Total Hip Arthroscopy
- This maybe because complete or a part of your previous hip replacement needs to be revised. This operation varies from a minor adjustment to a massive operation replacing significant amount of bone and hence is difficult to describe in full.
- Hip Resurfacing or bone conserving procedure replaces the acetabulum (hip socket) and resurfaces the femoral head. This means the femoral head has some or very little bone removed and replaced with the metal component. This spares the femoral canal.
- Total Hip Replacement (THR) procedure replaces total or part of the hip joint with an artificial device (prosthesis) to alleviate pain and restore joint movement.
- Femoroacetabular Impingement FAI is a condition resulting from abnormal pressure and friction between the ball and socket of the hip joint resulting in pain and progressive hip dysfunction. This when left untreated leads to the development of secondary osteoarthritis of the hip.
- Hip arthroscopy is a relatively new surgical technique that can be effectively employed to treat a variety of hip conditions.
- The hip is a ball-and-socket joint. The ball, at the top of your femur (thighbone), is called the femoral head. The socket, called the acetabulum, is a part of your pelvis. The ball moves in the socket, allowing your leg to rotate and move forward, backward, and sideways.
- In a healthy hip, soft tissue called cartilage covers the ball and the socket to help them glide together smoothly. If this cartilage gets worn down or damaged, the bones scrape together and become rough. This condition, osteoarthritis, causes pain and restricts motion. An arthritic hip can make it painful to walk or even to get in or out of a chair. If you have been diagnosed with hip arthritis, you may not need surgery. Nonsteroidal anti-inflammatory drugs (NSAIDs) and/or physical therapy may provide relief.
- The ball portion of the joint is removed by cutting the thighbone with a saw. Then an artificial joint is attached to the thighbone using either cement or a special material that allows the remaining bone to attach to the new joint.
- The doctor then prepares the surface of the hipbone — removing any damaged cartilage — and attaches the replacement socket part to the hipbone. The new ball part of the thighbone is then inserted into the socket part of the hip. A drain may be put in to help drain any fluid. The doctor then reattaches the muscles and closes the incision.
- You will likely stay in the hospital for four to six days and may have to stay in bed with a wedge-shaped cushion between your legs to keep the new hip joint in place. A drainage tube will likely be placed in your bladder to help you go to the bathroom. Physical therapy usually begins the day after surgery and within days you can walk with a walker, crutches, or a cane. You will continue physical therapy for weeks to months following the surgery.
- For anywhere from six to 12 months after hip replacement surgery, pivoting or twisting on the involved leg should be avoided. You should also not cross the involved leg past the midline of the body nor turn the involved leg inward and you should not bend at the hip past 90 degrees. This includes both bending forward at the waist and squatting.
- Even after your hip joint has healed, certain sports or heavy activity should be avoided. The replacement joint is designed for usual day-to-day activity.
- There are a few simple measures that you can take to make life easier when you return home after hip replacement surgery, including:
Keep stair climbing to a minimum. Make the necessary arrangements so that you will only have to go up and down the steps once or twice a day.
Sit in a firm, straight-back chair. Recliners should not be used.
To help avoid falls, remove all throw rugs and keep floors and rooms clutter-free.
- Use an elevated toilet seat. This will help keep you from bending too far at the hips.
- Keep enthusiastic pets away until you have healed completely.
You should ask your doctor before returning to such activities as driving, sexual activity, and exercise.
- A total hip replacement (known as hip arthroplasty) is a procedure in which the damaged joint, bone, and cartilage are removed and replaced with prosthetic (artificial) components.
- A partial hip replacement (known as a hemiarthroplasty) involves replacing the femoral head only and not the acetabulum. This procedure is more common in older patients suffering from a hip fracture and is an option when the acetabulum is healthy.
Materials Used in Hip Implants
- There are currently three types of total hip replacement devices available with different bearing surfaces. These are:
Metal-on-Polyethylene: The ball is made of metal and the socket is made of plastic (polyethylene) or has a plastic lining.
- Ceramic-on-Polyethylene: The ball is made of ceramic and the socket is made of plastic (polyethylene) or has a plastic lining.
- Ceramic-on-Ceramic: The ball is made of ceramic and the socket has a ceramic lining.
- An orthopaedic surgeon should determine which hip implant will offer the most benefit and least risk for each patient.
- You may need a hip replacement because of:
- Inflammatory arthritis (Rheumatoid arthritis, psoriatic arthritis).
- Injuries, like a hip fracture or dislocation from a fall.
