Joint Replacement
What Is Total Joint Replacement?
Total joint replacement is surgical procedure that comprises complete removal as well as replacement of diseased/damaged joints with prosthetic implant. Also called prosthesis, prosthetic implants are designed for replicating natural pain free movement of joints.
What is the life of artificial joints?
On an average, artificial joints have lifespan of about 20 yearsor more (depending upon the activity levels of the persons).
Primary Knee Replacement
What are the Indications for Knee Replacement Surgery?
Joint Pain relief is the primary reason for knee replacement with expected benefits from limb realignment, reduced pain and functional improvement. The reduced knee function accompanies stiff and painful knee and requires knee replacement operation to improve their functionality.
What type of Implants are used in Knee Replacement Surgery?
We are using latest knee replacement implants that deliver good post operative results. Backed by rich expertise in total knee replacement, we have with us complete solutions for almost any indications related to knee surgery. The present day knee care system and processes are designed to deliver excellent results for both patients and surgeons.
Some of the materials used by us for implants include:
· Titanium and Cobalt-Chrome Alloys
· Ultra-high Molecular Weight Polyethylene Polymers
What are the Medical Clearances required for Knee Replacement Surgery?
We may recommend general medical evaluation to ensure patients are healthy and fit for surgery. Some of these tests include:
· Blood samples
· EKGs
· Echocardiograms
· Urine samples
What is the Post Hospital Discharge procedure for Knee Replacement Surgery?
Some of the activities that need to be performed by patients post their discharge from hospitals includes:
· Continue using CPM and towel roll/other exercises as directed by surgeon
· Continue performing knee exercises taught by PTs
· Talk with surgeon about timeline for returning to higher level of daily activities
What are the benefits of Knee Replacement Surgery?
Some of the derived benefits that accompany a successful knee replacement operation include:
· No joint pain or significant reduction in it
· Increased mobility in day-today activities
· Correction of angular leg deformity
· Increased strength of the leg
· Improved quality of life
What can be possible complications after Knee Replacement?
Some of the complications that can occur following knee replacement surgery include:
· Excessive swelling/bleeding
· Blood clots (deep vein thrombosis)
· Pulmonary embolism (PE)
· Phlebitis
· Neurovascular damage
· Skin healing problems
· Peri- and intra-articular infection
· Stiff joint (arthrofibrosis)
· Early loosening of implants
· Allergy to metal parts of implants
Revision Knee Joint Replacement
What are the Surgical Intervention and Considerations for Revision Knee Surgery?
Knee revision surgery is done keeping in consideration problems related to areas like –
· Femur (thigh bone)
· Tibia (shin bone)
· Patella (kneecap)
The failed implants are removed using combination of surgical methods and specialized tools that help in effectively replacing lost ligament stability.
What are the Surgical Procedures that are followed in Revision Knee Surgery?
In revision surgery, as the possibility of complications are more, surgeons involved need to have good planning before the operative procedures begin. With the nature of the surgery varying from simple liner exchange to changing one or all of the implants, it is more extensive than previous done primary surgery.
What are the Postoperative Care procedures for Revision Knee Surgery?
The post operative care required for revision surgery is same as that needed for original replacement surgery. Here, patients need to closely follow all directives related to:
· Home health care
· Physical and occupational therapy
· Other forms of rehabilitation
What are the Risks and Complications involved in Revision Knee Surgery?
As with other major surgeries, there is potential risk involved in Revision Joint Replacement Surgery as well. The primary decision to proceed with surgery is made by the surgeon in consultation with patients as advantages of surgery outweigh potential disadvantages.
Complications that can occur can be medical (general) or local (specific to the knee). These include:
Medical -
· Allergic reaction to medication
· Blood loss that requires transfusion (involving low risk of disease transmission)
· Complication related to Heart attacks, Strokes, Kidney failure and others
· Complications from nerve blocks
Local -
· Stiffness in knee that requires bending of knee in theatre under anaesthetic care
· Wound irritation/breakdown
· Infections that can be superficial or deep
· Blood clots (Deep Venous Thrombosis)that and can travel to lung (Pulmonary embolism)
· Damage to nerves/blood vessels that leads to weakness/loss of sensation in part of leg
· Wear down of plastic liner used in the implant
· Dislocation that include ends of knee joints or plastic insert losing contact
· Dislocation (breaking or loosening) of the Patella (knee cap)
· Ligament injuries surrounding the knee that may require corrective surgery
· Fractures or breaks in bones during surgery/post operation due to reasons like falling
Primary Hip Joint Replacement Surgery
What is Total Hip Replacement?
