Also acknowledged as hip arthroplasty, hip replacement or total hip replacement (THR) is a kind of surgical procedure to help patients get rid of hip pain. In the procedure, a hip surgery doctor removes the affected hip parts and performs artificial implants. The hip joint has a socket (known as the hip bone) and a ball (acknowledged as the thigh bone and lies at the top of the hip bone). The THR surgery includes the replacement of both hip parts. This surgical procedure aims to help you resume your daily life activities and workouts with less or no pain.
When do you need a total hip joint replacement?
Your doctor may advise you a total hip joint replacement surgery when you have inflammation or noticeable pain in your hip area, or damage to your hip due to the following conditions:
- Injury such as hip fracture
- Osteonecrosis (avascular necrosis)
- Rheumatoid arthritis
- Tumour in the hip joint
When should you consult the best hip replacement surgeon in Rajouri Garden?
You should consult the best hip replacement surgeon in Delhi when you notice there is a decline in your quality of life. Symptoms of a decline in your quality of life may be as follows:
- Lack of restful sleep at night due to hip pain
- Difficulty in climbing stairs, changing clothes, walking, and allied daily life activities
- Inability to participate in your favourite activities
Initially, your doctor might suggest alternative treatments such as pain or inflammation medication, walking assistance devices, joint injections, and physical therapy. If these approaches fail to alleviate the pain and stiffness, the option of undergoing hip replacement surgery may become necessary to restore functionality and enhance the overall quality of life.
Types of Hip Replacement Surgery
Hip replacement surgery, also known as total hip arthroplasty, is a common procedure performed to alleviate pain and restore functionality in individuals with hip joint damage or conditions such as osteoarthritis. This surgical intervention involves replacing the damaged or diseased parts of the hip joint with artificial components. Over the years, advancements in medical technology have led to the development of various types of hip replacement surgeries. Here are the different types of hip joint replacement surgery:
- Total Hip Replacement (THR) - Total hip replacement, the most common type of hip replacement surgery, involves replacing both the ball and socket parts of the hip joint with artificial components. It is typically recommended for patients with severe hip joint degeneration due to osteoarthritis, rheumatoid arthritis, or other joint diseases. The procedure aims to restore joint function, reduce pain, and improve quality of life. The artificial components used in THR include a metal or ceramic ball attached to a stem that is inserted into the femur, and a plastic or ceramic socket placed in the pelvis.
- Partial Hip Replacement (Hemiarthroplasty) - Partial hip replacement, or hemiarthroplasty, involves replacing only the damaged or diseased femoral head while preserving the native hip socket. This procedure is commonly performed in cases of femoral neck fractures, where the blood supply to the femoral head is compromised. By replacing the femoral head with a prosthetic component, stability and function of the hip joint can be restored. The prosthetic femoral head can be made of metal or ceramic, and it articulates with the native socket, which remains intact.
- Hip Resurfacing - Hip resurfacing is an alternative to total hip replacement that involves preserving more of the patient's native bone. In this procedure, the damaged surface of the femoral head is reshaped, and a metal cap is placed over it. The acetabulum (hip socket) is also fitted with a metal cup. Hip resurfacing is typically recommended for younger, active patients with good bone quality, as it allows for easier revision surgery in the future if necessary. However, it is not as commonly performed today due to concerns about metal-on-metal wear and associated complications.
- Minimally Invasive Hip Replacement - Minimally invasive hip replacement is a surgical technique aimed at reducing the size of the incision and minimising tissue disruption compared to traditional hip replacement procedures. The procedure may be performed using specialised instruments and techniques that allow for smaller incisions, resulting in potentially faster recovery and less scarring. The actual prosthetic components used in minimally invasive hip replacement are similar to those used in total hip replacement, but the surgical approach differs.
- Anterior Approach Hip Replacement -The anterior approach to hip replacement involves accessing the hip joint from the front of the body, between the muscles, instead of the more traditional posterior (back) or lateral (side) approaches. This approach offers potential benefits such as reduced muscle damage, shorter hospital stays, and faster recovery. It allows the surgeon to access the hip joint without detaching any muscles or tendons. The prosthetic components used in anterior approach hip replacement are similar to those used in other types of hip replacement.
Discussing the best approach with a hip replacement doctor in Delhi
The choice of surgical approach recommended by the best doctor for hip replacement in Delhi will depend on several factors. These factors include the method through which the surgeon will access the hip, the specific type and design of the implant, the attachment technique to be used, your age and activity level, and the condition and shape of your hip bones. In addition, the possibility of future surgery is also taken into consideration, as certain surgical approaches and implant attachments can affect the ease or difficulty of a revision surgery.
During the evaluation process for hip replacement or total hip replacement surgery, your orthopaedic surgeon will thoroughly discuss the available options, which may include minimally invasive surgery or traditional hip replacement. They will also explain their planned surgical approach and the type of implant that will be utilised.
What happens during a hip joint replacement surgery?
Hip replacements are typically carried out in a hospital or a surgery centre, with the procedure often categorised as an outpatient treatment. However, in certain cases, you may need to stay overnight for observation or to address any complications that may arise. The typical process for an uncomplicated total hip replacement surgery involves the following steps:
- Upon entering the operating room, you will have an intravenous (IV) line inserted into your hand or arm. Additionally, a urinary catheter may be put in place.
