Is Hip Replacement The Best Solution For Advanced Hip Arthritis?

A renowned knee and shoulder joint surgeon with skills in minimally invasive and arthroscopic procedures and advance replacement surgeries.

Hip joint arthritis is an extremely disabling condition. Hip arthritis is characterised by pain of the hip joint which may be mild to severe, shortening of the extremity, difficulty in bearing weight on the hip, deformities of the hip joint, and decrease in the range the movement. This causes difficulty in walking and activities of daily living.

There can be various reasons that may cause the arthritis of your hip joint. It may be due to residual effect of previous trauma or fractures, it can be due to developmental problems, it can happen due to various inflammatory diseases like rheumatoid arthritis, ankylosing spondylitis, etc. Hip Arthritis is also caused by condition known as `Avascular Necrosis' (which means damage to the head of the hip joint due to reduction or loss of blood supply), which itself can happen due to multiple reasons like excessive consumption of alcohol, excessive intake of alcohol, various problems with your blood clotting mechanisms.

Hip Arthritis, although less common as compared to the knee arthritis, is a concerning situation as they tend to occur in younger patients, with the average age of 25 years to 45 years, which is the most active age for any individual. Such a debilitating condition in the age of maximum activity can lead to severe economic as well as psychological setback. As the arthritis progresses, the pain would gradually progress and worsen, and it hampers the activities of daily living. In severe conditions, patient may need a walking aid like sticks or walkers to be mobilised. However, there are lots of concerns and queries that patients and their relatives have about going ahead with the surgery, lot of apprehension about the outcomes, and many of them may refrain from taking the decision to go ahead at appropriate time, leading to further problems and damages to the socket.

Hip joint replacement surgery was popularised in the western world in the middle of the previous century and believe me, we have come a long way since then

There are multiple treatment options when the hip arthritis is mild to moderate, but according to Dr. Abhishek Nerurkar, Consultant Orthopaedic Surgeon, Hinduja Healthcare Surgical, Khar and SL Raheja Fortis, Mahim, the best treatment for advanced arthritis when the head and the socket of the hip joint are severely damaged, is to go ahead with the total hip replacement surgery. This surgery essentially involves complete removal of the damaged portion of the hip joint and replace it with an artificial component, which is modular and can be customised to give the best fit to the patients.

Hip joint replacement surgery was popularised in the western world in the middle of the previous century and believe me, we have come a long way since then. There have been advances in the component material, advances in designs and fits of the prosthesis components, and also in the articulation surfaces. There have been advances in the approach and techniques to optimise the outcomes. This has made total hip replacement a very safe procedure with a predictable outcome even in the most severe forms of arthritis. The longevity of the prosthesis and joint interface has significantly increased and given us a better long term perspective, which was desirable since the surgery is conducted at a younger age.

The evolution of ceramic heads and cups have changed the dynamics of the Total Hip Replacement surgery. Moreover, we have prosthetic coatings which have better initial fit as well as better integration with the bone in uncemented hips, leading to excellent long term outcomes in replacement surgeries. Now, we also get `Dual Mobility' implants. These implants have 2 articulating surfaces which leads to a better hip range of movement after the surgery and they also reduce the chances of dislocations after the surgery. The post operative mobilisation protocols have also improved and we make the patients stand and walk on the immediate post operative day.

There are always concerns about what activities should the patient avoid after Hip Replacement surgery? In order to improve the longevity of the bearings, we generally instruct the patients to avoid squatting and sitting on the floor with their legs crossed. However, one should do regular exercises and physiotherapy to maintain the flexibility and mobility, and to build up strength.

If you are suffering from hip arthritis, you should consult your orthopaedic surgeon to give you the best solution for your hip pain. Be rest assured, the results of Total Hip Replacement are excellent and you should get good pain relief and function. The longevity of the prothesis is also significantly improved and your doctor will guide you for the best possible combination for you for optimise the outcomes. This will help you live pain free with active and cheerful life.