Hip replacement

Overview:

A hip replacement is a surgery that involves the replacement of the damaged portions of the hip or certain parts of it with an artificial implant called a prosthesis. The prosthesis is made of materials like metal, ceramic, or plastic. The replacement helps enhance the functionality of the person and decreases the pain. The surgery is called hip arthroplasty and is advised if the pain interferes with the daily activities of the person like standing, walking, and regular movement, and if the non-surgical interventions have not helped.

The surgery is carried out by an orthopedic surgeon and the majority of hip replacement procedures are performed on people above 50 years of age. 

What Are The Different Types Of Hip Replacements:

There are two main kinds of hip replacement procedures.

• Total hip replacement: In this type of surgery the doctor replaces the entire hip with a prosthetic. The replaced portions include the top section of the thigh bone and the socket to which it belongs. Most of the hip replacement surgeries are total hip replacements.
• Partial hip replacement: This type of replacement is not very common and it includes replacing only a part of the hip when there is an injury, fracture, or removal of a tumor. 

Why Is The Procedure Done:

Any health condition that deteriorates or damages the hip joint necessitates hip replacement surgery. They include: 

• Osteoarthritis- Osteoarthritis occurs when the cushiony cartilage that covers the end of the bones to make them move smoothly without any resistance is damaged.
• Rheumatoid arthritis- This condition erodes the cartilage and some parts of the bone due to inflammation and leads to deformity in the joints.
• Osteonecrosis- The condition happens when there is inadequate blood supply to a certain section of the hip joint leading to a fracture, dislocation, or deformity.

The other conditions that may require hip replacement are

• Psoriatic arthritis
• Femoroacetabular impingement syndrome or hip impingement.
• Hip dysplasia.
• Benign tumors or cancer.
• Perthes disease.

What Are The Symptoms That Doctors Look For Hip Replacement Surgery:

If a person experiences the following symptoms, it could indicate a health condition and the doctor may advise a hip replacement surgery.

• Severe pain in the hip joint despite taking medication.
• The pain increases when the person walks even with the help of a stick or walker.
• The pain and discomfort interfere with the sleep of the person.
• Disrupts the daily activities of the person like climbing the stairs.
• The person finds it difficult to stand up after sitting. 

The Procedure Details:

• In preparation for the surgery, the person is asked to wear a gown. A spinal block or general anesthesia is administered to numb the lower portion of the body. The doctor may also inject a numbing machine around the nerves to stop the sensation of pain after the procedure is over.
• The hip replacement procedure takes two hours to complete. The doctor cuts the hip through the tissue layers.
• The affected sections of the bone and cartilage are removed during the procedure while the healthy portion is retained.
• The implant is fixed inside the pelvic bone and a metal stem is put on the top end of the thigh bone along with the replacement ball.
• After the procedure is completed, the person is moved to a recovery room for a couple of hours till the effects of anesthesia are completely gone. The team monitors the vitals of the person such as their blood pressure, etc, and if they require any medication.
• The person is asked by the doctor to breathe deeply, cough, or blow into a machine to ensure that the lungs are not filled with fluids.
• The amount of time a person stays in the hospital depends on their medical condition. Fit people can go home the same day.
• Since the people are at risk of developing blood clots they are instructed by the doctor to sit and walk as soon as possible after surgery.
• During and after the surgery the person is required to wear compression stockings on the lower part of their legs to prevent the blood from entering the veins and stop the blood from clotting. The doctor may also prescribe blood thinners depending on how quickly the person can resume walking.
• Physical therapy is recommended for the person to help them regain their strength and mobility and gradually resume walking with the assistance of a walker, stick, or crutches. After some time the weight on the legs of the person is increased and the person is encouraged to walk without help.
• The person is given specific instructions before they are discharged from the hospital. Their environment needs some modification to make things accessible and ensure mobility is easier. This includes elevating toilet seats, and placing daily items on a raised level so that they don’t have to bend.
• Most people recover optimally within the first three months of surgery and completely after a year.
• The surgery allows the person to enjoy better movement with reduced pain. However, they may not be able to do all the activities they were doing before they developed the hip joint complication.
• High-intensity activities like running or basketball have to be avoided. The person can do low-intensity activities like swimming and cycling.

What Are The Risks Of A Hip Replacement Surgery:

• The development of blood clots: The blood can clot in the veins of a person’s leg after surgery. This can create complications as a portion of the blood clot can travel up to the lungs, heart, or brain. 
• Infections can happen at the site of surgery or in the tissues. If the infection is major then surgery is required to remove it by replacing the prosthesis.
• During the procedure the healthy sections of the hip joint may be fractured. If the fracture is minor it is left to heal by itself however the bigger ones need to be fixed with wires, screws, and metal plates or grafts.
• The ball of the new joint can loosen from the socket within the first few months of the surgery. If the dislocation of the hips happens a brace is required to place the hip back into the right position. 
• Sometimes the new hip makes one leg shorter than the other due to the contractions of the muscles around the hip. The difference is usually not seen after a couple of months.
• Nerves around the implant area can be damaged and lead to numbness, pain, and weakness.
• In rare cases the new joint may not be fixed well and can loosen up requiring another surgery to fix the issue.
• The prosthesis can wear off and a second hip replacement surgery may be needed.

Conclusion:

Surgeries can be intimidating but a hip replacement is a safe procedure that enables a person to get back on their feet again and reclaim their lives.

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