HIP JOINT REPLACEMENT

It is the largest ball-and-socket joint. The socket is formed by the acetabulum of the pelvis bone. The ball is the femoral head, which is the upper end of the thigh bone.

A smooth tissue called articular cartilage, lines the surfaces of the joint hence enabling them to move smoothly & easily. Synovial membrane surrounds the hip joint, which secretes synovial fluid that lubricates the joint. Ligaments & capsule connects the ball to the socket and provide stability to the joint.

Causes of Hip pain:
  • Osteoarthritis
  • Rheumatoid arthritis
  • Post traumatic arthritis
  • Avascular necrosis
  • Congenital Hip dislocation
hip
Total Hip Replacement

The damaged bone and cartilage is removed and replaced with prosthetic components.

Pre op Evaluation:
  • Clinical examination
  • X rays of the hip joint
  • Blood investigations
  • CUE
  • Chest x ray
  • ECG
  • 2D echo
  • Physician and cardiologist opinion
  • Anaesthetic check up
On the day of surgery:
  • Surgery takes around 1 ½ to 2 hours for hip replacement.
  • Patients are kept in ICU overnight if warranted
Hip Replacement Procedure:
  • The damaged femoral head is removed and replaced with a metal stem. The femoral stem is either cemented or uncemented into the bone.
  • 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 a metal socket that is secured with screws or cement.
  • A plastic, ceramic, or metal spacer is inserted between the new ball and the socket to allow for a smooth gliding surface.
Postoperative period:
  • Patient is made to walk with help of walker by the physiotherapist
  • Strengthening exercises are taught during the hospital stay
  • Hospitalization is for 3-4 days
  • It will take 4-6 weeks on an average to get back to normal and walk independently with walker depending on individuals.
Complications:
Intraoperative:
  • Damage to neurovascular structures
  • Fractures
Post operative:
  • Thromboembolism
  • Infection
  • Dislocation of hip
  • Leg length discrepancy
Late complications:
  • Infection
  • Aseptic loosening
  • Periprosthetic fracture
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Email:drnaveenreddyortho@gmail.com

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