- Developmental hip dysplasia.
- Not joined/united fracture neck of femur.
- Osteonecrosis (avascular necrosis).
- Childhood hip disorders, like Legg-Calvé-Perthes disease and slipped capital femoral epiphysis.
- Background. A new family of micro-posterior approaches, percutaneously assisted total hip (PATH), SuperCapsular (SuperCap), and Supercapsular percutaneously assisted total hip (SuperPATH) allow preservation of the short external rotators.
- Dr. Sharath K R does a posterior approach mini-invasive approach similar to superPATH but he reattaches the short external rotators and capsule if in case he has to release from the trochanter.
- There is no difference in the long-term outcome of different approaches. The long-term outcome means longevity/life of the implant. Longevity mainly depends on implant positioning/angles of placement initially and bone growth later on.
- The direct anterior approach means, surgery done from the front of the upper thigh implants fixed. Its intermuscular and muscle-sparing muscles are not cut during the procedure
- No. severe deformities, the Hip replacement for severe dysplasia, fused hip, femoral long periprosthetic fractures, etc are those cases that cannot be operated using a direct anterior approach.
- The posterior approach is most versatile to handle any complex /difficult cases and also posterior approach is the most widely used.
- Unlike older implants that were metal, modern hip prosthetics are made of a combination of metal, plastic and ceramic parts, so they are more durable and cause fewer issues. These implants can last 25 to 30 years, and the risk of failure and the need for repeat surgeries are low. Dr. Sharath K R usually does uncemented press-fit acetabular components without screws. He uses screws if bone quality is found weak at the time of surgery.
- The goal of surgery is to get you back to your normal life, whether it’s going to work, playing with kids, or engaging in your favorite sport or hobby. Depending on the amount of physical activity a task requires, the amount of time it will take to be able to perform that task differs.
Driving. Usually, it is advised to drive after a month or 6 weeks after hip replacement.
- Work. If you have a desk job with minimal activity, you can return to work in about two weeks. If your job requires heavy lifting or is otherwise tough on the hips, it is recommended to take off about six weeks to recover.
- Sports. High impact contact sports you should avoid after hip replacement. Before getting into a pool, you should also wait about six weeks until the incision completely heals. Slow cycling, walking for 2-3 km can be done after 4 weeks.
- Sexual Activity. You can return to sexual activity whenever you feel comfortable.
- No. You are not supposed to sit crossed leg or squat after hip replacement.
- Hip pain that affects activities of daily living
- Constant hip pain while resting.
- Constant pain after hip fracture surgery which is not healed properly.
- Inability to walk independently without support.
- Hip stiffness limits the ability to move or lift the leg.
- Failed improvement with treatments such as anti-inflammatory medications and physical therapy.
- Hip replacement for the dysplastic hip is different from other causes of hip replacement. It is more complex and more technically demanding. Dr. Sharath K R has performed hip replacement for various types of dysplastic hips and attained expertise by performing successful surgeries.
- This is again complex hip replacement and not commonly performed. Dr Sharath K R has performed uncemented hip replacement for ankylosing spondylitis in a large number of patents and has published his work in an international hip journal.
- AVN avascular necrosis is a condition where the head of the femur gets damaged/ collapsed gradually and the hip joint goes in for arthritis. The patient will have severe pain in the involved hip and will have difficulty in carrying out regular activities. Hip replacement for this condition will be a very successful procedure if done properly. The patient will have complete pain relief and will be able to carry out all activities. Dr. Sharath K R has successfully performed THR for AVN of the femoral head to several patients and he has published his work in Karnataka orthopaedic association journal.
- It’s a type of hip replacement where, instead of the stem in femur side, large diameter ball fixed with a peg to neck of femur. Its bone conserving operation. Nowadays hip resurfacing is not commonly done instead hip replacement is done.
- He has performed over 6000 orthopedic surgeries and more than 1000 hip replacements.
- He himself performs the whole procedure (Not some important steps). He takes personal care in form of regular visits and guides proper post-operative protocol physio and wound care.
- Dr. Sharath K R Keeps updating the latest techniques and newer surgical skills which help patients to recover faster and get back to normalcy after surgery.
- His technique of Total Hip replacement implant/cup positioning has proven to give an excellent success rate and faster recovery for youngsters and also senior citizens to return to their pre-surgery lifestyle.
- He is an invited faculty for several national conferences on hip replacement and he has published more than 10 articles on hip replacement in indexed and peer-reviewed journals. He is committed to giving excellent results to his patients.