The Normal Hip Joint
Your hip is a ball and socket joint where the thigh bone (femur) meets the hip bone (pelvis). A healthy hip has layers of smooth cartilage that cover the ball-shaped end of the femur and socket part of the pelvis. The cartilage acts as a cushion and allows the ball of the femur to glide easily on the socket of the pelvis. The muscles around the joint support your weight and help move the joint smoothly so that you can walk without pain.
The Degenerated Hip Joint
The smooth cartilage layers can wear down on the ball of the femur and the pelvic socket. This is called degeneration. It can happen because of arthritis, injury or as a side effect from medicines, such as steroids. When the joint wears down, the smooth surfaces become rough. Instead of gliding smoothly with leg movement, the ball grinds in the socket causing pain and stiffness.
Hip replacement, or arthroplasty, is a surgical procedure in which the diseased parts of the hip joint are removed and replaced with new, artificial parts. These artificial parts are called the prosthesis. The goals of hip replacement surgery include increasing mobility, improving the function of the hip joint, and relieving pain.
The goal of total hip replacement is to return patients to a good level of function without hip pain. The large majority of patients are able to achieve this goal.
Condition which requires Hip Replacement
Osteoarthritis:Sometimes called degenerative joint disease (DJD) or "wear-and-tear" arthritis
Post-traumatic arthritis: After a severe fracture of the pelvis or a dislocation of the hip the joint surface cartilage may suffer damage--either because of direct trauma or because of a loss of joint congruity (the good fit between the ball and the socket)--leading to pain and stiffness.
Rheumatoid arthritis: This is a condition in which the body's own cells attack joint surface cartilage. It may affect any joint in the body
Avascular necrosis (or steonecrosis) of the Femoral Head: This is not exactly a type of arthritis but rather a condition in which the circulation to the "ball" of the "ball and socket" part of the hip joint becomes impaired.
Cemented hip Replacement or Uncemented hip replacement
Cemented replacements are more frequently used for older, less active people and people with weak bones, such as those who have osteoporosis, while uncemented replacements are more frequently used for younger, more active people.
Uncemented prosthesis is the extended recovery period. Because it takes a long time for the natural bone to grow and attach to the prosthesis, a person with uncemented replacements must limit activities for up to 3 weeks to protect the hip joint.
Who Should Have Hip Replacement Surgery?
People with hip joint damage that causes pain and interferes with daily activities despite treatment may be candidates for hip replacement surgery. Osteoarthritis is the most common cause of this type of damage. However, other conditions, such as rheumatoid arthritis (a chronic inflammatory disease that causes joint pain, stiffness, and swelling), osteonecrosis (or avascular necrosis, which is the death of bone caused by insufficient blood supply), injury, fracture, and bone tumors also may lead to breakdown of the hip joint and the need for hip replacement surgery.
How Long Are Recovery and Rehabilitation?
Usually, people do not spend more than 7 days in the hospital after hip replacement surgery. Full recovery from the surgery takes about 3 weeks, depending on the type of surgery, your overall health, and the success of your rehabilitation.
It is important to get instructions from your doctor before leaving the hospital and to follow them carefully once you get home.
Each patient will be instructed in "Hip Precautions" after surgery. This is a short list of restrictions on particular motions designed to prevent dislocation of the joint replacement. Which specific precautions are used in an individual case depends on the approach used but in general patients are encouraged to avoid the extremes of hip rotation (twisting motions of the leg) and flexion (bending forward). Low chairs low couches and swivel chairs should be avoided. After about six weeks some of those restrictions are relaxed--for example most patients can easily put on shoes and socks once they've recovered from surgery and the surgeon gives them the OK--but others including extreme flexion and rotation should always be limited to be on the safe side.
Q. How soon will I recover from my surgery?
- Ans.After single knee replacement, you can stand with assistance of physiotherapist, 1 - 2 days after surgery and start mobilizing with walking aid.
- You can use toilet seat (raised) 3 - 4 days after surgery.
- By the time you get home, you should be able to go to toilet independently with walking aid.
- You will need to use crutches or walking frame for 2 - 4 weeks.
- If will take 8 - 1 2 weeks to achieve full benefit of surgery.
- In case both knees were done together, the process is a little slower but same principles are followed.
Q. How frequently do I need to visit the hospital?
Ans.You will come to hospital 10 days after surgery for stitch removal. After that we may see you 2 - 4 weeks later to see the progress. Other visits after 3 months, 1 year after surgery unless medical condition dictates otherwise.
Q. Is Knee "Replacement detetected by a metal detector?
Ans.Yes. Please collect a credit card shaped certificate from orthopedic office certifying that you had joint replacement. This can be shown to the security staff.