Specialist in Spine & Joint Replacement Surgery

FAQ'S

We offer introductory answer to frequently asked questions about Hip Replacement, Knee Replacement & Spine Surgery.

Hip Replacement

Damage, diseased femoral head (a ball) is removed.
Damaged articular cartilage of acetabulum is removed to expose underlying bone.
Acetabular cup is fitted in acetabulum in perfect position.
The femoral head is replaced with an artificial ball and fitted in a femur.

1) Cemented THR:
Medical bone cement is used for fixation of the implant i e acetabular cup and femoral stem to the bone.

2) Uncemented THR:
The implant is press fit to the bone without intervening bone cement. Generally cemented total hip replacement is done in elderly age group patients but can be done at any age. Uncemented total hip replacement is usually done in young active individuals

  • 1) UHDPE (Plastic) Cup and Metal ball. Low cost most commonly used.
  • 2) UHDPE cup and Ceramic Head.
  • 3) Ceramic cup and Ceramic head. Costly but best combination for young patients.
  • 4) Metal cup and Metal ball is discontinued due to the high complications.
  • Size of the acetabular cup is same as the size of acetabular but size of the Femoral head can be variable. Large size head gives better movement and decreases chances of hip dislocation.

• Cemented Total Hip Replacement

Day 1: Exercises in bed

Day 2/3: Walking full weight bearing hip, knee & ankle exercises

• Uncemented Total Hip Replacement

Non-Wt. bearing walking For 3 weeks

PWB walking Next 3 weeks

FWB 6 weeks after surgery

Weight bearing can be started earlier if the component fitting is good.

Can be done: Walking, stair climbing/going down to staircase, driving, bicycle riding, certain forms of dancing.

Avoid: Jumping/jogging, sitting cross-legged, squatting

It is a planned surgery usually done under spinal and epidural anaesthesia.

It takes approximately 1½ - 2 hours.

Usually, blood is not required unless patient’s hemoglobin is low, to begin with.

If epidural analgesia is given, post-surgical pain is negligible.

Diabetes, High Blood Pressure and Heart Disease are not contraindications for THR.


Knee Replacement

The most important criteria is the knee pain. If the knee pain continues, increases on standing and walking, causing difficulty in daily routine activities (i.e. avoids going to temple, market, social gatherings etc.) & need to take painkillers on regular basis is the correct time for Total Knee Replacement surgery.

Non-surgical treatment i.e. drugs, Heat, Physiotherapy is effective in early stages of the disease only. Once the cartilage is destroyed, no other treatment is effective.

Usually spinal or Epidural or combined anaesthesia is used for surgery.

Approximately 2 - 3 hours including anaesthesia.

During surgery, we inject pain controlling solution around the knee. Also we give adductor canal block (injection in thigh region to block the nerves temporarily for 12-18 hours). Both these, control the pain well. In addition, we give intravenous painkiller injections as and when required.

Day 1: Knee, Ankle & Foot exercises
Day 2: Knee exercises, standing, walking
Day 3: Walking

Presently available knee joint usually last for 15-20 years. The longevity depends on various factors like body weight, activities etc.

Avoid: Jumping, jogging, running, contact sports, hiking

Can do: Walking, climbing staircase, cycling, driving a car, games like golf, and dance like ballroom dancing.

cross-legged sitting can be done but not recommended as excessive pressure on articulate surface decreases the life of implant .

Yes, provided the patient is not a high-risk patient and his medical condition permit longer surgery.

Delay in surgery causes more damage to bones. It can make surgery more difficult and complicated.

It’s a use of computer Software to make an accurate cuts of the bone and exact placement of the prosthesis during surgery. But literature doesn’t show significant difference between computer assisted and without.

The cost of imported implant is around Rs. 70,000. Other charges include Doctor’s professional charges, which vary with doctor’s experience and the Hospital Charges etc.


Spine Surgery

The success or failure of spine surgery depends upon the type of problem and the expected result. The good result is important aspect of the treating doctor's experience and expertise. The patient and the doctor must have realistic expectation from a back operation. A patient in extreme pain and disability may become ecstatic even if his or her pain is reduced partially.

In the current state of the art spine surgery, the aim is to get the patient on his feet as early as possible. In majority of the cases, the bed rest only for about 3 to 5 days after which the patient is allowed to walk and carry out the activities of daily living. With a better understanding of spinal problems, a given condition is tackled with the minimum amount of surgery required.

No operation is free of risks. Possibility of complications is higher if the operation is very major. In routine spine operations, the difficulty rate is minor.

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