Why is the procedure for Total Hip Replacement (THR) done for?
Total Hip Replacement (THR) is done to establish a pain free function of the hip joint when the joint becomes painful due to destruction of cartilage. There are many reasons when hip joint cartilage can be destroyed, like osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, AVN, tubercular infection, septic arthritis, and the following fracture around the hip. Some childhood conditions later on cause significant hip dysfunction in adult life like DDH, Parthe’s disease, septic arthritis. THR is being done to restore hip joint function, reduce pain, increase level activity, and improve quality of life.
What are the different choices for THR prosthesis?
There are different types of prosthesis available for THR. Cemented prosthesis where prosthesis are fixed to the bone with the help of bone cement. Uncemented prosthesis where prosthesis is fixed with bone as snap fit and later on bony integration happens between bone and prosthesis surface. Joint articulation surfaces can also be of different types like the socket articulation can be metal, polyethylene or ceramic. Same as for ball articulation surfaces it can be either metal or ceramic. It has been seen that articulation between ceramic to ceramic and ceramic to polyethylene has a better survivorship and longevity.
How is the procedure done?
This procedure is done commonly under regional anaesthesia but also can be done under general anaesthesia. Hip joint is accessed and exposed by surgical incision over skin followed by separating different muscle planes and incising joint capsule. Hip joints can be accessed either from back, front or lateral side. How your joint will be accessed depends on the condition of the hip joint due to disease, your body configuration and surgeons expertise. Outcome of the procedure is not dependent on how the hip joint is accessed but meticulously and technically sound surgery has been done. Here depends on the surgeon’s skill and expertise how precisely they can perform the procedure. After accessing the joint it needs to dislocate from the socket and head needs to be sacrificed by cutting it at a desirable level from the main bone. Hip socket and femur canal is prepared with specific instruments specific for that hip prosthesis provided and recommended by the prosthesis manufacturer. Trial prosthesis is fixed fist and joint is reconstructed. Following trial joint reconstruction joint stability and limb length equality is being checked. After satisfaction of trial joint reduction appropriate size of the prosthesis is selected according to it. Original prosthesis is fixed according to trial reduction and the joint is reconstructed. All tissues that were surgically incised, repaired with suture and dressing applied.
How does recovery happen?
After a successful THR one can start to weight bear and walk as soon as possible following adequate postoperative pain control. Usually after 2-3 days of surgery one gets discharged from hospital and goes home. Due to recent advancement in prosthesis design we can achieve near normal joint stability and one can do nearly all normal activities and function following THR. There may be some restriction of activity like sitting cross legged and squatting. Physiotherapy rehabilitation is required to regain hip joint muscle power, proprioception reflex, body balance and gait improvement. Normally after 2-3 months of surgery
What should you expect from the procedure?
After a successful THR one can expect a pain free activity with near normal functional capacity. Our patients are doing jogging, dancing, recreational sports, cycling, swimming, tracking and so many other things that they love to do.
Why is this procedure done?
This procedure is done to regain the pain free function of the hip joint and improvement of quality of life.