TOTAL HIP REPLACEMENT: WHAT TO DO?

 

Total hip replacement (arthroplasty) is a surgical procedure consisting in replacing the hip joint with artificial parts. Most often, it is people whose degenerative disease destroys the hip joint and causes chronic pain.

The World Health Organization (WHO) has said that approximately 28% of people over 60 years of age have osteoarthritis and, of this group, 80% have limitation in their movements of ordinary life. In India, as we continue to age, the possibility of this reality is becoming more and more frequent.

According to the orthopaedic in Delhi, Osteoarthritis of the hip, in musculoskeletal diseases, is perhaps the one that generates the greatest disability; the functionality of the patient decreases due to loss of movement and disabling pain. But let’s review what osteoarthritis really is to understand its treatment.

Articular cartilage is a specialized tissue that covers every joint, allowing mobility and ideal adaptation in these areas to favour arches of motion.

But how is cartilage formed? They are highly specialized cells called chondrocytes, which differ from the embryonic stage and, when located in the joints, have biomechanical properties; They are capable of supporting the necessary loads associated with movement, walking, etc.

These cells produce collagen, which makes it possible to better support the physiological loads of movement and determine the characteristics of structure and differentiation according to the stimulus. These cells accompany us throughout life in our joints.

The downside is that these cells are not capable of reproducing in vitro and if there is injury or local damage they do not regenerate.

There is still no proven drug that can stimulate the reproduction of new chondrocytes that have the same properties as the original cells. When the cartilage erodes, a cartilage with regular characteristics called fibrocartilage is produced, which is not capable of imitating the original functions of the original articular cartilage. If the injury is considerable, it will inevitably end in osteoarthritis, says the orthopaedic surgeon in Delhi.

Osteoarthritis has different origins. It can be presented by a degenerative process, such as collagen diseases and the best known is rheumatoid arthritis; due to mechanical alteration, as is the case of angular or rotational alterations of the extremities, which wear irregularly the articular surface, for example, untreated hip dysplasia in children will surely end in osteoarthritis at some point in life. Osteoarthritis, too, can occur due to intra-articular fracture, which destroys cartilage and ends in post-traumatic osteoarthritis.

Finally, patients who have been apparently healthy, for genetic reasons and individually end up developing osteoarthritis in a primary way.

The treatment of osteoarthritis is aimed at protecting the function of the joint; This implies controlling the patient’s weight, performing activities of daily living that reduce excessive loads on the compromised joints, maintaining an adequate balance of the muscles around the joints, and understanding that the progression of osteoarthritis will possibly end in a greater compromise, explains the orthopaedic doctor in Delhi.

Each case is different and therefore the approach must be individualized.

On the market they offer different drugs that promise to “improve” osteoarthritis; unfortunately, studies show that the vast majority either do not work or barely achieve a feeling of pain control and a placebo effect. But none have succeeded in making the destroyed cartilage regenerate hyaline cartilage. Caution should be exercised with the use of these options, some of which are expensive and do not guarantee substantial changes.

When osteoarthritis has compromised the hip and the pain becomes disabling, the patient should go to the orthopaedist in Delhi, who will assess the age, work activity, sports and family expectations of the patient. Generally, hip replacement in Delhi will be the option, to control pain and regain mobility.

We owe the development of hip prostheses to the British orthopaedist Sir John Charnley, who through experiments on animals and then on humans in the 1940s managed to design and develop hip replacement using bone cement. (methyl methacrylate) to better adapt it to the bone.

This design allowed the hip joint replacement technique to be perfected in the following years, being today one of the most frequent surgeries in the world of orthopaedic surgery.

This managed to change the prognosis of the disease and allowed the patients to have an ordinary life, without pain, and with the functionality necessary according to their condition.

For this reason, when this procedure is defined, one must have the peace of mind of traceability over time, the high performance of prosthetic materials, refined techniques and in-hospital processes that favour a rapid recovery of the patient.

Of course, this hip replacement surgery in Delhi embodies inherent risks such as infection associated with any procedure, thromboembolic disease and other entities that are generally associated with the condition of each patient.

They are risks that are tried to be minimized with guides and protocols that help to give patients an excellent post-operative period and that increasingly show us success stories.

So, when you have hip pain, lameness and functional limitation, go to an orthopaedic doctor in Delhi specialized in traumatology to guide you and improve your style and quality of life.

Hip Replacement Surgery- What you need to know

 

The specialty is generically known as the hip and deals with complex problems involving the pelvis region (pelvis), in addition to the hip joint itself, which is the meeting point between the femoral head and the pelvis. 

The pelvis is responsible for the transmission of body weight and its distribution to the lower limbs, a frequent site of inflammation, pain, tendonitis, and muscle imbalances, which compromise the quality of life, both of sedentary patients, and of amateur or professional athletes.

The complicated anatomy characterized by an intimate relationship with the lumbar spine, in addition to pelvic organs and neurovascular bundles, often causes diagnostic doubt and treatment errors, says the orthopaedic in Delhi.

