Chairman & Executive Director
Elite Institutes of Orthopaedics & Joint Replacement
Formerly:
Director & Head Orthopaedics – Fortis Hospital- Mohali, Amritsar
Director & Head Orthopaedics – Max Hospital- Mohali, Bathinda, Dehradun
Hip Replacement
Hip Replacement
The Hip Joint
The hip is one of the body’s largest joints. It plays an important role in movement and maintaining balance. It also supports weight while we are standing, sitting, running, or walking. The Hip Joint is a ball and socket joint. It is made up of two parts. The first is the hip socket and the other is the thigh bone called the femur. A smooth material called cartilage lines the socket, allowing the ball to move smoothly inside the socket.
In a diseased hip, the cartilage wears out resulting in the bone to bone contact that can be painful.
Characteristics /Symptoms of Osteoarthritis hip
- Pain in the groin or thigh that might radiate to buttocks or knee and aggravates on vigorous activity
- Stiffness
- Tenderness
- Swelling
- Decreased range of motion
Causes :
- Osteoarthritis
- Rheumatoid arthritis.
- Post-traumatic arthritis
- Osteonecrosis.
- Childhood hip disease. Some infants and children have hip problems. Even though the problems are successfully treated during childhood, they may still cause arthritis later on in life. This happens because the hip may not grow normally, and the joint surfaces are affected.
Treatment options
The first choice is mostly non-operative which includes weight loss, exercise, medication, injections, or bracing. Surgery is the next option when non-operative treatments have exhausted and symptoms still persist and quality of life is compromised with features like-
- Pain at rest
- Difficulty in sleeping
- Walking with a limp
- Difficulty in bending joint or walking even with a stick
- Increasing joint stiffness and swelling
- Difficulty in doing daily routine activities due to severe painful joints.
- Limb length discrepancy (shortening or lengthening of the affected leg)
- No relief even after taking multiple pain killers and doing exercises.
- Chronic painful joints affect your emotional and mental well being
Goals of Hip Replacement Surgery
- To provide pain relief
- To correct limb length difference
- To restore normal limb alignment
- To restore functional range of motion of hip joint
Types of Hip Replacement Surgery options:
- Cemented- The cemented hip implant is designed to be implanted using bone cement (a group that helps position the implant within the bone). Bone cement is injected into the prepared femoral canal. The surgeon then positions the implant within the canal and the grout helps to hold it in the desired position.
- Uncemented -The porous hip implant is inserted into the prepared femoral canal without the use of bone cement. Initially, the femoral canal is prepared so that the implant fits tightly within it. The porous surfaces on the hip implant are designed to engage the bone within the canal and permit ingrowth into the porous surface. Eventually, this growth can provide additional fixation to hold the implant in the desired position.
Your Hip Replacement options at Elite Institutes of Orthopaedics & Joint Replacement
There are many options possible in hip replacement surgery. There are different types of bearing options and stem options available.
Ceramic/ Ceramicised Material
Bearing affects your hip’s mobility, flexibility, and range of motion, as well as how the implant will stand up over time and how stable it will be in your body. Bearings can be made of ceramic or polyethylene (medical-grade plastic). At Elite Orthopaedics, we use the best in class bearing options that are proven to withstand the demand of your lifestyle.
- The ceramic head is tougher than the metal head and smoother which reduces friction, thereby resulting in lesser polyethylene wear
- Ceramic is biologically inert, and hence well tolerated in the human body and almost no scope of metal allergy
- These bearings are especially relevant for the high-demanding Indian lifestyle or for patients who would like to pursue an active lifestyle including activities like sports, yoga, hiking, etc
- Newer materials like delta ceramic have been engineered to provide excellent WEAR properties along with unmatched STRENGTH and STABILITY
Ceramic technology offers much lower wear than metal on metal or poly components- meaning longer-lasting and avoiding debris that can be harmful to the body. Lots of concerns over metal ions having carcinogenic properties, not suitable for young pregnant women, metal ions causing allergies, etc have come up worldwide in recent times-ceramics don’t have this issue. The material used is “Delta ceramic which is the new generation advanced ceramic technology and is up to 30 times as hard as the previous ones, overcoming concerns of cracking or fracture or breakage of the ceramic. The demand today is for an implant that could last a lifetime to avoid revision surgery-a well implanted Ceramic on ceramic with a small stem could potentially deliver that without compromising on a range of motion and stability.