Total Hip Replacement as a surgical procedure is well recognized as a successful procedure for meeting the treatment needs of Hip Arthritis. Here, the involved process includes removal of hip socket (acetabulum) and ball (femoral head), the two damaged and worn parts of hip joint. These are surgically replaced with artificial implants called prostheses that assist in making hip strong, stable and flexible. Here, the surgeon may attach replacement joints to bones with/without cement.
Why this Surgery is required?
Joint replacement surgery is recommended by doctors when there is severe hip pain and loss of function and there is no help from oral medication in relieving the pain. Prior to operation, doctor makes use of X-rays to look at bones and cartilage in Hip area for seeing if these are damaged and ensuring that the resultant pain is not because of any other reasons.
What are Cemented Joints?
These are attached to existing bone with cement that acts as glue and attaches artificial joint to bones.
What are Uncemented Joints?
These are attached using porous coating designed to allow bone to adhere to artificial joint. Over a period of time, there is a growth of new bone that fills up openings in porous coating, thus attaching joints to bone.
The requirement of General or Regional Anesthesia?
For joint replacement surgeries, the doctor often uses general anesthesia. But at times seeing the overall health of patients and their marked preferences, the operation can also be carried out under regional anesthesia.
What is the Post Surgery care that needs to be taken?
Patients who have undergone Hip Replacement are administered intravenous (IV) antibiotics and medicines for controlling blood clotting and pain for around a day after surgery. The initial few days requires taking medicines as prescribed by the doctor including pain killers that would decrease over the time. However, there may be the need to take anticoagulant medicines for several weeks after the surgery has been performed.
What is the Rehabilitation procedure?
· The rehab process post hip replacement surgery starts next day after the surgery
· Exercises are started under supervision of the team and accompanying physiotherapist
· Pt is allowed to sit on side of the bed/chair on next day of surgery
· Gait training is begun on second post op day or according to patients compliance,
· Initially partial wt bearing walking with help of walker is allowed and gradually shifted to crutch /cane support,continued for 6 weeks, after which full
weight bearing is allowed
How well does the Surgery Works?
People having undergone hip replacement surgery feel less pain than pre-surgery stage and are able to successfully resume daily activities. With the passing days, patients would probably be able to do handle daily activities more easily as joint start moving better. Most of the artificial hip joint replacements done under experienced guidance last for 20 years or even longer without any possibility of loosening.
The overall lifespan of the hip implant depends on factors as:
· Lifestyle of the patient (how much stress is put on a joint)
· The weight of the patient (overweight patients tend to put extra stress on joints)
· How well new joint and bones mend together
What are the Risks Involved in this surgery?
Depending on other health problems and on the skills of the surgeon, risks of hip replacement surgery is divided into two groups:
Risks Involved at Surgery and Post Operative Recovery Stages -
· Blood clots
· Infection in surgical wound/in the joint that may be treated with antibiotics or if found deep in joint, the removal may require more surgery including
removal of artificial joint
· Nerve injury that may cause numbness or difficulty in moving a muscle
· Problems related to wound healing especially for patients having rheumatoid arthritis and diabetes
· Deposits of bone in soft tissues around hip joint that may decrease motion range of the hip
· Hip dislocation post surgery
· Difference in leg lengths which are usually very small and do not cause any pain or functional issues
· Risks carried through general anaesthesia procedure especially for people who have had recent heart attack as well as those having chronic lung,
liver, kidney, or heart disorders
Long-Term Risks -
· Loosening of artificial hip joint parts
· Infection around the implant
· Fracture of bone
· Implant breakage
Revision Hip Joint replacement Surgery
What is the purpose of Revision Hip Replacement?
The Hip Revision Surgery is performed for three main purposes:
· Relieving pain in affected hip
· Restoring mobility of the patient
· Removing loose/damaged prosthesis before an irreversible harm to the joint
What are the considerations for Revision Joint Surgery?
