Hip Replacement Surgery: Procedure, Types & Risks

Hip replacement surgery, also known as hip arthroplasty, a common orthopaedic procedure, involves replacing a damaged or worn-out hip joint with an artificial implant, made of metal, plastic, or ceramic components. It is typically performed to alleviate pain and improve mobility in conditions like osteoarthritis or injury.

Hip replacement surgery aims to restore function and enhance the patient's quality of life. Recovery involves physical therapy and rehabilitation, enabling patients to regain strength and their ability to perform daily activities with reduced discomfort.

Types of Hip Replacement Surgery

There are several types of hip replacement surgeries, each with its specific approach and considerations. The choice of procedure depends on factors such as the patient's condition, age, and the extent of hip joint damage.

Following are some common types of hip replacement surgery:

Total Hip Replacement (THR):

It is the most common type of hip replacement surgery.

In a total hip replacement, both the ball and socket of the hip joint are replaced with prosthetic components. The damaged portion is removed and replaced with a metal stem that is inserted into the femur (thigh bone).

The damaged cartilage and bone in the acetabulum (hip socket) are removed and replaced with a metal socket.

Partial Hip Replacement (Hemiarthroplasty):

In this procedure, only the femoral head (the ball) is replaced, while the natural acetabulum is retained. It is often performed in cases of fractures involving the femoral neck, particularly in older individuals.

Hip Resurfacing:

This involves reshaping the damaged hip joint rather than completely replacing it. It is similar to total hip replacement, but less bone is removed.

In hip resurfacing, the damaged femoral head is capped with a metal prosthesis rather than being completely replaced.

Minimally Invasive Hip Replacement:

This approach involves smaller incisions and less muscle dissection than traditional hip replacement surgery. The goal is to reduce postoperative pain, shorten recovery time, and minimize scarring.

Following are the various steps involved in a hip replacement surgery:

Preoperative assessment: Before the surgery, the patient undergoes a thorough preoperative assessment. This includes a physical examination, imaging tests (X-rays, MRI), and a review of medical history.

Blood tests and other diagnostic evaluations ensure the patient is fit for surgery.

Anaesthesia: The patient is administered general or local anaesthesia, depending on the surgeon's preference and the patient's health. General anaesthesia induces a state of unconsciousness, while local anaesthesia numbs the lower half of the body.

Incision: Once the patient is anaesthetized, the surgeon makes an incision along the side of the hip, typically between 8 to 12 inches long. This incision provides access to the hip joint.

Removal of damaged tissues: The damaged cartilage and bone in the hip joint are removed, leaving healthy bone and tissue intact. This step prepares the joint for the prosthetic components.

Insertion of prosthesis: A metal or ceramic ball is attached to a stem that fits into the hollow space of the femur, and a socket is implanted into the pelvic bone.

The prosthesis is typically secured using bone cement or, in some cases, through a press-fit technique that encourages natural bone growth around the implant.

Closure of incision: The surgeon carefully closes the incision using sutures or staples. A sterile dressing is applied to protect the wound.

Recovery and rehabilitation: Post-surgery, the patient is monitored in the recovery room and then transferred to a hospital room. Physical therapy begins soon after surgery to aid in regaining mobility and strength.

Patients are encouraged to start walking with the help of crutches or a walker.

Postoperative care: Pain management, infection and blood clot prevention are crucial aspects of postoperative care. Patients may be prescribed medications, such as pain relievers and blood thinners, to facilitate a smooth recovery.

Follow-up and long-term monitoring: Regular follow-up appointments with the orthopaedic surgeon are essential for monitoring progress and addressing any concerns. Patients are advised on long-term care, including exercises to maintain joint flexibility and prevent complications.

Risks associated with Hip Replacement Surgery

Like any other surgical procedure, hip replacement surgery poses certain risks. Following are the various risks associated with hip replacement surgery:

· Infection: Post-surgery infections can occur, potentially leading to serious complications. Strict adherence to sterile procedures is important to minimize infection.

· Blood clots: The formation of blood clots is a common risk. Surgeons may prescribe blood thinners and encourage early mobilization to mitigate this risk.

· Dislocation: Improper movement or positioning may cause the hip joint to dislocate. Following post-operative guidelines and restrictions helps prevent this complication.

· Implant wear and tear: Over time, the artificial joint may wear down, potentially requiring revision surgery. Regular follow-ups and lifestyle adjustments can extend the implant's lifespan.

· Nerve and blood vessel damage: Surgical procedures can inadvertently damage surrounding nerves and blood vessels. Skillful surgical techniques and careful monitoring minimize this risk.

· Anaesthesia complications: Adverse reactions to anaesthesia can occur. Thorough pre-operative assessments and close monitoring during surgery are essential to address such complications promptly.

· Leg length discrepancy: Inaccurate implant placement may result in leg length inequality. Precise surgical techniques and postoperative assessments are vital to ensure proper alignment.

To summarize, hip replacement surgery is a highly effective procedure, providing significant relief from pain and improved mobility in individuals suffering from severe hip joint issues. It has a high success rate, enhancing patients' overall quality of life. However, like any surgery, it involves risks and requires careful postoperative care. The decision to undergo hip replacement should be made after a thorough consultation with a medical professional, weighing the potential benefits against the associated risks.

KM NU Hospitals in Ambur, India, is renowned for its excellence in hip replacement surgery. With a commitment to patient-centric care, experienced orthopaedic surgeons employ cutting-edge techniques to ensure optimal outcomes. The hospital's state-of-the-art facilities and personalized approach make it a preferred choice for individuals seeking high-quality hip replacement procedures, promoting mobility and improved quality of life.

References:

1. Total Hip Replacement. American Academy of Orthopaedic Surgeons.

https://orthoinfo.aaos.org/en/treatment/totalhipreplacement/.

2. Hip Replacement Surgery. John Hopkins Medicine.

https://www.hopkinsmedicine.org/health/treatmenttestsandtherapies/hipreplacementsurgery.

3. Hip Replacement Surgery. National Institute of Arthritis & Musculoskeletal & Skin Diseases.

https://www.niams.nih.gov/healthtopics/hipreplacementsurgery.

Author: Dr. Allen Sunny Deol S V