- You will receive anaesthesia, which can be either general anaesthesia (affects the whole body) or regional anaesthesia below the waist (such as an epidural). The choice of anaesthesia will be determined by your anesthesiologist and orthopaedic surgeon.
- The surgeon will position you appropriately to access the hip joint and make an incision. The location of the incision depends on the surgical approach chosen by the surgeon, which can be from the front, back, or side.
- The surgeon will remove the head of the femur (the ball part of the joint) and create an opening in the top of the femur. They will then insert the stem of the ball prosthesis, either with or without cement. The ceramic replacement head will be attached to the top of the femur implant.
- Next, the surgeon will remove the damaged cartilage from the acetabulum (the socket part of the joint) and attach the new cup.
- Your surgeon will test the functionality of your leg by bending and moving it to ensure proper operation.
- The layers of tissue will be closed using dissolvable stitches, while the outermost layer of skin will be sealed with surgical glue. No stitches will need to be removed after the surgery.
- You will be transferred to the recovery room for a few hours and then moved to a hospital room. Your surgeon will determine when it is safe for you to return home, which may be on the same day depending on your condition.
Duration of the Total Hip Joint Replacement Surgery
Typically, the duration of a hip replacement surgery is approximately two hours on average. However, the time required may vary depending on the specific procedure. A partial hip replacement usually takes less time, while a double hip replacement may take longer. In some cases, complications during surgery can also lengthen the overall surgical duration. After the procedure and throughout the recovery period, it may be necessary to undergo imaging, such as an X-ray. These imaging tests serve to verify the success of the surgery and monitor the healing progress of your new hip.
After Hip Joint Replacement Surgery
The process of recovering from a hip replacement begins immediately after the surgery. It is encouraged that you start moving and getting up as soon as possible. Unless you have underlying health conditions, you can return home once you demonstrate your ability to walk, climb stairs, and get in and out of a car.
In certain cases, patients may need to spend time in an inpatient rehabilitation unit to ensure they can live independently at home. Whether you go home or to a rehabilitation unit, you will require physical therapy for several weeks until you regain muscle strength and achieve a good range of motion.
Your surgeon, physical therapist, or occupational therapist will provide guidance on when you can start walking with or without assistance, as well as how to manage any pain you may experience. They will discuss your rehabilitation needs, what to expect during the recovery period, and provide advice on maximising your recovery process. Your dedication and cooperation in completing the physical therapy sessions are crucial for a successful recovery and overall surgical outcome.
During your recovery, it is important for you to:
- Keep the surgical area clean and dry following the specific bathing instructions provided by your doctor.
- Take all medications as directed.
- Attend all follow-up appointments with your surgeon.
- Participate in physical therapy sessions and diligently perform the prescribed home exercises.
- Resume your normal diet unless instructed otherwise.
- Elevate your leg and use ice to control swelling.
- Refrain from driving until your doctor declares it safe to do so.
It is normal to experience some fluid drainage from the incision during the initial days after surgery. However, if you notice increased redness, swelling, excessive drainage, a high fever, chills, or severe pain, promptly inform your surgeon's office. Similarly, if your pain does not improve, contact the office for further guidance.
Risks Associated with the Total Hip Replacement (THR)
Hip joint replacement surgery generally has positive outcomes for most patients. However, as with any surgical procedure, there are potential risks that may occur during and after the operation:
- Formation of blood clots in the legs or lungs
- Leg length inequality
- Nerve damage in the surrounding area
- Persistent pain or stiffness
- Dislocation of the prosthetic joint
- Loosening or deterioration of the artificial joint over time
- Temporary unrelieved joint pain
In extremely rare cases involving bone surgery, particularly those involving cement, there is a risk of fat embolism. This occurs when fat from the bone marrow enters the bloodstream, potentially increasing the likelihood of a heart attack or stroke. In addition, depending on your specific medical condition, there may be other risks associated with the procedure. It is crucial to discuss any concerns you have with your doctor before undergoing the surgery and inquire about the risks that are most relevant to your situation. After the surgery, it is important to notify your doctor if you experience any of the following:
- Redness, swelling, bleeding, or unusual discharge from the incision site that persists for more than a few days
- Increased pain around the incision site
- Unrelated leg pain below the incision
- New or increased swelling in the lower leg
Keep your hip replacement doctor in Delhi informed about these symptoms to ensure prompt evaluation and appropriate management.
Why Should I Contact Dr Rajesh Malhotra for Hip Replacement Surgery in Delhi?
Dr. Rajesh Malhotra is the best hip replacement surgeon in Delhi. As the best doctor for hip replacement in Delhi, he has done a large number of surgeries and assisted patients get rid of pain and improve quality of their life with enhanced mobility. Here are more points why you should consult him for your hip replacement surgery in Rajouri Garden, Delhi:
- Several years of experience
- 24x7 medical care and support
- Pick up & drop facility to patients
- Easy payment options
- Fast response
- Post Surgical Rehabilitation
- Excellent patient care during and after shoulder replacement surgery
- Customised approach