Hip Surgery - Indications, Description of the Procedure, Complications

What is hip joint degeneration?

Contrary to appearances, degeneration of the hip joint is not a disease that affects only the elderly, because the first symptoms of this disease may be felt even in people over 45, and sometimes even earlier. If the disease is not properly treated, the accompanying symptoms worsen over time and cause pain in patients, mainly in the groin, hip and buttock, gait disturbances in the form of limping and rocking to one side while walking, such as also the stiffness and limitations of movement that are most troublesome in the morning. 

Additionally, patients report to best orthopaedic in Delhi with symptoms such as jumping and crackling in the hip, and complaints of weakening of the thigh and buttock muscles on the degenerative side. All these ailments result from the weakening of the regenerative capacity of the articular cartilage, which due to the influence of various factors becomes thinner and loses its elasticity and, above all, ceases to act as a shock absorber. As a result, the surface of the head and acetabulum rub against the surface of the hip joint and secondary inflammation is formed in and around the joint, leading to reduced mobility.

The causes of hip osteoarthritis

Degeneration of the hip joints can be both primary, where the disease is mainly caused by natural wear and tear. The secondary causes responsible for the accretion of degenerative changes include: congenital defects of the hip joint (dysplasias), inflammation of the hip joint caused by e.g. rheumatoid arthritis or gout, acute injuries of the hip joint such as fractures and dislocations leading to the disturbance of the anatomical conditions of the hip. In addition, overloads that occur as a result of the nature of the work performed or the overweight or obesity of the patient are also important.

Hip osteoarthritis diagnosis

In most cases, a detailed medical history combined with an examination and an X-ray image are sufficient to make a diagnosis, on the basis of which the symptoms of degeneration are assessed, such as e.g. bone tissue thickening, bone spurs (osteophytes) on the edges of the acetabulum or narrowing of the joint space due to the loss of cartilage thickness. In some cases, the orthopaedic doctor in Delhi also orders an MRI of the hip, which allows him to assess in detail any damage to the labrum and cartilage of the hip joint.

When is a hip endoprosthesis necessary?

The indication for hip arthroplasty is critical and irreversible damage to the joint, which causes permanent and resting pain, the importance of limiting the range of motion. These ailments do not respond to treatment with other therapeutic methods. In these cases, arthroplasty is the only effective solution. Additional indications for the procedure are rheumatoid diseases, consequences of fractures in the area of ​​the hip joint, fractures of the femoral neck, early forms of sterile bone necrosis as well as neoplastic diseases.

What is a hip endoprosthesis?

An endoprosthesis is an artificial joint that replaces our natural one in the form of an implant. Thus, the endoprosthetics procedure consists in removing degraded and worn out elements of the hip joint and replacing them with artificial parts. Endoprostheses are made of metals inert to the patient's body, such as titanium, which minimize the risk of implant rejection. The endoprosthesis consists of a shaft that is inserted into the medullary canal of the femur and the spherical head is mounted on it, which allows for movements. Additionally, the endoprosthesis includes an acetabular component in the form of a hollow hemisphere, which is implanted in the place of the diseased natural, bony acetabulum and it is between the acetabulum and the head that moves.

What types of hip endoprostheses are there?

Hip joint endoprostheses can be divided due to the way they are bound to the bone base, and they are:

• cement prostheses where it is attached to the bone with the so-called bone cement. In most cases, this type of prosthesis is used in procedures in the elderly as well as in patients suffering from osteoporosis or rheumatoid arthritis.
• Cementless endoprostheses, which are implanted directly into the bone and are used in the case of young patients who have not had bone degeneration
• Hybrid endoprostheses, which are a combination of both previous types, because one element of the prosthesis, which is most often the cup, is embedded with the cementless method and the other element of the implant with the cement method

What does hip arthroplasty look like?

The duration of the hip replacement surgery in Delhi depends on the degree of deformation of the hip joint and lasts from 1 to 2 hours. The procedure is performed under spinal or epidural anesthesia, during which the feeling in the legs is turned off. After the surgical approach is performed, the orthopaedic surgeon in Delhi reveals the affected area and proceeds to resection of the head and neck of the femur, which creates space for an artificial joint element. In the next stage of the operation, the bone bed is prepared for the hip joint endoprosthesis and the endoprosthesis is fixed. At the beginning of implantation, an artificial acetabulum is implanted into the iliac bone, and then the endoprosthesis stem is inserted into the femoral canal. The stage that ends the procedure is the reconstruction of soft tissues, placing a layered suture on the surgical wound,

Does hip replacement surgery pose a high risk to the patient?

Correctly performed hip joint prosthesis implantation is a routine operation with documented good results. As with any surgical procedure, postoperative complications may occur, the most common being mechanical loosening of implants, infections in the skin and tissues near the prosthesis, the occurrence of venous thrombosis, change in limb length or joint ankylosis.

Do implanted endoprostheses need to be replaced? 

Due to the fact that modern prostheses are made of good-quality, long-lasting materials, a properly implanted endoprosthesis can serve the patient for decades. However, it should be emphasized that a hip joint prosthesis is an artificial element in our body that can simply wear out in the form of loosening, displacement, falling out of the joint or cracking. Although such situations rarely occur, it is good news for patients because virtually every malfunctioning endoprosthesis can be replaced during the so-called revision replacement of the hip joint endoprosthesis.

What is the patient's life like after the hip replacement surgery?

Hospitalization after hip replacement in Delhi is approximately 5 - 6 days. For each patient, an antibiotic shield is used for 3-4 days after the procedure, as well as thromboprophylaxis, which is applied until the 30th postoperative day. The next day after the surgery, the patient is upright and learns to walk on crutches and skillfully weight the operated side of the body. As a standard, on the next day after the procedure, it is possible to start walking with gradual loading of the operated limb. It takes about 3 months to recover. During this time, rehabilitation is recommended, followed by a gradual introduction of physical activity such as walking, cycling or swimming.

Hip prosthesis implantation procedures are actually a rescue operation that will damage but a very important part of our skeletal system, which allows patients to regain the correct quality of life, eliminate pain as well as return to everyday life and work activities.