Normally, we consider revision surgery for providing pain relief when conservative measures like medication do not help. Other that the pain factor, revision surgery is also performed for:
· Loosening of prosthesis
· Wearing down of surfaces of hip joint
· Loss of bone tissue (even in cases where patients may not feel any discomfort)
· Breakage of implant
· Presence of infection
· Dislocation of prosthesis
Which part of the hip region is addressed for this surgery?
In cases of hip revision surgery, both femoral (stem and ball) implants and acetabular (socket) portion are addressed. If hip bones have deficiencies related to loosening, fracture or shielding of bone from normal stress, the suitable method is chosen to remove existing implants. Further, if some of the implants are still properly functioning, Surgeon makes efforts to retain them.
For addressing the issue, we may perform specialized removal technique including surgically splitting femur bone for removing cement and implants. The selected revision hip implant should be firmly fixed to bones either through bone growing into small pores in outer layer of implant/through cementing process.
What are the factors concerning condition of Bone Tissue in Femur?
Some of the critical factors that affect length of operation and specific steps that are followed in hip revision surgery is condition of bone tissue in the femur.
Some of the stages under which defects in bones are classified into include:
· Minimal bone defect
· Most damage at the metaphysis with minimal damage to shaft of bone
· All damage at the metaphysis
· Extensive bone loss in femoral shaft and at metaphysis
What is the process of Diagnosis?
Some of the early indications early indications of Revision Surgery are:
· Increase in pain
· Greater difficulty in placing weight on hip
· Loss of mobility in hip joint
How does the diagnosis process help?
The diagnosis procedure helps in location of pain and may point to part of affected prosthesis. In general, diagnostic imaging done on the patients show:
· Bone loss
· Loosening of prosthesis
· Wearing away of joint tissues
Further, X-ray studies also help in diagnosing fractures of hip/dislocated prostheses.
What are the Preoperative Preparation undertaken?
Certain health conditions are also considered as indicators for hip revision surgery. These include:
· Current hip infection
· Severe vascular disease
· Poor condition of skin covering hip
· Paralysis of quadricep muscles
What are the Aftercare requirements?
Aftercare that is required for hip revision surgery is the same as required for primary hip replacement surgery. The only major difference is for the patients having weak bones being asked to make use of canes/walkers for longer time following revision surgery.
Hip Resurfacing Surgery
What is Hip Resurfacing Surgery?
Hip Resurfacing surgery takes approximately 45 minutes of operating time. Here, surgeon removes only the part of the diseased bone from head of femur and from acetabulum that is done through incision which is around 15-20cm in length and runs over outer edge of hip joint. Most part of the surgery is carried out under epidural spinal injection which is a safer and quicker way to recover.
Why Hip Resurfacing Surgery?
As an alternative to Hip Replacement, Hip resurfacing surgery is a preferred treatment option for young patients with hip arthritis. Further, as Hip resurfacing involves only replacement of the damaged surfaces in hip joint by making use of metal surfaces, the process is very helpful for patients under 65 years of age with advanced hip disease. The design of the implant also permits greater range of movement as well as lower risk of dislocation.
Some of the other reasons of why this process is more beneficial include:
· Unlike in Total leg Hip Replacement, in hip resurfacing patients can expect no substantial leg lengthening as hip musculature remains unchanged
· Rehabilitation is quicker as well as easier after Hip Resurfacing Surgery
· There is a normal feeling of the Hip Joints
· Implants available in varied sizes to suit individual hip size requirements
· Hip Resurfacing is a bone conserving procedure as in this process femoral head is only reshaped and resurfaced using metal cap
· The use of Metal on Metal (MoM) joint also eliminates wearing away of prosthetic joint
What are the options considered for Hip Resurfacing Surgery?
This operation is highly preferred for people who are in requirement of hip placement at earlier age of their life. By undertaking this surgical procedure, patients can get relief from advanced hip diseases like osteoarthritis and rheumatoid arthritis. Some of points that are considered for this surgery include:
Activity Level of Candidates - For hip resurfacing surgery, activity level of candidate is taken into account as prosthetics used in MOM hip resurfacing are harder to wear by the high activity levels.
Age of the Candidate - Usually patients up to 65 years of age benefit from this procedure as Hip Resurfacing Surgery process is not recommended for older patients due to higher risks associated with femoral neck fractures.
