Improved Mobilization – Total Hip Replacement (THR)
Total Hip Replacement (THR or Total Hip Arthroplasty)
Hip Replacement is a treatment modality when other pain management therapies fail to provide relief from the arthritis of the Hip. Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant. Such joint replacement surgeries are generally conducted to relieve pain due to arthritis or severe physical joint damage as part of the hip fracture. After the Hip Replacement surgery one gets back all motions that one may need to carry out daily tasks. Also referred to as Total Hip arthroplasty or Total hip replacement
Why THR ?
Osteoarthritis of the hip joint is the most common reason for people opting in favour of Hip Replacement surgery. Hip Replacement is an option worth considering if there is severe pain, loss of motion or deformity of hip joint. Hip replacement is also used in people with hip injuries, rheumatoid arthritis and other medical conditions, such as a bone tumor or bone loss due to insufficient blood supply (a vascular necrosis).
- Pain that keeps one awake at night
- Little or no relief from pain medications
- Difficulty walking up or down stairs
- Trouble standing from a seated position
- Having to stop activities such as walking, because of pain
Earlier Hip replacement was an option primarily for adults aged 60 and above. But rapid improvements in medical technology has made strong and longer lasting artificial joints easily available that are suitable for even active and younger people. However, active people face the possibility of another surgery to replace worn out artificial hip joints after 15 or 20 years.
Preparing for THR
Before the surgery an orthopedic surgeon will counsel the patient in person and carry out examination and evaluation. The surgeon will thoroughly check the patient’s medical history so as to ensure that the patient is healthy enough to undergo surgery. The surgeon will physically examine the hip, paying attention to the range of motion in your joint and the strength of the muscles around the hip. Blood tests, and X-ray or other radio-logical investigations are routine procedures that may be required.
This preoperative evaluation is a good opportunity to ask questions and doubts if any about the procedure.. The hip is a ball and socket joint, linking the “ball” at the head of the thigh bone (femur) with the cup-shaped “socket” in the pelvic bone ( as seen in the image below). A total hip prosthesis is surgically implanted to replace the damaged bone within the hip joint.
The total hip prosthesis (implant) consists of three parts:
- A cup that replaces the hip socket. The cup is usually plastic, although some centers are trying other materials like ceramic and metal.
- A metal or ceramic ball that will replace the fractured head of the thigh bone.
- A metal stem that is attached to the shaft of the bone to add stability to the prosthesis.
If the surgery is a “hemi-arthroplasty,” the only bone replaced with a prosthetic device is the head of the femur.
Expectations from the new joint
Before The Chances of a successful recovery in case of a THR are highly favourable as clinical studies show . Hip replacement surgery is successful more than 99% percent of the time. Expect the new hip joint to considerably reduce the pain and increase the range of motion in the joint. However, one must not expect to carry out activities which were not possible before the surgery such as extreme sports or advanced yogic postures. Such and other high-impact activities — such as running or playing basketball — may never get the doctor’s approval. However with time one can swim, play golf, walk or ride a bike comfortably.
Hip Resurfacing: An alternative to conventional hip replacement?
Unlike traditional hip replacement, hip resurfacing doesn’t replace the “ball” of the hip with a metal or ceramic ball. Instead, the damaged hip ball is reshaped and capped with a metal prosthesis. The damaged hip socket is fitted with a metal prosthesis — similar to what is used in a conventional hip replacement. With newer materials, the artificial joint implants used for total hip replacement last about 15 years. This isn’t an issue for older people who receive a hip replacement late in life. But hip resurfacing might be a better choice for younger people because the procedure leaves more bone intact, which can make it easier to perform a total hip replacement if needed later.
Resurfacing generally results in a bigger hip ball than what is typically used in a conventional hip replacement, which may reduce the risk of dislocation. But newer implants used for conventional hip replacement now offer the option of a larger hip ball, similar in size to what results from hip resurfacing procedures. Hip resurfacing is technically more difficult and generally requires a larger incision than what is used for a conventional hip replacement. And the risk of complications is slightly higher with hip resurfacing — even when counting against factors such as age, sex and activity levels.
Hip resurfacing isn’t recommended for people who have:
- Impaired kidney function
- Known metal hypersensitivities
- Large areas of dead bone (avascular necrosis)