jointsguruHello friends, have you been advised hip replacement? Are you having pain in hip and doctor has told you that you will need hip replacement? If yes, then watch this video from start till end. You will get all information from here. So friends, hip is a very important part of our body. It helps us in walking; it helps us in climbing up stairs. Hip joint is used while lying down; while sitting. Hip joint is a very mobile joint. Such joints are named as ball or socket joints. It’s called ball or socket as it has a cup shaped structure which is called acetabular labrum and a ball which is call hip joint. Due to ball and socket it moves around a lot, but is a very stable joint. As you can see, I have a model of hip joint with me. So this portion makes its bowl and this portion makes its ball. So friends, the hip joint is a very strong and stable joint but sometimes it can get damaged. The two main reasons for a hip joint to be damaged are One is fracture and second is AVN. So, I will tell about both in detail. Generally, when there is fracture in hip joint and we go to the doctor in emergency. They fix it by putting 3 screws.
Friends, sometimes at that time the blood supply of hips get damaged.
Unfortunately, the quality of blood supply of hips is not so good. So, if you have been put 3 screws, then to a large extent, there is a possibility that the fracture does not get joint in 1 or 2 years and even if it gets joint, the blood supply of the hip gets damaged. If blood supply of the hip gets damaged, then you start getting pain in hip when you walk, there is springiness and you start walking with jerks. A lot of people, when they send X-Ray’s to me; then I can see 3 screws fixed, but the joint space of the hip is reduced quite a lot and in such cases, doctors advise for hip joint replacement. The second important reason for damage of hip joint is its name is AVN means avascular necrosis of the femoral head. Friends, AVN disease is found to happen due to consuming alcohol or steroids or it can also happen due to prolonged skin disease treatment. If you have taken any ayurvedic or homeopathic medicines for a long time and if it has content of steroids. Due to this also blood supply of hip joint is damaged. For them, AVN is suggested. Friends, there are several stages of AVN disease. First stage, which is visible in MRI is just the start of AVN. In second stage, the hip starts getting deformed and in third stage, the hip is completely damaged. When you go to the doctor with a problem of hip joint, they advise you to get MRI done. If they can see anything in X-Ray, then it is good. But most of the time, in case of AVN, certain things are not visible in X-Ray. That is why, they advise for MRI. When you get MRI done. In that there is mention of various stages of AVN such as Ficat and Arlet Stage 1, 2, 3 or 4. If it’s 1st or 2nd stage, then you are prescribed medicines. Here a medicine named Alendronate is prescribed which increases the vascularity of hip. After taking Alendronate, many people find reduction in pain. If you are at Stage 2, then you are advised for an operation called core decompression. In this, the pressure of the bone is reduced by making many drill holes. But friends, whether you talk about core decompression or about medicines. They have a limited role. Avascular Necrosis is a progressive disease. In this, now or later, the hip gets completely damaged and the patient is required to get the operation done. Sometimes, their both hips get damaged and he is advised for operation on both hips. But there is nothing to worry about, as hip replacement is a very successful operation and after that you can lead a normal life again. Now, I will tell you what all you should prepare before hip replacement. When you are selecting a doctor for hip replacement, I would suggest you to do research on YouTube because this is a technically demanding surgery and should be done by an expert doctor only. Many people think that you can go to any orthopaedic doctor and tell them to do hip replacement and they do it. Here, you do not get expected results. Friends, here, implant also has an important contribution. Good quality, expensive implants should be selected. Which will bring good results. By expensive, I do not mean High cost with low quality. Mostly, the top 3 or 4 companies which manufactures implants of hip replacement which I will mention are Johnson & Johnson; Zimmer; Stryker. These are the big companies which manufacture good implants. You can discuss with the doctor as to which company’s implant are they using and you should get the surgery done accordingly. Friends, There is a word which is quite in news – MIS Technique. Many say that they do operation by MIS Technique and its very successful and all. Basically, MIS is nothing. Its full form is Minimal Invasive Surgery. Friends, whether the incision is big or small, it does not affect the result of operation. So, it’s better not to get influenced by such false advertising and talk to your doctor about long term results because the stitches of the incissions will be cut after 15 days. So, it does not matter if the incissions was small or big. Other than this, there is no much difference between MIS technique and normal technique. However, at our place, facilities for MIS Technique are available. So, we can do MIS Technique too, if you prefer. Now, friends, I will tell about the different types of Hip Joint implants. The Hip joint implants can be divided in 2 parts. One is cemented implant and the other is uncemented implant. Friends, cement is one kind of adhesive. Not the normal cement. We use a different white coloured cement. We require to use this when the quality of the bone is not good. So, when we put the metal ball in the bone, we want the grip to be strong. If your age is above 50-60 or 65. After this age, the bones do not have much power to hold the metal ball. So, we need to use cement in such cases. And it’s called cemented hip replacement. In many European countries, cemented hip replacement is done on young people too. So, if your budget is less, you can go for cemented hip at young age too. But, the trend in India is that cemented hip is done only after 60 – 65 years. Before that uncemented hip is done.
