TOTAL HIP REPLACEMENT

Dr. A.MOHAN KRISHNA M.S.ORTHO, MCh ORTH(U.K)

Consultant Orthopaedic surgeon ,

Trauma, Arthroscopy, Arthroplasty

Surgeon

Apollo hospitals, Hyderabad

Consultant Orthopaedic Surgeon at

www.drmohankrishna.com

www.healthyjointclub.com

www.bonesandjointsclinic.com

Smooth round head of thigh

bone articulates with cup like

bone of pelvis

CARTILAGE

Lining of the joint

Shock absorber

HIP JOINT IS BALL AND SOCKET

JOINT WHICH TRANSMITS WEIGHT

FROM UPPER BODY TO LEGS

What causes it?

Osteoarthritis

Rheumatoid

arthritis

Worn-out cartilage

Injury to the

joint

Avascular Necrosis

Infections

How common is it?

Commonly affected joint in the

body after knee joint

Nearly 15% of general

population

Risk factors

Age - Uncommon under 40

years

1 in 5 over 60 years

Overweight / obesity

Runs in families

Joint injury

Restriction of activities

like squatting, sitting

cross legged

Swelling of

the joint

Joint pain &

Stiffness

Difficulty in

walking/Limp

• Diagnosis is made on

X-ray of the Hip joint

• Decrease in the joint space,

•Irregular and rough surface

Weight Reduction

Pain Killers

Tablets/ local gels

Nutritional Supplements

Glucosamine

Physiotherapy

Hip exercises

Injections

Steroids/ lubricant

Key hole surgery

TOTAL HIP REPLACEMENT

CEMENTED / UNCEMENTED

Replacing the damaged cartilage

in the Hip joint with metal stem,

metal or ceramic ball and liner

with Plastic or Metal or Ceramic

combinations.

METAL

Cobalt-chrome or

Stainless steel

PLASTIC

Specialised

polyethylene

CERAMIC

Cemented Total Hip Cementless Total Hip

CEMENTED TOTAL HIP

REPLACEMENT

Cement is used to fix the

thigh and cup component

to the bone.

CEMENTLESS TOTAL HIP

REPLACEMENT

The cup component is fixed as

press fit with or without

augmentation with screws.

The thigh component is fixed

press fit with the bone.

Hundreds of operations

are carried out every

year in the INDIA

Needs General / Spinal /Epidural

anaesthetic

Operation may take up to 1 ½ hours

A cut is made on the side of upper

thigh.

The new joint can last

nearly up to 15 years

BENEFITS

Better quality of life Pain relief

Relief from PAIN/ SLEEP

disturbances

Improves mobility with daily

activities

oWalking,

oClimbing stairs

oVehicle driving

RISKS

Risks related to the anaesthetic

Infection of the joint (2 - 3%)

Clots in the legs and the lungs

Damage to the nerves and the

blood vessels

Weight Height (BMI)

Blood & Urine tests, ECG, Chest X-

ray,

2D Echo

Check up by a General physician,

Cardiologist, anaesthetist

Details of medical

conditions/Allergies

Previous operations

List of medicines you are taking

To stop blood thinning drugs

(ASPIRIN , CLOPIDOGREL)

General examination : Dental

check

Discussion regarding operation

Sometimes a further check-up by an

Anaesthetist may be required

Continue regular medications if any for

Diabetes / BP /any long term drugs

Early Light dinner (Fat free) on the

night before surgery.

Plenty of fluids on the day before

surgery.

Informed consent & site marking of the

limb.

Good bath

At least six hours of fasting before

surgery.

Take BP/Thyroid medications after consulting

the doctor. Normally you are advised not to

take medication for diabetes

IV lines and monitors will be placed in the

operation theatre.

Commonly General anaesthesia will be given

and other measures for post surgery pain relief.

Urinary catheter will be placed

Cleaning and draping of the leg will be done

prior to surgery & surgeon will proceed for

surgery

If you have any heart or other problem you

will be kept in ICU for a day.

At least six hours after surgery you will be

allowed to have liquids first & followed by

normal diet.

SURGICAL STEPS

WOUND CLOSURE AFTER

SURGERY

UNCEMENTED

TOTAL HIP

REPLACEMENT

CEMENTED TOTAL HIP REPLACEMENT

RIGHT

Day 1

Exercises for ankles and toes to prevent blood clots

You can sit on a chair or take a few steps with a

frame

Day 2

Removal of bandage and drain from the Hip joint

Knee exercises – straightening / bending

Cemented Hip: Full weight bearing walking with

frame.

Day 3

Walking up and down the stairs

Continue the exercises

You may be able to go home

within 3 to 5 days after the

operation

Stitches / clips removed

at 12 - 14 days

You can shower/ bathe after

removal of stitches / clips

Return to household work & other

day to day activities in 6-8 weeks

Frequent deep

breathing1Pull your toes towards

you and point away. 2

Circle your feet in

both directions3

Push knee down

Tighten thigh muscles

Count to 10 and relax

Do it 10 times / hour

4

Place a rolled towel

under your knee. Lift

your heel to straighten

knee. Count to 10 and

do 10 times / hour

5

Place a rolled towel

under your knee.

Push your knee and

heel down. Count to

10 and do 10 times /

hour

6

Sit at the edge of bed / chair. Bend

the operated leg and straighten

slowly. Repeat 10 times/hour. 7

Note: it is important to do frequent repetitions of all exercises for a short

time than spending more time on exercises once or twice a day. Do not

force any movements

Raise and support your

operated leg on a stool

Do walk short distances initially

As you get stronger increase

the distance of walking

• Neurological risks In previous neurological problems

• Cardiac risks (elderly with uncontrolled blood pressures

• Anaestheticrisks

Infection of joints 2-

3%

hip stiffness

Clots in legs & lungs

Damage to nerves & blood vessels

Risks of TOTAL HIP REPLACEMENT

SPECIAL CONSIDERATIONS

Inform other doctors about artificial joint. As these

joints are risk of bacterial infection from the above mentioned procedures.

Dental procedures

Urological procedures

Endoscopic procedures

CONTACT

Dr.A.MOHAN KRISHNAM.S.Ortho., MCh Ortho(U.K).,

Consultant Orthopaedic Surgeon,

Apollo Hospitals,

Hyderabad.

Appointments: Secretary : 09247258989 / 09441184590

08332936085

www.drmohankrishna.com

www.healthyjointclub.com

www.bonesandjointsclinic.com

Email: bonesandjointsclinic@gmail.com