One of the common and severe problems in the geriatric age group is degeneration of Hip bones. It is caused by arthritis, osteoporosis-induced fracture, osteoarthritis especially obesity. The treatment for the degeneration of hip bone is commonly partial or total Hip replacement surgery. Depending upon the severity and grades of degeneration the type of surgery is determined.
Anatomy of Hip
The hip is normally called known as ball and socket joint that is attached to the head of the femur and the acetabulum of the pelvis the hip bone. The head of the femur is usually a ball-like structure and the acetabulum is like the socket. So, the ball moves in the socket allowing the leg to rotate and move forward, backward, and sideward.
The healthy hip naturally contains cartilage that covers the ball and socket to help them glide together smoothly.
Degradation of Hip
When there is alteration or degradation of the cartilage either in a ball or in the socket of the hip it is known as osteoarthritis. That causes pain, restricted motions, and difficulty in walking sometimes crackling sounds can be heard at the time of initiation of movement. This type of damage in the hip cartilage may be due to modifiable and non-modifiable causes.
Modifiable causes include sedentary lifestyle, obesity, and repeated stress on hip joints, especially in physical sports. Non-modifiable causes include age, gender, and family history of hip osteoarthritis, rheumatic arthritis, and osteonecrosis. The most common treatment for hip bone degeneration is hip replacement surgery.
Hip Replacement Surgery
This is a surgical procedure in which the hip joint is replaced by a prosthetic implant that is a hip prosthesis. Hip replacement surgery can be a single hip replacement, bilateral hip replacement, or total hip replacement. It is also known as hip arthroplasty. This procedure is mostly based on the location of degradation of the cartilage.
If the cartilage is damaged in one side of the hip bone, then mostly single replacement technique is chosen. If the damage is bilateral both the hip bones are involved then bilateral hip replacement is chosen. In case both the hip, bone cartilages are damaged then total replacement of hip bone is the only choice.
Components of Hip Implants
There are three separate implants known as the stem, the ball, and the socket.
- Usage of the type and amount of implants estimate the cost hip joint replacement in India
- The stem is made out of metal usually titanium or cobalt-chrome is inserted into the natural thigh bone.
- The ball is usually made out of polished metal or ceramic and fits on top of the stem.
- The socket is usually a combination of a plastic liner and cobalt-chrome or titanium backing.
Risks After Hip Replacement Surgery
- Blood clots in leg veins after surgery is the most complicated post-operative risk. This can be dangerous if a piece of the clot of blood can degrade and enter into the bloodstream. That might travel to the brain, lungs, and heart which could cause serious complications.
- Infections can occur at the site of incision and in deeper tissues near replaced hip prosthetics. Most infections are treated with antibiotics but the infection near the new prosthetic area might require re-surgery.
- During surgery the healthy portion of the hip may be fractured. In case of small fragments of fracture, the bone can heal on its own. But in case of larger fractures, they needed to be stabilized with wires, screws, and possibly a metal plate.
- Dislocation can be caused because the new ball in the femur end can come out of the socket in the acetabulum. It can be corrected with the usage of braces to keep the hip incorrect position.
- Change in length can be caused because of the contracture of the muscle around the hip.
- Nerve damage is a rare complication but can occur where the implant is placed.
Post-surgical Measures for Successful Total Hip Replacement Surgery
Minimizing the risk factor will be the possible measure to attain successful hip replacement recovery as a post-operative care measure.
1. Blood Clot Prevention
After the surgery moving early will be an important step to reduce blood clots in leg veins. Initially patient needs to sit up and walk with crutches or a walker soon after the surgery.
Applying pressure especially after the surgery wearing compression stockings or inflatable air sleeves similar to a blood pressure cuff on lower legs. This helps to prevent the pooling of blood in the veins of the legs and reduce the chance of clot formation.
Blood-thinning medications can be prescribed either it can be oral or injected blood thinners.
2. Physical Therapy
Regular mild to moderate exercises after surgery as instructed by doctors for a speedy recovery. Activity and exercise must be a regular part to regain the use of joints and muscles. Strengthening and mobility exercises will help the patients to learn the procedure to use a walking aid, such as a walker, a cane, or crutches. As therapy progresses usually the hip joints will gain the power to bear weight and the patient can walk without assistance.
3. Home Recovery and Follow-up Care
Before leaving the hospital, bystanders will be instructed on measures to follow at home.
Proper food with nutritional supplements needs to be given at regular intervals as prescribed by a dietitian. Every necessary thing needs to be placed at waist level until the physical therapy is completed. Regular follow-up has to be done as per the instruction of the doctor.
4. Follow Medications Regularly
Postoperative medications include antibiotics that are prescribed to prevent infection. For reducing the pain analgesics are prescribed which need to be taken at regular intervals to prevent post-operative pain.
5. Watch Out Carefully While Walking
Walking with assistance is mostly preferred walk carefully and slowly until the complete course of physical therapy gets over. This can reduce the risk of falls and displacement or dislocation of the implants.
Total hip replacement is a common operation in modern days and the positive outcome is beneficial. Improvements in post-operative measures paved a successful rate of the surgery. It was reported for the functional, clinical, and betterment of life after the total hip replacement surgery.