Health Status of Candidates - For patients with severely deformed hips or who are undergoing osteoporosis, Hip Resurfacing Surgery is not considered as an option. Further, the surgery is also not considered for patients having previous hip joint surgery that has resulted in deformity.
What is the Post Operation - Physical Therapy for Hip Resurfacing Surgery?
The physical therapy of patients may begin on day of surgery or the day after the operation depending on their specific condition. The physical therapy processes are aimed at teaching:
· How to comfortably move in bed
· Get in and out of bed
· Make use of walker/crutches to walk up and down stairs
· Starting gentle exercises to give movement to leg
· Protect hips during these activities
With most of the patients able to sit/stand day after the surgery is performed, they can move around by taking assistance of crutches as early as two days post surgery. It takes around three months for patients to walk free of stick/crutches with more improvement in the movement continuing over next few years.
What is the Advantage of Hip Resurfacing Surgery?
Hip Resurfacing process has the advantage as it preserves the femoral bone stock as well as easy future revision to THA if required as femur is persevered in initial hip surface replacement and is available to support THA stem. Some of the other benefits of this process include:
· Maintaining integrity of femur bone aids in more natural transfer of weight and stress
· Generally absence of thigh pain experienced by patients who have undergone THA
· Use of smaller device that makes recovery quicker
· Reduction in the bone removed thus allowing femur (thigh) bone to be preserved
· Decrease in complication as it reduces disruption of joint, thus providing shorter recovery period
· A more stable hip as a smaller ball is used. Further, the dislocation rate is also less as ball is not removed and remains same size as patient’s
original hip
· Ease of Revision as hip resurfacing does not damage thigh bone and if the process fails patients can easily convert to total hip replacement
What are the Risks Involved for Hip Resurfacing Surgery?
The risks that are involved in hip surface replacement surgery are same as risks involved in any major surgery. Some of the risks that are specific to hip surface replacement involve:
· Potential for cracking in neck of femur bone because of drilling of guide hole through neck for support pin in metal cap
· Negative reaction of femur head to dislocation and being reshaped to fit metal cap that can lead to avascular necrosis (bone death)
What Is Total Joint Replacement?
Total joint replacement is surgical procedure that comprises complete removal as well as replacement of diseased/damaged joints with prosthetic implant. Also called prosthesis, prosthetic implants are designed for replicating natural pain free movement of joints.
What is the life of artificial joints?
On an average, artificial joints have lifespan of about 20 yearsor more (depending upon the activity levels of the persons).
Primary Knee Replacement
What are the Indications for Knee Replacement Surgery?
Joint Pain relief is the primary reason for knee replacement with expected benefits from limb realignment, reduced pain and functional improvement. The reduced knee function accompanies stiff and painful knee and requires knee replacement operation to improve their functionality.
What type of Implants are used in Knee Replacement Surgery?
We are using latest knee replacement implants that deliver good post operative results. Backed by rich expertise in total knee replacement, we have with us complete solutions for almost any indications related to knee surgery. The present day knee care system and processes are designed to deliver excellent results for both patients and surgeons.
Some of the materials used by us for implants include:
· Titanium and Cobalt-Chrome Alloys
· Ultra-high Molecular Weight Polyethylene Polymers
What are the Medical Clearances required for Knee Replacement Surgery?
We may recommend general medical evaluation to ensure patients are healthy and fit for surgery. Some of these tests include:
· Blood samples
· EKGs
· Echocardiograms
· Urine samples
What is the Post Hospital Discharge procedure for Knee Replacement Surgery?
Some of the activities that need to be performed by patients post their discharge from hospitals includes:
· Continue using CPM and towel roll/other exercises as directed by surgeon
· Continue performing knee exercises taught by PTs
· Talk with surgeon about timeline for returning to higher level of daily activities
What are the benefits of Knee Replacement Surgery?
Some of the derived benefits that accompany a successful knee replacement operation include:
· No joint pain or significant reduction in it
· Increased mobility in day-today activities
· Correction of angular leg deformity
· Increased strength of the leg
· Improved quality of life
What can be possible complications after Knee Replacement?
