TOTAL HIP REPLACEMENT

The hip joint is a ball and socket joint and one of the bigger joints of our body. It plays a very important role in our day to day living like walking, running, sitting, squatting, sitting cross-legged etc. When the help joint is damaged, these activities tend to become difficult.

Common causes of hip damage:

1. Osteroarthritis: This is a common where there is degeneration of the smooth cartilage covering the ball and cup of the hip joint due to wear and tear. Apart from excess weight and work, genetic and racial causes also are attributed to obsteroarthritis.
2. Avascular necrosis: The bone is a living organ and it requires blood to survive. The blood supply to the hip joint is educed in this condition and the ball part of the hip bone dies and the bone collapse and become irregular. This cause pain and disability to a person.
3. Rheumatoid arthritis: Rheumatoid arthritis is a disorder affecting many joints of body, where there is cartilage damaged and resulting in arthritis.
4. Post-traumatic arthritis: Sometimes serious injuries to the hip joint like dislocations or fractures can lead to irregular joints and causes secondary arthritis and pain.
5. Childhood hip disorders: Some childhood hip conditions like congenital hip dislocations, perthes disease, etc can lead to secondary arthritis.
6. Infections: Infections of the hip joint especially Tuberculosis in our country can lead to joint damage and arthritis.

When all modalities of treatment such as physiotherapy, exercise, medicines do not give any pain relief , then a total hip replacement is given as an option to people suffering from hip arthritis

Total hip replacement is a surgery, where both the ball and socket of the hip joint are replaced with artificial materials. This surgery was pioneered by Sir John Charnely of England in the 60s and evolved over the years to long lasting implants available today.

In a total hip replacement (also called total hip arthroplasty), the damaged bone and cartilage is removed and replaced with prosthetic components.

1. The damaged femoral head is removed and replaced with a metal stem that is placed into the hollow center of the femur. The femoral stem may be either cemented or “press fit” into the bone.
2. A metal or ceramic ball is placed on the upper part of the stem. This ball replaces the damaged femoral head that was removed.
3. The damaged cartilage surface of the socket (acetabulum) is removed and replaced with a metal socket. Screws or cement are sometimes used to hold the socket in the place.
4. A plastic, ceramic, or metal spacer is inserted between the new ball and the socket to allow for a smooth gliding surface.

THR is usually done under general or epidural anaesthesia, and the person is made to walk after 2 days from surgery and patient can go home after 5-7 days. Complications like infections, DVT and dislocations can be avoided by taking adequate precautions.

Like mentioned earlier, newer materials like titanium, ceramics and materials allowing bone growth into the artificial implants lead to longer life of implant. Also larger diameter ceramic heads allows the person to sit on the floor and squat as well. A well done uncemented, ceramic implant can last upwards of 30 years.

Total hip replacement is a successful surgery, and can change the lives of people who are suffering from arthritis of the hip.

Dr. SATHISH DEVADOSS
M.B.B.S., M.S.,(Ortho)M.Ch., Ortho (UK),FASIF (Aust)
Orthopaedic Surgeon | MEDICAL DIRECTOR
DEVADOSS MULTISPECIALITY HOSPITAL

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