage length of stay is 3-4 days
Before you are discharged from care, you will need to accomplish several goals, such as:
- Getting in and out of bed by yourself.
- Having acceptable pain control.
- Being able to eat, drink, and use the bathroom.
- Walking with an assistive device (a cane, walker, or crutches) on a level surface and being able to climb up and down two or three stairs.
- Being able to perform the prescribed home exercises.
How Long Will I Have to Take Off Work?
It is recommended that patients take 2-6 weeks off of work depending on their occupation. Patients who have a desk job can typically go back to work sooner than patients who have manual labour jobs or have to be on their feet often.
How Long Will Full Recovery Take?
Patients should be able to move around the house after immediately after discharge without experiencing pain using walking aids. After that point, the amount of time that is necessary for a full recovery varies between patients. Some patients recover extremely quickly within 3 -4 weeks—while others require a full six 6 weeks. returning to their pre-surgery levels of activity will require 8-12 weeks in total.
Will I Need Physical Therapy?
Yes. Physical therapy is an essential part of your total hip replacement recovery process. Physical therapy begins the following day of your surgery and will take place over the course of several weeks. At first, you will do some simple exercises like contracting and relaxing your muscles in order to strengthen your hip. You will also learn new techniques for movements such as sitting, standing, and bending, in order to prevent any possible damage to your hip replacement. Typically patients are in physical therapy for 6-8 weeks and have sessions twice to thrice a week.
What Will Physical Therapy Entail?
The specific exercises depend on the patient and their rehabilitation goals. For example, if the patient’s home has lots of stairs, the physical therapist may prioritize preparing the patient for going up and down stairs.
Regardless of individual goals, physical therapy is essential to hip replacement rehabilitation. Patients who attend their physical therapy appointments and perform their prescribed exercises tend to recover more quickly and have better outcomes than those who do not.
How Long Before I Can Drive After Surgery?
Some patients may drive as soon as 2 weeks after surgery, while others may need as long as 8 weeks. During this period, simply getting in and out of a car can be challenging, especially if the car’s seats are low to the ground. In order to drive a car safely, patients must meet the following requirements:
- The patient must be off of narcotic pain medication while driving. If the patient takes pain medication at night only and not during the day while driving, that is acceptable.
- The patient must be able to hit the brake quickly.
- The patient must be able to get in and out of the car comfortably and safely.
In addition, reflexes and muscle strength should have returned to their pre-surgical levels.