Some of the complications that can occur following knee replacement surgery include:
· Excessive swelling/bleeding
· Blood clots (deep vein thrombosis)
· Pulmonary embolism (PE)
· Phlebitis
· Neurovascular damage
· Skin healing problems
· Peri- and intra-articular infection
· Stiff joint (arthrofibrosis)
· Early loosening of implants
· Allergy to metal parts of implants
Revision Knee Joint Replacement
What are the Surgical Intervention and Considerations for Revision Knee Surgery?
Knee revision surgery is done keeping in consideration problems related to areas like –
· Femur (thigh bone)
· Tibia (shin bone)
· Patella (kneecap)
The failed implants are removed using combination of surgical methods and specialized tools that help in effectively replacing lost ligament stability.
What are the Surgical Procedures that are followed in Revision Knee Surgery?
In revision surgery, as the possibility of complications are more, surgeons involved need to have good planning before the operative procedures begin. With the nature of the surgery varying from simple liner exchange to changing one or all of the implants, it is more extensive than previous done primary surgery.
What are the Postoperative Care procedures for Revision Knee Surgery?
The post operative care required for revision surgery is same as that needed for original replacement surgery. Here, patients need to closely follow all directives related to:
· Home health care
· Physical and occupational therapy
· Other forms of rehabilitation
What are the Risks and Complications involved in Revision Knee Surgery?
As with other major surgeries, there is potential risk involved in Revision Joint Replacement Surgery as well. The primary decision to proceed with surgery is made by the surgeon in consultation with patients as advantages of surgery outweigh potential disadvantages.
Complications that can occur can be medical (general) or local (specific to the knee). These include:
Medical -
· Allergic reaction to medication
· Blood loss that requires transfusion (involving low risk of disease transmission)
· Complication related to Heart attacks, Strokes, Kidney failure and others
· Complications from nerve blocks
Local -
· Stiffness in knee that requires bending of knee in theatre under anaesthetic care
· Wound irritation/breakdown
· Infections that can be superficial or deep
· Blood clots (Deep Venous Thrombosis)that and can travel to lung (Pulmonary embolism)
· Damage to nerves/blood vessels that leads to weakness/loss of sensation in part of leg
· Wear down of plastic liner used in the implant
· Dislocation that include ends of knee joints or plastic insert losing contact
· Dislocation (breaking or loosening) of the Patella (knee cap)
· Ligament injuries surrounding the knee that may require corrective surgery
· Fractures or breaks in bones during surgery/post operation due to reasons like falling
Primary Hip Joint Replacement Surgery
What is Total Hip Replacement?
Total Hip Replacement as a surgical procedure is well recognized as a successful procedure for meeting the treatment needs of Hip Arthritis. Here, the involved process includes removal of hip socket (acetabulum) and ball (femoral head), the two damaged and worn parts of hip joint. These are surgically replaced with artificial implants called prostheses that assist in making hip strong, stable and flexible. Here, the surgeon may attach replacement joints to bones with/without cement.
Why this Surgery is required?
Joint replacement surgery is recommended by doctors when there is severe hip pain and loss of function and there is no help from oral medication in relieving the pain. Prior to operation, doctor makes use of X-rays to look at bones and cartilage in Hip area for seeing if these are damaged and ensuring that the resultant pain is not because of any other reasons.
What are Cemented Joints?
These are attached to existing bone with cement that acts as glue and attaches artificial joint to bones.
What are Uncemented Joints?
These are attached using porous coating designed to allow bone to adhere to artificial joint. Over a period of time, there is a growth of new bone that fills up openings in porous coating, thus attaching joints to bone.
The requirement of General or Regional Anesthesia?
For joint replacement surgeries, the doctor often uses general anesthesia. But at times seeing the overall health of patients and their marked preferences, the operation can also be carried out under regional anesthesia.
What is the Post Surgery care that needs to be taken?
Patients who have undergone Hip Replacement are administered intravenous (IV) antibiotics and medicines for controlling blood clotting and pain for around a day after surgery. The initial few days requires taking medicines as prescribed by the doctor including pain killers that would decrease over the time. However, there may be the need to take anticoagulant medicines for several weeks after the surgery has been performed.
What is the Rehabilitation procedure?
