• The hip joint is one of the largest joints in the body. It’s a ball joint.
• The socket is formed by the hip socket, which is part of the pelvis.
• The ball is the femoral head representing the upper end of the femur (thigh bone).
• The bone surfaces of the ball and socket are covered with articular cartilage. Articular cartilage is smooth tissue that cushions the ends of bones and allows them to move easily.
• The hip joint is covered with a thin tissue called synovium. In a healthy hip, this membrane produces a small amount of fluid that lubricates the cartilage and eliminates almost all friction during hip joint movements.
• A tissue band, the so-called ligament (hip capsule), connects the ball to the glenoid fossa and ensures stability of the joint.

Common reasons for Hip Replacement Surgery 

Arthropathy. This is an age-related arthritis caused by wear and tear. It usually occurs in people over the age of 50 and is more common in people who have a family history of arthritis. The cartilage that cushions your hip bones wears down. This causes the bones to rub against each other, causing pain and stiffness in the hip joint. Osteoarthritis can also be caused or accelerated by subtle irregularities in the development of the hip joint during childhood.

Rheumatoid arthritis. This is an autoimmune disease in which the synovium becomes inflamed and thickened. This chronic inflammation can damage cartilage and cause pain and stiffness. Rheumatoid arthritis is the most common form of a group of diseases called inflammatory arthritis.

Post-traumatic arthritis. This may be the result of a severe hip injury or fracture. Damaged cartilage can cause pain and stiffness in the hip joint over time.

Osteonecrosis. Injuries to the hip joint, such as dislocations or fractures, can limit the blood supply to the femoral head. This is called osteonecrosis (sometimes called avascular necrosis). A lack of blood can destroy bone surfaces and cause arthritis. Some diseases can also cause osteonecrosis.

Hip disease in childhood. Some infants and children have hip problems. Even if the problem is successfully treated in childhood, it can lead to arthritis later in life. This is because the hip joint does not grow properly and the articular surface can become damaged. Learn more: Developmental dysplasia of the hip (DDH), adolescent hip dysplasia.

Different types of Hip Replacement Surgery in Nagpur

There are different types of hip replacements, each tailored to a patient’s specific needs and circumstances. Common variations are:

1. Total Hip Replacement (THR): This is the most common type of hip replacement. In total hip replacement, both the ball and socket of the hip joint are replaced with an artificial implant. Hip replacement surgery typically consists of a metal or ceramic ball that replaces the femoral head and a metal or plastic socket that replaces the damaged cartilage in the hip socket.

2. Partial hip replacement (hemiarthroplasty): In this surgery, only the femoral head (the ball of the hip joint) is replaced with an artificial implant. This type of surgery is often done for hip fractures, especially in older people.

3. Hip Resurfacing: This technique involves reshaping the existing femoral head rather than completely removing it. A metal cap is placed over the reshaped femoral head, and a metal cup is inserted into the hip socket. Hip replacement surgery is an alternative to total hip replacement and may be considered in younger, more active patients.

4. Minimally Invasive Hip Replacement: This approach requires smaller incisions compared to traditional hip replacement. Minimally invasive techniques aim to reduce tissue damage, blood loss, and recovery time. However, not all patients are suitable for this approach, and the expertise of the surgeon plays an important role.

5. Anterior Hip Replacement: In this approach, the surgeon approaches the hip joint from the front (front) rather than from the side or back. This technique aims to preserve muscles and tendons and may lead to faster recovery and less pain after surgery.

6. Robotic Hip Replacement: This procedure uses robotic technology to allow for precise planning and execution of the surgery. Surgeons can control robotic systems to assist in implant placement, potentially improving accuracy and results.

How does Hip Replacement Surgery takes place?

Hip replacement surgery is a detailed process that involves several important steps. Below is an overview of the typical steps of the surgery.