CERAMIC Hip Replacement
- Large head ceramic on ceramic/polyethylene cup technology leading to a higher range of motion and greater stability-ideally suited for the Indian patient with demands like sitting cross-legged- Puja and Namaz & using the toilet
- Much lower wear than metal on metal or poly components- meaning longer-lasting and avoiding debris that can be harmful to the body.
- Lots of concerns over metal ions having carcinogenic properties, not suitable for young pregnant women, metal ions causing allergies, etc have come up worldwide in recent times- ceramics don’t have this issue.
- The Material used is BIOLOX DELTA which is the new generation advanced ceramic technology and is up to 30 times as hard as the previous ones, overcoming concerns of cracking or fracture or breakage of the ceramic.
- It is ideally suited for small Indian anatomies- accommodating an XL head in a small cup as well as younger high-demand patients.
- The demand today is for an implant that could last a lifetime to avoid revision surgery- a well-implanted Hip with a well-implanted stem could potentially deliver that without compromising on a range of motion and stability
- People in good health, live very active lives and expect to live well into their eighties. Clearly, these are “high demand “patients who deserve a high-quality hip replacement that will serve them well for the rest of their lives. These arthritic patients stand to benefits from the ceramic hip prosthesis.
- This surgery can be done minimally invasive- very small skin cuts and allowing ambulation the next day
It is indeed the hip for the Lifetime
Latest in Hip Replacement
REVOLUTIONARY NEW HIP REPLACEMENT SURGERY
- Minimal Trauma to soft tissues
- Minimal muscle damage around Hip Joint
- Minimal blood loss, smaller scar
- Walking 3 hours after surgery
- Leg length restoration better
- No pain during and after surgery
- Almost No blood transfusion is needed
- Quicker return to a normal life
- Most patients can do mild squatting/ sit cross-legged
- Smaller scars for improved cosmetics
Direct Anterior Approach (DAA)
Tissue sparing approach
As it does not require muscular attachment resection, the least pain, fast recovery & back to normal life. The combination of an Anterior approach with a short stem achieves both objectives of bone & soft tissue preservation. Short Stem system is a total hip system consisting of porous-coated titanium alloy and easy-to-use instrumentation.
Minimally Invasive THR
Minimally invasive hip replacement allows your surgeons to implant traditional hip components through one or two small(1.5 to 4 inch) incisions. The goal of minimally invasive hip replacement is to minimize the amount of soft tissue damage that occurs when a surgeon reconstructs a hip. The potential benefits of this approach include:
- Less bleeding during surgery
- Less post-operative pain
Verilast Technology for Hip
It is an exclusive bearing combination of oxinium and highly cross-linked polyethylene which provides low wear, high flexibility, and real-life results. It is the best option for metal allergy patients to restore an active lifestyle.
Preparing yourself for Hip Surgery
- Choose the right doctor
- Understand the procedure well -educate yourself
- keep all your past medical records handy and assemble all the documents and other things required on admission, during the stay in the hospital, and for discharge.
As with all surgeries, there are a number of things that the hospital will ask you to do to contribute to the success of the operation.
- Pre-operative fitness tests are done, medical clearance is obtained (sugar levels and BP is maintained in the normal range), a few medications like blood thinners are generally stopped before surgery.
- If you have any questions or concerns, ask your doctor or hospital staff.
- Your doctor may want you to meet the Physical Therapist (PT) before surgery. The PT may give you some tips on preparing your house for rehabilitation and how you should sleep, get out of bed, sit, stand, and walk following surgery.
Post Operative Physical Therapy
- Your surgeon will recommend and supervise your hip rehabilitation program, which typically begins 3 hours after surgery.
- Isometric exercises (tightening muscles without moving the joint) will begin while you are still in bed.
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