· The rehab process post hip replacement surgery starts next day after the surgery
· Exercises are started under supervision of the team and accompanying physiotherapist
· Pt is allowed to sit on side of the bed/chair on next day of surgery
· Gait training is begun on second post op day or according to patients compliance,
· Initially partial wt bearing walking with help of walker is allowed and gradually shifted to crutch /cane support,continued for 6 weeks, after which full
weight bearing is allowed
How well does the Surgery Works?
People having undergone hip replacement surgery feel less pain than pre-surgery stage and are able to successfully resume daily activities. With the passing days, patients would probably be able to do handle daily activities more easily as joint start moving better. Most of the artificial hip joint replacements done under experienced guidance last for 20 years or even longer without any possibility of loosening.
The overall lifespan of the hip implant depends on factors as:
· Lifestyle of the patient (how much stress is put on a joint)
· The weight of the patient (overweight patients tend to put extra stress on joints)
· How well new joint and bones mend together
What are the Risks Involved in this surgery?
Depending on other health problems and on the skills of the surgeon, risks of hip replacement surgery is divided into two groups:
Risks Involved at Surgery and Post Operative Recovery Stages -
· Blood clots
· Infection in surgical wound/in the joint that may be treated with antibiotics or if found deep in joint, the removal may require more surgery including
removal of artificial joint
· Nerve injury that may cause numbness or difficulty in moving a muscle
· Problems related to wound healing especially for patients having rheumatoid arthritis and diabetes
· Deposits of bone in soft tissues around hip joint that may decrease motion range of the hip
· Hip dislocation post surgery
· Difference in leg lengths which are usually very small and do not cause any pain or functional issues
· Risks carried through general anaesthesia procedure especially for people who have had recent heart attack as well as those having chronic lung,
liver, kidney, or heart disorders
Long-Term Risks -
· Loosening of artificial hip joint parts
· Infection around the implant
· Fracture of bone
· Implant breakage
Revision Hip Joint replacement Surgery
What is the purpose of Revision Hip Replacement?
The Hip Revision Surgery is performed for three main purposes:
· Relieving pain in affected hip
· Restoring mobility of the patient
· Removing loose/damaged prosthesis before an irreversible harm to the joint
What are the considerations for Revision Joint Surgery?
Normally, we consider revision surgery for providing pain relief when conservative measures like medication do not help. Other that the pain factor, revision surgery is also performed for:
· Loosening of prosthesis
· Wearing down of surfaces of hip joint
· Loss of bone tissue (even in cases where patients may not feel any discomfort)
· Breakage of implant
· Presence of infection
· Dislocation of prosthesis
Which part of the hip region is addressed for this surgery?
In cases of hip revision surgery, both femoral (stem and ball) implants and acetabular (socket) portion are addressed. If hip bones have deficiencies related to loosening, fracture or shielding of bone from normal stress, the suitable method is chosen to remove existing implants. Further, if some of the implants are still properly functioning, Surgeon makes efforts to retain them.
For addressing the issue, we may perform specialized removal technique including surgically splitting femur bone for removing cement and implants. The selected revision hip implant should be firmly fixed to bones either through bone growing into small pores in outer layer of implant/through cementing process.
What are the factors concerning condition of Bone Tissue in Femur?
Some of the critical factors that affect length of operation and specific steps that are followed in hip revision surgery is condition of bone tissue in the femur.
Some of the stages under which defects in bones are classified into include:
· Minimal bone defect
· Most damage at the metaphysis with minimal damage to shaft of bone
· All damage at the metaphysis
· Extensive bone loss in femoral shaft and at metaphysis
What is the process of Diagnosis?
Some of the early indications early indications of Revision Surgery are:
· Increase in pain
· Greater difficulty in placing weight on hip
· Loss of mobility in hip joint
How does the diagnosis process help?
The diagnosis procedure helps in location of pain and may point to part of affected prosthesis. In general, diagnostic imaging done on the patients show:
· Bone loss
· Loosening of prosthesis
· Wearing away of joint tissues
Further, X-ray studies also help in diagnosing fractures of hip/dislocated prostheses.
What are the Preoperative Preparation undertaken?
Certain health conditions are also considered as indicators for hip revision surgery. These include:
· Current hip infection
· Severe vascular disease
· Poor condition of skin covering hip
· Paralysis of quadricep muscles
What are the Aftercare requirements?