Preoperative Evaluation:

Before surgery, patients undergo a thorough preoperative evaluation. This includes a medical history, physical exam, and diagnostic tests such as x-rays and blood tests. The medical team will assess your overall health and determine if you are a good candidate for hip replacement surgery.

Anesthesia:

Anesthesia will be administered on the day of surgery to ensure that the patient is comfortable and pain-free during the procedure. The two main types of anesthesia are general anesthesia (in which the patient is unconscious) and regional anesthesia (in which the lower body is numbed while the patient is awake, such as spinal or epidural anesthesia).

Incision:

Once the patient is anesthetized, the surgeon makes an incision to access the hip joint. The location and size of the incision will depend on the surgical approach chosen by the surgeon.

Joint Exposure:

The surgeon carefully cuts through the layers of skin, muscle, and other tissue to expose the hip joint.

Removal of damaged tissue:

Damaged or arthritic cartilage and bone within the hip joint are removed. During total hip arthroplasty, both the femoral head (ball) and the acetabulum (socket) are prepared for insertion of the artificial implant.

Inserting a prosthetic implant:

Inserting a prosthetic hip component consisting of a metal or ceramic ball and a metal or plastic socket. These components are secured with cement or press fit, allowing natural bone growth within the implant.

Closure:

After the implant is secured, the surgeon closes the incision with sutures or staples. A sterile dressing is applied to the wound.

Postoperative Care:

The patient will be transported to the recovery area where vital signs will be monitored. Measures to prevent complications, such as pain management and blood clot prevention, are taken.

Rehabilitation:

Postoperative rehabilitation is an important part of the recovery process. Physical therapy is started to help the patient regain strength, flexibility, and mobility. Patients are usually encouraged to move and walk with assistance immediately after surgery.

Possible Complications of Hip Replacement Surgery

The incidence of complications after total hip arthroplasty is low. Serious complications such as joint infections occur in less than 2% of patients. Serious medical complications such as heart attacks and strokes are even rarer. However, chronic illness can increase the risk of complications. These complications are rare, but when they occur, they can delay or limit full recovery.

Infectious disease. Infection can occur on the surface of the wound or deeper around the prosthesis. This may occur within days or weeks after surgery. It could even happen years later. Minor wound infections are usually treated with antibiotics. Severe or deep infections may require further surgery and removal of the prosthesis. Infections within the body can spread to the replaced joint.

Blood clot. Blood clots in the leg veins or pelvis are one of the most common complications of hip replacement surgery. If these blood clots break away and travel to the lungs, they can be life-threatening. Your orthopedic surgeon will introduce you to a prevention program that may include:

• Anticoagulants (medications that thin the blood)
• Support stockings
• Inflatable leg covers
• Ankle pump exercises
• Early ambulation

Preparing for Hip Replacement Surgery

Preparation for hip replacement begins several weeks or more before the actual surgery. Staying as healthy as possible before surgery can help speed your recovery and reduce your risk of complications. Before hip replacement surgery, there are several steps you can take to prepare for the surgery and recovery.

Discuss what to expect with your surgeon and other members of your medical team. Visit one of the websites listed in the Related Resources section to request written information or learn more about the process.

Ask your surgeon about exercises you can do before surgery to strengthen your core, upper body, and leg muscles.

If you smoke, please quit or cut back.

If you are overweight, try to lose weight. Being overweight can increase your risk of complications during or after surgery.

Arranges transportation for surgery and follow-up visits with surgeon.

When you get home from the hospital or surgery center, ask for help around the house for a week or two. This includes helping with cooking, shopping, and laundry.

Please prepare your meals in advance.

Please designate an area in your home where you spend most of your time relaxing.

Keep TV remotes, telephones, cell phones, medicines, tissues, and trash nearby.

Other items you use every day should be placed at arm’s height for easy access.

Wear an apron with pockets to carry things around the house. This allows your hands and arms to be free to balance or use crutches.

Use a long-handled “reachcha” to turn on lights or grab objects outside arm’s length.