Dr. Harish Chandran

Avascular Necrosis(AVN)AVN is the loss of blood supply to the bone as a result of fracture or vascular damage. As a result, the affected bone dies, then the bone collapses, the joint is destroyed and the person develops a painful and stiff joint. This can taken from 2-8 years to develop, but can happen at an early age too.
The common reason for AVN are: alcohol abuse, use of steroids, dislocation and post trauma(accidents).

Osteoarthritis(OA)

Osteoarthritis or the degenerative joint disease, is the most common type of arthritis.  OA  is a chronic condition characterized by the break down of the joints cartilage.
The breakdown of the cartilage causes the bones to rub against each other, causing stiffness, pain and loss of movement of the joint. It is associated with aging and most typically beings among people aged  50 years or older. A young person who develops osteoarthritis, typically has had an injury to the hip or may have an inherited form of disease.

Treatment options

When medication, physical therapy and other conservative methods of treatment no longer relieve pain, Total Hip Replacement may be recommended by your surgeon.
Total Hip Replacement helps relieve pain and allows patient to perform many activities that may have been limited due to hip pain.

What is Total Hip Replacement?

Total Hip Replacement is the replacement of the ball and socket of the hip joint with implants. There are 2 main components used in Total Hip Replacement:
The acetabular shell replaces the hip socket; The femoral stem replaces the worn out top of the femur.
During surgery, the head of the femur (thigh bone)is removed and replaced with both the stem and socket, mimicking your existing anatomy.

• Advantages of Hip Replacement Surgery
• Relieves pain
• Corrects any deformity .For example, leg length inequality
• Restores any loss of function in your hip
• Improves your quality of life; ability to return to normal activities

Preparing for a Hip Replacement

There are several things that you can do before your surgery to make your recovery successful, easier and safer.

Commit to the success of the surgery: Working as a team, you, your doctor, your physiotherapist and your family must adopt a positive attitude towards the success of your surgery.

Remain as active as possible: Remaining active before the operation will help in a quicker recovery and more flexibility after the operation.

Stop smoking: This will help reduce the risk of complications during and after your surgery.

Make sure all infections are cleared up prior to the surgery:

These include tooth abscesses, bladder infections, infections such as leg ulcer, cold and the flu. This is to ensure that the infection does not spread through the body during the operation and infect the newly replaced joint.

On the day of operation, it is usual that the doctor will ask you not to drink or eat anything. The area around your knee may be shaved to reduce the risk of infection.
Approximately, an hour before the operation you may be given tablets or an injection to relax you.

What to expect after the surgery?

•  It is normal to feel the pain and discomfort after surgery. Be sure to inform the nurse about your pain.
•  Your leg will be supported and elevated on one or two pillows to help circulation and stretch muscles.
• The nurse will encourage you to do  the ankle exercises.
•  After 24 hours, you should begin to drink fluids regularly, according to your surgeon’s directions.

Physiotherapy

         
Physiotherapy is an essential part of recovery following a total  hip replacement aims to:

• Provide an exercise program to improve the joints movement, strength and flexibility
• Improve mobilization and enhance confidence
• Education on how to protect your new hip

Your commitment  to follow the exercise program recommended by your physiotherapist is essential for your post recovery rehabilitation.
Remaining active and practicing the prescribed exercises are the quickest ways to full recovery.

Home care

It is normal for you to have some discomfort during initial days. You will probably receive a prescription for pain medication before you go home. However, contact your surgeon if you develop any of the following:

1. Drainage and/ or foul odor from the incision.
2. Fever(temperature at around 101degreesF or 38 degrees C)for two days.
3. Increased swelling, tenderness, redness and/or pain.

Myths & realities about Hip Replacement

Myths No.1: Arthritis pain is just part of aging. It’s just something you learn to live with

Reality: OA is the most common form of arthritis today, but still many people choose years of conservative care(physical therapy, drugs, injections)to lessen, but not eliminate, their joint pain. If regular pain is interfering with your daily activities, you may benefit from a consultation with an orthopaedic surgeon.

 Myth No .2: A Hip Replacement won’t feel natural

Reality: They have been significant advances in materials, designs, and surgical procedures for Hip Replacement. There are many implants options available than ever before including a wide range of sizes, designs and materials to best meet individual patient needs and recreate the feel and movement of a natural hip. While the choices are many, the goal is the same: to bring you long-term relief from pain and increase your mobility

Myth No. 3: I’m too young for Hip Replacement

Reality: Hip Replacement is related to need, not age. Total Hip Replacement is considered to be an effective  procedure that can help patients resume a more active lifestyle

Myth No. 4: I should wait as long as possible to undergo Hip Replacement surgery

Reality: Many patients who could benefit greatly from a Hip Replacement are worried that they will not be able to comfortably and confidently return to their normal activities of daily living. In fact, delaying surgery lower’s  patients ‘ quality of life before the operation and may lead to complications.

Myth No.5: All hip implants are the same

Reality: Today, Hip Replacement patients have a choice of hip implant types as a variety shapes and sizes designed to accommodate specific needs and different lifestyles. Talk to your orthopaedic surgeon about your individual needs and the clinical history of the implant your surgeon  recommends for you.

When to visit an orthopaedic surgeon?

If you have difficulty  performing  the movements  below, it may be time to talk with your doctor. For each activity, rate your level of discomfort from one (mild or no pain)to five (extreme discomfort).Share the results with your healthcare provider.

Activity  1: Pretend to drive a car, pushing an imaginary accelerator and then break with the right foot. Repeat  the procedure for the left  foot.

Activity  2: Bend at the hips and knees as if you were watering flowers.

Activity  3: Walk several steps, leading with the left foot.

For each exercise, rate your level of discomfort  from 1 (mild or no pain)to 5 (extreme discomfort). If your rating is more than 3 in any of the 3 activities, it is recommended to share your results with the orthopaedic surgeon.