KNOW ABOUT HIP
Hip Joint is the largest and the most stable joint in the human body. It is the largest ball socket joint, socket cup formed by the Acetabulum, which is the part of pelvic bone and the ball is formed by the upper end of the thigh bone (Femur). The ligaments and the hip provide stability, acting in coordination during each and every degree of mobility in our day to day activities.
Common Causes Of Hip Pain
OSTEOARTHRITIS : Age related wear and tear seen in people of 50 years and beyond where bones rub against each other causing pain and stiffness.
Rheumatoid ARTHRITIS : An autoimmune disease in which the synovium in the cartilage destroys the cartilage. It is also termed as Inflammatory Arthritis.
AVASUCLAR NECROSIS (AVN) Any injury to the hip, previous dislocation, childhood disease, long term use of steroids smoking and alcoholism may result in lack of blood supply, leading to the collapse, deformation and arthritis of the Hip.
Trauma:
In old age, fractures are more commonly seen around hip due to trivial fall. Replacements are done like Intracapsular, where the replacements can be partial or total. In Extracapsular, expertisemobilize the fractured hip geriatric patients specially to prevent complications such as bed sores, chest infections, deep vein thrombosis, paralytic ileus (decreased bowel mobility) and painful toilet care, Surgery is performed taking overall condition of the patient into account.
Key Hole Surgery for Hip:
Arthroscopy is a surgical procedure that allows to diagnose and treat problems inside a joint with the help of Arthroscope.
Femoral Acetabular Impingement:
Snapping Hip Syndromes
Loose Bodies in the Hip Joint
BMAC:
Avascular necrosis is another common condition seen in middle aged patients where patients need to get evaluated immediately and need to take proper treatment to prevent progression with minor surgeries.
It is treated in early stage with core decompression of femoral head with bone marrow augmentation, where bone marrow is collected from iliac crest. Here, around 60cc of BM is obtained to produced 6ml of concentric BM. The collected cells are precursorsget activated when injected into joint and this has potential to enhance healing and recovery.
Middle age:
Ankylosingspondylitisis seen in those who are middle aged with associated back pain. This usually require surgery and further medications to prevent stiffness and increased ROM (Range of Motion)
Old age:
Most common conditions in old aged patients with hip pain are fractures due to Trivial fall, Osteoarthritis, Rheumatoid Arthritis, Avascular necrosis. Those with family history overweight, injury to hip andobese people are more prone to this.
Partial Hip Replacement
In Partial Hip Replacement, fractured head is removed and replaced with prosthecis . Only the femoral head removed & replaced with metallic stem & ball.
Total Hip Replacement
In Total Hip Replacement surgery, the damaged bone and cartilage is removed and replaced with prosthetic components. The damaged femoral head is removed and replaced with a metallic stem that is placed in to the hollow center of the femur. A metal or ceramic ball is placed on the upper part of the stem. The damaged cartilage surface of the socket (Acetabulum) is removed and replaced with metal socket to allow for a smooth gliding surface.
Is Hip Replacement For You?
The decision to undergo hip replacement is made by you, your family and the treating Joint Replacement surgeon.
Candidates for surgery
There is no age or weight restrictions for Hip replacement and is based on patient pain.
When is Surgery Recommended ?
• Hip pain that limits everyday activities like walking stairs, bending etc.
• Pain at rest – day or night
• Stiffness
• Inadequate relief from medication, physiotherapy and walking aids.
Surgery Evaluation
Medical history of the patient is first checked. Physical examination includes hip mobility, pain score strength alignment. X-rays show degeneration/deformation while MRI is helpful in soft tissues condition and early stages of AVN.
Realistic Expectations
Most patients who undergo Hip replacements experience significant/dramatic pain relief and improvement in the ability to perform daily activities. With aging, the prosthetis material between the head the socked (liner) begins to wear. With appropriate activity and life style modification, hip replacements can last for years.
Surgical Protocol
Once the need for surgery has been decided, the patient will undergo a set of surgical profile, medical /cardiology clearance and pre anesthetic evaluation. The implant to be used will be chosen according to the patient requirements and is based on the quality and strength of the bone.
Patient will be staying in the hospital for 2-3 days initially for pain management. Wound heals after approximately 2 weeks of surgery.
Post Operative Care
There has to be a graduated walking program followed by normal activities such as sitting, standing and climbing stairs in 3-4 weeks
Possible Complications of Surgery
The rate of complications in hip replacements in as low as 2% world wide. These include infections, blood cots, limb length inequality, dislocation etc.
Hip replacement in a boon for the patients with severe hip pains impacting the day to day activity. The success of the surgery is based on the selection of the patient, education of the patient before and after surgery, necessary evaluation and right expert intervention.
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Consultant Orthopaedic Surgeon,
Srikara Hospitals,#222 & 223,
Mythri Nagar,Phase-II,
Miyapur,Hyderabad-500 049.
Srikara Hospital, Hyderabad.
To Contact: + 91 9177 679 797
E-Mail ID: dr.kirthi.paladugu@gmail.com
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