Hip Replacement Surgery

Types of Hip Replacements

Total hip arthroplasty, is a surgical procedure in which a damaged or diseased hip joint is replaced with an artificial implant. It is commonly performed to relieve pain and restore function in individuals with severe arthritis, hip fractures, or other hip joint disorders as: Osteoarthritis, Rheumatoid arthritis, Avascular necrosis and Hip fractures.

Procedure Overview

Anaesthesia – General or spinal anaesthesia is indicated.
Incision – The surgeon makes an incision on the side of the hip.
Removing the Damaged Joint – The femoral head (top part of the thigh bone) is removed.
Implanting Prosthetic Components
– A metal or ceramic ball replaces the femoral head.
– A metal or plastic socket replaces the damaged hip socket.
Closing the Incision – The muscles and tissues are repaired, and the incision is closed.

Recovery & Rehabilitation

– Hospital stays: usually 2-4 days
– Physical Therapy: Starts immediately to restore motion and strength and patient start to walk within 24 hours.
– Use of a walker or cane for 6 weeks.
– Full recovery takes about 3-6 months.

Benefits

– Significant pain relief
– Improved mobility and quality of life
– Increased joint stability
– Long-Term Effectiveness

Risks

– Infection
– Blood clots
– Dislocation of the new joint
– Implant wear and loosening over time
– Nerve Damage – Rare but can cause numbness or weakness.

Partial Hip Replacement Surgery

A partial hip replacement (also called a hemiarthroplasty) is a surgical procedure where only the ball part of the hip joint is replaced with a prosthetic implant, while the hip socket is left intact. Partial hip replacement is typically performed for:
Hip fractures, especially in elderly patients, Avascular necrosis (when the femoral head loses blood supply and dies), Arthritis limited to the femoral head

Procedure Overview

– Anaesthesia – General or spinal anaesthesia is given.
– Incision – The surgeon makes an incision near the hip.
– Removal of Damaged Bone – The femoral head is removed.
– Implant Placement – A metal or ceramic prosthetic head is inserted and secured to the femur.
– Closure – The incision is closed, and recovery begins.

Recovery & Rehabilitation

– Hospital Stay: Usually 2-3 days.
– Weight-Bearing: Usually allowed with assistance soon after surgery within 24 hours.
– Physical Therapy: Starts within a day to regain strength and mobility.
– Full Recovery: About 6–12 weeks for most patients.

Benefits

– Pain relief
– Improved mobility
– Faster recovery.
– Durability – Can last 10–20 years depending on activity level and bone health.

Risks

– Infection
– Bleeding and Blood clots
– Reaction to anaesthesia
– Dislocation
– Loosening of the implant

Hip AVN

Osteonecrosis of Hip, is a condition where the blood supply to the ball of the hip joint is reduced or cut off, leading to bone death and joint collapse over time.

Core decompression: A surgical procedure aimed at reducing pressure within the bone and improving blood flow to the affected area. It is typically recommended in the early stages before significant bone collapse occurs.

Procedure Overview

– Anaesthesia: Usually performed under general or spinal anaesthesia.
– Incision: A small incision is made on the side the hip.
– Drilling a Channel: A surgeon drills one or more holes into the femoral head to relieve pressure and stimulate new blood vessel growth.
– Bone Graft (Optional): Sometimes, bone grafts or biologic materials (such as stem cells or bone marrow aspirate) are added to promote healing.
– Closure & Recovery: The incision is closed, and post-op care begins.

Recovery & Rehabilitation

– Crutches for 6–12 weeks to reduce weight on the joint.
– Physical therapy to regain strength and mobility.
– Full recovery may take 3–6 months.
– Success rates are higher in early-stage AVN but decrease if the bone has already collapsed.

Alternatives and long-term management for Hip AVN:

– Medications
– Lifestyle Modifications
– Weight-bearing restrictions – Reduce stress on the joint.
– Physiotherapy – Strengthen surrounding muscles to support the joint.
– Avoid alcohol & smoking – These worsen blood flow issues.

Advanced Stage Treatment

Total Hip Replacement (THR)
– Best for severe pain and joint collapse.
– Durable option, but longevity is a concern in younger patients.