Aftercare that is required for hip revision surgery is the same as required for primary hip replacement surgery. The only major difference is for the patients having weak bones being asked to make use of canes/walkers for longer time following revision surgery.
Hip Resurfacing Surgery
What is Hip Resurfacing Surgery?
Hip Resurfacing surgery takes approximately 45 minutes of operating time. Here, surgeon removes only the part of the diseased bone from head of femur and from acetabulum that is done through incision which is around 15-20cm in length and runs over outer edge of hip joint. Most part of the surgery is carried out under epidural spinal injection which is a safer and quicker way to recover.
Why Hip Resurfacing Surgery?
As an alternative to Hip Replacement, Hip resurfacing surgery is a preferred treatment option for young patients with hip arthritis. Further, as Hip resurfacing involves only replacement of the damaged surfaces in hip joint by making use of metal surfaces, the process is very helpful for patients under 65 years of age with advanced hip disease. The design of the implant also permits greater range of movement as well as lower risk of dislocation.
Some of the other reasons of why this process is more beneficial include:
· Unlike in Total leg Hip Replacement, in hip resurfacing patients can expect no substantial leg lengthening as hip musculature remains unchanged
· Rehabilitation is quicker as well as easier after Hip Resurfacing Surgery
· There is a normal feeling of the Hip Joints
· Implants available in varied sizes to suit individual hip size requirements
· Hip Resurfacing is a bone conserving procedure as in this process femoral head is only reshaped and resurfaced using metal cap
· The use of Metal on Metal (MoM) joint also eliminates wearing away of prosthetic joint
What are the options considered for Hip Resurfacing Surgery?
This operation is highly preferred for people who are in requirement of hip placement at earlier age of their life. By undertaking this surgical procedure, patients can get relief from advanced hip diseases like osteoarthritis and rheumatoid arthritis. Some of points that are considered for this surgery include:
Activity Level of Candidates - For hip resurfacing surgery, activity level of candidate is taken into account as prosthetics used in MOM hip resurfacing are harder to wear by the high activity levels.
Age of the Candidate - Usually patients up to 65 years of age benefit from this procedure as Hip Resurfacing Surgery process is not recommended for older patients due to higher risks associated with femoral neck fractures.
Health Status of Candidates - For patients with severely deformed hips or who are undergoing osteoporosis, Hip Resurfacing Surgery is not considered as an option. Further, the surgery is also not considered for patients having previous hip joint surgery that has resulted in deformity.
What is the Post Operation - Physical Therapy for Hip Resurfacing Surgery?
The physical therapy of patients may begin on day of surgery or the day after the operation depending on their specific condition. The physical therapy processes are aimed at teaching:
· How to comfortably move in bed
· Get in and out of bed
· Make use of walker/crutches to walk up and down stairs
· Starting gentle exercises to give movement to leg
· Protect hips during these activities
With most of the patients able to sit/stand day after the surgery is performed, they can move around by taking assistance of crutches as early as two days post surgery. It takes around three months for patients to walk free of stick/crutches with more improvement in the movement continuing over next few years.
What is the Advantage of Hip Resurfacing Surgery?
Hip Resurfacing process has the advantage as it preserves the femoral bone stock as well as easy future revision to THA if required as femur is persevered in initial hip surface replacement and is available to support THA stem. Some of the other benefits of this process include:
· Maintaining integrity of femur bone aids in more natural transfer of weight and stress
· Generally absence of thigh pain experienced by patients who have undergone THA
· Use of smaller device that makes recovery quicker
· Reduction in the bone removed thus allowing femur (thigh) bone to be preserved
· Decrease in complication as it reduces disruption of joint, thus providing shorter recovery period
· A more stable hip as a smaller ball is used. Further, the dislocation rate is also less as ball is not removed and remains same size as patient’s
original hip
· Ease of Revision as hip resurfacing does not damage thigh bone and if the process fails patients can easily convert to total hip replacement
What are the Risks Involved for Hip Resurfacing Surgery?
The risks that are involved in hip surface replacement surgery are same as risks involved in any major surgery. Some of the risks that are specific to hip surface replacement involve:
· Potential for cracking in neck of femur bone because of drilling of guide hole through neck for support pin in metal cap
· Negative reaction of femur head to dislocation and being reshaped to fit metal cap that can lead to avascular necrosis (bone death)