Hip replacement surgery for diseases and injuries of hip

What is done in hip replacement surgery?

Hip replacement surgery may be carried out in two ways:

• Total hip replacement: In this procedure the whole of the joint is replaced with a hip prosthesis. It is also known as total hip arthroplasty.
• Hemi/half/partial hip replacement: Also known as hip hemiarthroplasty, in this procedure only the ball or the femoral head of the damaged hip joint is replaced.

Hip replacement surgery: Hip replacement surgery is a major operation done under general anaesthesia and can be performed either traditionally using the standard technique of a single 8 to 10 inch cut or incision along the side of the hip or by using a minimally-invasive technique consisting of one to two cuts from 2 to 5 inches long. The incision is made on the side of the hip to reach the hip joint. Once the joint is exposed, a saw is used to remove the ball form of the thighbone. An artificial joint or prosthesis is then fixed to the thighbone with the help of medical grade cement. Next, the surface of the hipbone is prepared with removal of any damaged cartilage and attached to the replacement socket part to the hipbone. The new ball part of the prosthesis in the thighbone is now inserted into the socket of the hip.

Hip arthroscopic surgery: Hip arthroscopy is a minimally invasive surgical procedure to diagnose and treat any hip injuries or deformities. Hip arthroscopic surgeries involve insertion of arthroscope through a small incision. The advantage of this method is reduced hip pain and scarring, faster recovery and delayed need for hip replacement. However, it only treats early hip conditions such as hip impingement, labral tears, removes loose fragments. It cannot replace partial or total hip replacement.

What are the benefits and risks/complications of hip replacement surgery?

Generally, hip replacement is a part of a comprehensive care, which is focused towards management of pain, and discomfort, as well as improvement in movement and function. The potential benefits achieved with hip replacement are:

• Relief from pain
• Improved mobility
• Increased ability to pursue day-to-day activities like climbing stairs, squatting, walking etc

However, hip replacement is a major surgery that carries some risks or complications. Some of the possible risks are:

• Formation of blood clots in the veins of the leg, known as deep vein thrombosis. The clots may travel to the lungs and lead to a condition called pulmonary embolism.
• Infections in the site of surgery or within the joint
• Dislocation of the hip
• Loosening and wear of the joint
• Damage to nearby nerves and structures
• One leg becoming longer than the other, affecting gait
• Persistent discomfort
• Haematoma/bleeding of the surgical site

It’s very important to note that many of these complications may arise due to a poorly performed technique of implant placement. Hence the skills of the orthopaedic surgeon play a vital role.

What factors govern the cost of hip replacement surgery?

The cost of surgery depends on many factors like:

• The type and brand of the implant.
• Orthopedic surgeon and team, expertise and experience.
• Underlying medical condition of the patient that can influence the hospital stay and requirement of additional tests and medicines.
• Room category availed; depending on the hospital’s billing policy.

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