Friends, the cost of cemented hip is very less. At our place, cemented hip can be done easily in 70 – 80 thousand. Now I will talk about uncemented hip. The speciality of uncemented hip is that on the implant, there is porous coating of calcium or HA coating covering. Its benefit is that it gets joint with the bone and becomes rock solid because of that the life of the implant is found to be very long. Uncemented hip can go on for even 20-25 years and if managed properly, it can go even more. So, if your age is between 15-20 to 50-55 years, I recommend uncemented hip replacement only. Cemented hip replacement should not be done. And as I told earlier, only imported implants should be used in any case. Quality of Indian implants is not found to be very good. Now, if you have decided on Uncemented, I will talk about the three variations in it.
One is Metal hip, one is ceramic hip and one is hybrid. Nowadays, the type that we use the most is ceramic on poly hip. Its life is of 20-25 years. If you don’t have any budget constraints, the costliest is ceramic on ceramic. So, there’s one metal on poly hip, then ceramic on poly hip and ceramic on ceramic hip. I recommend ceramic on poly hip only.
Its results are quite better. But, if you have fund constraint, then you can for metal on poly too. In metal on poly, the cup is made up of plastic and the ball is made up of metal. I has been observed that in case of young people, especially females. If they are unmarried and plan for pregnancy in future, there can be issue, due to metal, for kids.
But for males, there are no bad effects of metal. In long term, the wear rate of ceramic is stronger than the metal and therefore, ceramic on poly hip is more in trend and those who have insurance or mediclaim and can afford high cost can go for ceramic on ceramic hip. So friends, this was about the implants in brief. Now, I will talk about pre-operation preparations. Friends, when you get admitted for the operation, some blood tests are done the previous day. In that – haemoglobin, blood sugar level, Urea-creatinine, HIV, HBCG are tested. Once the reports are normal, next day you are taken for the operation. During operation, 1 unit of blood is kept ready. But, mostly in hip replacement, blood transfusion is not required. There are various approaches for the operation like anterior approach or posterior lateral approach.
Your doctor can select the approach as per their comfort. We, normally do the hip with the posterior lateral approach. Once you are taken to the operation theatre, you are given anaesthesia. There is no pain during the operation and there is no nervousness too during the operation.
Usually, this operation taken 1 – 1.5 hours to be completed.
Then you are shifted to the ward. Next day of the operation, the doctor gets your X-Ray done and you are given anti-biotics and pain killers for 4-5 days. If, while implanting hip joint, the doctor feels that the bone is quite solid and has caught on the hip joint properly. Then within 2-3 days, you can walk with full pressure. We normally, give walker to the patients, so they don’t feel pain while walking for a few days. 3rd or 4th day, after the dressing, the patient is discharged from hospital.
Once you are home, doctors tells you to take some precautions. One is that while walking, use the walker. Second-sitting crossed legs, sitting in squats position and climbing stairs should be started late.
Friends, many people ask me whether they can sit on ground again after the operation, and my answer is YES. 6-7 months after the operation, you can sit crossed legs on ground just like before. But, we also advise that sitting on ground should be avoided. Because that can reduce the life of the hip joint. But, such joints are available, which helps you sit down on ground. Secondly, when we lie down, doctor advises to use a pillow between both the legs. While turning to sides, so that both legs do not come close, in starting because, at that time, healing of ligament / capsule is happening. In 1.5 – 2 months, you can get back to your normal life; walk till 3-5 kms, climb the stair…and many of my patients have also started Gym. There are a lot of questions related to hip replacement like, how many days it will work, once I get my hip replacement.
So, for this I will give an example of purchasing a car. If you buy a car, and it is maintained properly, serviced regularly, then it can easily go up to 50k to 1.5L – 2L Kms. While if handled rough, it can wear out on 6 to 7 months. Friends, the same applies to hip replacement too.
If you avoid sitting crossed legs or in squat position; stop smoking and alcohol, then your hip joint will last for 20-25 or may be 30 years
It also depends on the fact that how is your body reacting to it. If you select imported implants and good doctor; if you come to us, you will get good results. Secondly, friends, the cost factor is also a point of worry for many. They feel, it may cost up to 2 -2.5L or 3L. So friends, at our place, the hip replacement is done at a very economical rate. You can contact on the below number; share your MRI and get all the details. For 15-20 days after the hip replacement, you have to use the walker; after that you can walk without the walker. So friends, this was a brief information about hip replacement. I think, most of your questions might have been answered in this information. If you want more information or have any other question, you can contact me on below mentioned number. You can take my online consultation on WhatsApp. If you want, you can come to our hospital in Jaipur, for hip replacement. I am also working in Apollo Hospital, Jaipur. If you have Medical insurance or mediclaim, or you are on any panel you can get the operation by me in Apollo Hospital.
Once again, Best wishes on Diwali. Greetings, Friends.
