Hip Replacement Surgery – The Procedure, Complications & Cost

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Hip replacement surgeries involve replacing damaged hip joint with implants that can be made of metal, ceramic and plastic. The artificial joint used can help patients improve their mobility, pain, and overall quality of life.

Hip Replacement

Why is a Hip Replacement Surgery Carried Out?

Many medical conditions can cause damage to your hip. As a result, your doctor may recommend hip replacement surgery. Typically, this surgery is carried out if:

  • The patient experiences pain which affects his/her daily functioning.
  • The pain interferes with the patient’s ability to sleep.
  • The pain increases when walking, climbing or descending stairs, and getting up from sitting or lying positions.

Osteoarthritis:

Osteoarthritis is also known as wear-and-tear arthritis. This condition causes damage to the cartilage that covers the joints, allowing bones to move without friction.

Osteonecrosis:

Osteonecrosis is a condition that can occur due to inadequate blood supply to the ball of the hip joint. Due to this, the bone collapses and deforms, leading to pain and difficulties with walking.

Rheumatoid Arthritis:

Rheumatoid arthritis occurs due to an overactive immune system. This is an inflammation that occurs in the hip joint and leads to cartilage erosion. It can damage and deform the joints.

Preparing for a Hip Replacement Surgery:

As is the case with most surgical procedures, patients must prepare themselves for a hip replacement surgery. If you are about to undergo this surgery, you can expect the following order of events to take place:

  • The surgeon explains everything there is to know about your upcoming surgery. This is the right time for you to ask all your questions so that you do not have any doubts left.
  • Once you agree to undergo the surgery, the nurse may bring a consent form. Read it carefully before you sign it, as this is a legal document. If you still have questions you may ask for clarifications from the nurse or doctor.
  • An anaesthesiologist will then perform general tests and examine you to ensure your body can withstand the surgery. Some of these tests may include blood tests like Haemogram, KFT and LFT etc. Let consult your doctor know about any allergies you may have.
  • You should also let your doctor know about the medications you are on. Ideally, this information should already be there in your patient chart at this stage of the proceedings. But, it does not hurt to provide pertinent information once more.
  • You will be advised to fast for a minimum of 6 hours prior to the surgery. This means you cannot have food or water.
  • You cannot smoke before and after surgery as it can interfere with wound healing.
  • You should also make sure you have an at-home nurse or someone to help you at home when you are discharged.

What Happens During a Hip Replacement Surgery?

Hip Replacement Surgery

A hip replacement surgery includes the following steps:

Step 1: Your nurse provides you a hospital gown to wear. You need to remove all jewellery and nail paint before the surgery.

Step 2: An IV line is inserted into a vein in your arm.

Step 3: You are administered general or regional anaesthesia. Most doctors ask their patients to count backwards from ten. This just helps calm the patient down and gives them something to focus on, rather than be anxious about the operation.

Step 4: During each step of the procedure, an anaesthesiologist will be monitoring your vital signs to ensure you are responding well to the anaesthesia.

Step 5: Once you’re under the influence of the anaesthesia, the surgical staff applies antiseptic on the skin over the surgical site to clean it. They may also mark the area for the incision.

Step 6: The surgeon makes the first incision.

Step 7: By using surgical tools, the surgeon keeps the incision site open while exploring the insides. They then remove the damaged bone with different cutting tools.

Step 8: Once the damaged bone is removed, the hip prosthesis is inserted. The prosthesis has different components that fit into different parts of the hip. For instance, the stem goes into the femur, the head joint fits onto the stem, and the cup goes into the socket of the hip. The surgeon can choose between a cemented and uncemented prosthetic. The former is cemented into place with surgical cement. Although, nowadays implants are preferred to the cementing process.

Step 9: The surgeon then uses internal and external stitches to close the incision.

Step 10:  Finally, the surgeon covers the wound with sterile bandages to prevent infection.

Your hip replacement surgery is finally complete.

What Happens After a Hip Replacement Surgery?

Once the hip replacement surgery is complete, the patient is wheeled into a recovery room to rest. It may take a few hours for the patient to wake up from the anaesthesia. Most patients are quite disoriented for the first few minutes and may ask the same questions over and over again. This is not a cause for alarm. It is natural to feel confused after being sedated.

A physical therapist will meet the patient quite soon.  Of course, the patient will not be asked to walk around immediately. But the physiotherapy may start as early as the next day. The physiotherapist will not only chart out a plan for the patient but will also decide whether he/she needs to go to rehab to recuperate.

When discharged from the hospital, the patient will be asked to keep the surgical area clean, bathe in a specific way, and also exercise daily.

Risks Involved in a Hip Replacement Surgery:

Most surgeries come with a few risks. The risks involved in a hip replacement surgery are as follows:

  • Deep Vein Thromobosis (DVT): Patients may experience blood clotting in leg. To combat this risk, doctors prescribe blood thinners.
  • Infection: Patients may suffer from bacterial infections. Minor infections can be easily treated with antibiotics. Major infections within the tissues of the hip can lead to further surgeries. In a centre with good and high-end facilities such as the modular OT (Laminar flow OT) the chance of infection gets highly minimised.
  • Dislocations:  Hip dislocations occur when the ball of the prosthesis comes out of the socket. If this happens, the doctor will give you a brace to keep the prosthetic ball in place. Repeated dislocations may require surgical intervention. Though if the doctor is highly experienced in hip replacement surgeries, the chance of dislocation post the surgery is very low. Patients are usually advised precautionary measures while moving their hips after the surgery to prevent dislocation.
  • Change in leg length: Sometimes, muscle contractions around the new implant can lead to the leg becoming shorter. To avoid this, you must stretch and exercise the leg muscles.
  • Loosening: If the joint is not fixed properly, it may become loose with time. As a result, patients may experience pain and may have to undergo surgery again to correct the issue. With implants the chance of the joints becoming loose is very minimal.

How Long is the Recovery Period for Hip Replacement Surgeries?

6-12 weeks after a patient is discharged, a follow-up check-up is scheduled in order to ascertain whether the new joint is healing sufficiently. By this time, patients are able to resume normal daily tasks, though in a slightly limited way. It can take anywhere between 6 months to a year to fully recover from the surgery. This recovery period can depend on the patient’s age, diet, and exercise.

How Much does this Surgery Cost in India?

The cost of any surgery depends in India on two factors:

  • the city where the surgery is to be performed.
  • the amenities available at the hospital that the patient chooses.

On an average, the cost of hip replacement surgery (both cementing and implant processes) in India can range from Rs. 3.00 lakhs to 3.50 lakhs.

Conclusion:

A hip replacement surgery is crucial for patients experiencing high levels of pain that interfere with their day-to-day functioning in daily life. Getting this surgery performed can help them improve the quality of their lives by a large margin. Consulting with an orthopaedic surgeon can help you understand how to manage your hip pain and whether you need this surgery.

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