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HOW DOES THE HIP WORK?
The hip joint is a ‘ball and socket’ joint that permits movement between the thigh bone (femur) and the hip bone (pelvis).The ball shaped head of the femur fits into a rounded socket (acetabulum) in the pelvis which enables the leg to have a broad range of movements.The outer surface of the femoral head and the inside surface of the acetabulum have a smooth and durable cover of cartilage that allows the two surfaces to slide against one another and enable them to move easily.
WHAT ARE THE COMMON CAUSES OF HIP PAIN?
The most common cause of chronic hip pain and disability is arthritis. Osteoarthritis, Rheumatoid Arthritis, Avascular Necrosis and Traumatic Arthritis are the most common forms of this disease. Osteoarthritis – commonly known as ‘wear and tear arthritis’, often occurs in an individual with advancing age, perhaps due to a genetic tendency.
Rheumatoid Arthritis – is an auto-immune disease where the inflammation causes an erosion of the articular cartilage and eventually damages the hip joint surface. Avascular Necrosis – low blood supply to a part of femoral head leads to its collapse and hence degenerates the hip joint. Alcoholism,fractures and dislocation of the hip and long term treatment with steroids are its prime causes. Traumatic Arthritis – serious injury to the hip or strange conditions of hip in childhood (congenital dysplasia of the hip) can also lead to degeneration of hip joint.
IS THERE ANY NON-SURGICAL TREATMENT FOR HIP PAIN?
There are a multitude of ways to get relief from hip pain viz. changing one’s lifestyle and pain relieving medications.
WHAT IS HIP REPLACEMENT SURGERY?
Hip Replacement Surgery is a procedure in which the head of the femur (ball) and the acetabulum (socket) are replaced with man-made components, called prosthesis. A healthy hip joint will allow the leg to move easily within its range of motion while supporting the upper body and absorbing the strain that occurs from common activities like walking and running.
WHAT IS SURFACE REPLACEMENT OF THE HIP?
It’s an advanced alternative of the traditional Hip Replacement Surgery, wherein the damaged and worn out surface at the end of the thigh bone (femur) is resurfaced with a metal cap. This implant is potentially more stable and long lasting than the traditional hip surgery and allows the patient to do multitude of strenuous physical activities like squatting and sitting on the floor. This surgery best suits young and/or active adults with better bone quality.
WHO SHOULD HAVE A HIP REPLACEMENT SURGERY?
If all other conservative measures have failed to cure and the pain is so severe that it is limiting your everyday activities such as walking or bending, you should seriously consider Hip Replacement Surgery. The goals of Hip Replacement Surgery include correcting any deformity (inequality in leg length), improving the function of hip joint, enhancing the quality of life and relieving pain.
WHAT IS THE HIP PROSTHESIS MADE OF?
A hip prosthesis is made up of many different materials. The acetabular component that replaces the acetabulum, has an outer shell made up of metal and the inner shell can be of plastic, metal or ceramic or the entire socket may be made up of plastic. The femoral component that replaces the femoral head can either be of single piece or two piece design. A single piece design includes a femoral stem made up of metal alloy and the femoral head that joins the stem can either be of ceramic or metal alloy. This component is also known as modular prosthesis.
WHAT PRECAUTIONS SHOULD YOU TAKE BEFORE THE SURGERY?
To assure proper recovery and to prevent any complications during and after your surgery, you must take special precautions. If you smoke, you should stop at least four weeks before your surgery. You should also ensure that you don’t have any infections like leg ulcer, cold and the flu. During the surgery, these infections could infect your new replaced joint. That’s why if you’re diagnosed or suspected with an infection, you must inform your surgeon as he may have to reschedule your surgery.
HOW TO PREPARE FOR THE SURGERY?
The mental and physical preparations you make can affect both the outcome of the surgery and your recovery time. Team up with your physician, physiotherapist and your family to embrace a positive attitude towards the success of your surgery. This partnership will help in assimilating common goals and expectations of the procedure. For a successful surgery, try to be as active as you can. Doing exercises before surgery strengthens your body and helps you in fast recovery and makes you more flexible. Ask your doctor for pre-surgical exercises.
WHAT HAPPENS BEFORE THE SURGERY?
You will be admitted to the hospital a day prior to the surgery. An anaesthetist will evaluate you and several medical tests of the chest and the heart will be performed.You will be asked not to eat or drink anything after midnight before the surgery. Your surgical hip will be scrubbed and shaved to prepare you for surgery and reduce the risk of infection. An hour prior to the surgery, you’ll be given tablets or an injection to relax you.
WHAT HAPPENS DURING THE SURGERY?
The surgical procedure will take a few hours.Your surgeon will remove the damaged cartilage and bone with new metal, plastic or ceramic joint surfaces to restore the alignment and function of your hip. Since various types of designs and materials are currently used in artificial hip joints, your surgeon will determine the type of prosthesis that best meets your needs.
WHAT HAPPENS AFTER THE SURGERY?
After your surgery, you will be shifted to the recovery room for close observation.You’ll be given a drip or two to restore fluids into your body. When you wake up from surgery, you’ll feel pain in your hip and you’ll find your leg swollen and bruised and the muscles stiff and sore. Pain medication will be given to make you as comfortable as possible. Once you are fully conscious and your blood pressure and pulse rate become stable, you’ll be shifted in the ward. You’ll lose appetite for a couple of days but it is vital to take fluids. The scar on the side of your hip will fade to a thin white line, over a period of time.
Your physiotherapist will visit you a day after the surgery, to teach you specific exercises to strengthen your hip and restore movement for walking. Initially,you may feel unstable and experience some discomfort but you’ll be given a frame to assist you in walking. Gradually you’ll be walking with crutches or a stick after few days. Over a period of 4-6 weeks, you will be able to walk without support, as per your surgeon’s instructions.
Once you, your surgeon and the physiotherapist are satisfied with your condition and mobility you’ll be discharged from the hospital.Your stay in hospital will last for approximately 5-7 days.
WHAT PRECAUTIONS SHOULD YOU TAKE AFTERTHE SURGERY?
After returning home, you will need some help for several weeks with shopping and tasks at home. The success of your surgery will depend in large measure on how well you follow your surgeon”s and physiotherapist”s instructions regarding home care during the first few weeks after surgery. Taking regular medications and practicing the prescribed exercises will help you recover quickly. You should be able to resume most normal light activities of daily living within a few months of the surgery.There will be continual improvement for the first 12 months. Once the surgical wound has fully healed, many people forget they have an artificial joint.
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