The hip joint is a ball and socket type of joint. The socket is in the form of cup called Acetabulum. The ball is globular, in shape called a Femoral head. Both, Acetabulum and Femoral head have a special type of coverings called as Cartilage. The ball i.e. Femoral head with cup i.e. Acetabulum forms a joint which allows us various movements at the hip and permits weight bearing.
Various disease conditions can cause damage to either femoral head or acetabulum or both or their covering cartilage. Damage to any of these causes roughening of the joint surfaces which results in friction and pain during walking or standing is called as arthritis.
Common conditions resulting in arthritis of hip are Avascular Necrosis of a femoral head, Rheumatoid Aarthritis, Ankylosing spondylitis, fracture of the femoral neck etc.
If the articulating surface of hip joints are arthritic and a patient has an inability to perform daily routine due to pain, is the time to go ahead for Total Hip Replacement Surgery.
With advances in surgical technique and easy availability of international standard quality implant, a result of THR Surgery is predictable and long-lasting.
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
• 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.