Hip Joints are one of the most important joints in the human body that allows for easy movement and almost all the postures of the body. Any kind of damage to this joint restricts the movement and may also obstruct all or many routine postures, interruption of daily activities like sitting down, getting up, walking, and climbing up and down the stairs. Though generally related to old age, damages to the hip could also occur at a young age too owing to accidents, trauma or childhood illnesses.
Causes for hip pain or damage
Among the many reasons for the pain or damage to the hips the most common are Osteoarthritis and Rheumatoid Arthritis. The damage can also occur due to unforeseen accidents and injury to the hip.
Osteoarthritis- Most commonly referred to as normal wear and tear, Osteoarthritis damages the cartilage that helps the movement of joints in the body. Usually, this occurs when old age settles in and also for those who have a history of arthritis in the family.
Rheumatoid Arthritis- This form of arthritis is an autoimmune disease and forms as an inflammation that can slowly affect and erode the cartilage spreading to the bones. Accompanied by pain, these are also known as inflammatory arthritis.
Osteonecrosis- Bones require regular blood supply for effective functioning. When there is a lack of blood supply, it may result in defect in the cartilage of joints, known as Osteonecrosis.
Accidents and injuries- Any major accidents or injuries resulting from accidents can lead to hip cartilage damage. The cartilage ends up getting damaged and in time pain and stiffness settles in.
What is hip replacement surgery?
Hip replacement is a highly effective form of treatment. The doctor may recommend undergoing this surgery when pain in the hip starts affecting the daily activities. Total hip replacement, also known as Arthroplasty will place an alternative artificial part instead of the damaged sections of the hip for better and continued movement post-surgery.
Who should undergo Total Hip Replacement or Arthroplasty?
Arthroplasty is not recommended for everyone who has pain in the hip or has damaged parts of the hip. Arthroplasty is administered when:
- There is continued pain, despite initial treatments for the ailment.
- The daily activities are completely affected and the patient has difficulty walking.
- The pain worsens at night and the patient is unable to sleep.
- Pain medications and therapeutic interventions do not reduce the pain.
Arthroplasty is removal of damaged cartilage and bone. A prosthetic socket is implanted into the bone which replaces the damaged socket. This implant contains a ball attached to a metallic stem that is inserted to the thighbone and a metallic cup with an inside plastic lining.
Two methods of THR, cemented and uncemented.
In cemented method, a fast-drying adhesive is used to fix prosthetic to the bone.
In uncemented method, which is also called press-fit prosthesis, the prosthetic is placed in such a way that over time the bone to grow and assume the natural position.
The surgeon talks to the patient before the surgery about the desired method to be used. There is also a third methodology adopted which is hybrid where in a combination of cemented and uncemented is used. The option to be used also depends upon the patient’s physical condition.
An acrylic polymer known as polymethylmethacrylate (PMMA) is used between the prosthetic part and joint to affix the component in place in cemented method. This dries within 10 minutes from affixing. The disadvantage of this method is that over a period of time the cement may deteriorate and break off, which may cause inflammation too.
In press-fit or uncemented option the natural bone grows into the prosthetic and offers long term and stronger bond. Press-fit prosthetic can be used only on patients with healthy bones with high density. The natural growth takes up to three months.
After the surgery, the patient will be shifted to a recovery or observation room. The vitals of the patient are monitored. In cases of any rare complications, the patient would have to stay under observation for a day or two.
The patient will be administered short-term medications for pain relief. The stitches will be removed after 14 days post-surgery. The patient will be able to resume daily activities within 3 to 6 weeks after surgery. Mild exercises are advised for the healing and healthy functioning of the joint.