Hip pain, as in any joint (meeting between two bones), can be of intra or extra-articular origin. The most prevalent intra-articular diseases are: femoroacetabular impingement, arthrosis, and avascular necrosis of the femoral head. Tendonitis, also known as bursitis, is the main cause outside the joint.

When is hip surgery indicated?

Hip Arthroplasty or hip replacement in Delhi is surgery to replace the joint with a mechanical model called a hip prosthesis. It reproduces joint function very similar to the original biological model.

We know that the hip is a joint formed by the meeting of the head of the femur (thigh bone) and the acetabulum (part of the pelvis), stabilized by a reinforced set of ligaments. 

In this way, Hip Arthroplasty is indicated when the patient has some type of disease in the hip that results in the joint’s inability to perform natural day-to-day activities. 

The main advantage of hip replacement surgery in Delhi is the relief of pain and the recovery of the functions of the joint, which makes the patient return to perform daily activities painlessly, explains the orthopaedic surgeon in Delhi.

There are several factors that cause a person to experience pain in the hip. Some of them are:

• Osteoarthritis: type of arthritis that causes wear of the cartilage that cushions the hip bones and is related to age. It can also be caused by small irregularities in the development of the hip in childhood.
• Rheumatoid arthritis: autoimmune disease that causes inflammation and thickening of the synovial membrane, which can damage cartilage, causing pain and stiffness.
• Post-traumatic arthritis: cartilage injury that may arise following an injury or severe hip fracture, causing pain and stiffness in the hip over time.
• Avascular necrosis: limitation of blood supply to the femoral head caused by an injury to the hip, such as a dislocation or fracture.

Once the orthopaedic doctor in Delhi and the patient opts ​​for hip surgery, the specialist can request several physical exams before the surgical procedure, to confirm that the health conditions allow the surgery to be performed.

Before and after hip surgery

Now let’s talk a little more about everything that involves before and after hip replacement surgery in Delhi. Do you know how you know the care that must be taken by both patients and doctors? 

Before surgery

Before surgery, the patient is advised to perform blood tests, chest radiography, electrocardiogram and urine samples. That’s because many elderly patients may have undiagnosed urinary tract infections that can lead to a hip infection after surgery, explains the orthopaedic in Delhi.

The type of anaesthesia can vary between general anaesthesia with a breathing tube or regional blocks. In some situations, where only a few screws are planned for fixation, local anaesthesia with heavy sedation can be considered, explains the orthopaedic surgeon in Delhi. 

During surgery and for the next 24 hours, all patients receive antibiotics.

After surgery

After hip arthroplasty, patients may be discharged from the orthopaedic clinic in Delhi to return to their homes or to seek a stay in a rehabilitation unit. In all cases, assistance and attention is needed for patients to recover properly, says the orthopaedic in Dwarka.

Pain after hip surgery is a natural part of the healing process and so the doctor and the nursing staff work to reduce the pain. The drugs are prescribed for short-term pain relief.

It is possible that some patients will be encouraged to get out of bed the day after surgery with the assistance of a physical therapist, who will work to assist in the recovery of strength and the ability to walk. This process can take up to three months.

In some cases, a blood transfusion may be necessary after surgery. However, long-term antibiotics are generally not needed. Most patients can still receive a dose of blood thinning medications to reduce the chances of developing blood clots.

It is also important to note that, after hip replacement surgery in Delhi, most patients will regain the mobility and independence they had before the injury.

Some important precautions after hip surgery, to avoid complications such as prosthesis dislocation and bone fracture are:

• Lie on your back and with your legs spread;
• Do not cross your legs to avoid displacement of the prosthesis;
• Do not sit in very low places;
• Avoid turning your leg in or out;
• Physiotherapy;
• Perform activities only under the guidance of the doctor or physiotherapist.

What are the main diseases of the hip?

The patient should seek guidance from an orthopaedic specialist in the hip in the following cases: 

• Hip arthritis: inflammation of local joints. The most common type is inflammatory arthritis, which is when there is a change in the patient’s immune system, involving pain and swelling in the region.
• Hip arthrosis: it is also known as osteoarthritis; it is degeneration of the cartilage that protects the bones. This damage also extends to the ligaments and joints causing pain, swelling and difficulty in movement.
• Hip stress fractures: it occurs in the neck of the femur when stress is generated in the bone. 
• Fracture in the coccyx: occurs mainly in cases of fall or a very strong impact, capable of causing some type of injury at the site. It is common for the patient to feel a lot of pain in the region, in addition to having difficulty moving.
• Hip dislocation: it is a dislocation of the bones of the hip joint. They happen in moments of trauma in the place, for example, in a fall. However, the condition can also be congenital, when the child is born with the dislocation or ends up acquiring it (developmental dysplasia of the hip).
• Hip tendonitis: inflammation in the tendons of the region, capable of causing pain and swelling. 
• Hip bursitis: inflammation of the bursa that is between the muscle and the tendon, in order to avoid a large impact between tendons and bones. When the patient presents this condition, he feels pain in the joints and difficulties to move the inflamed site.