Total Hip Replacement surgery and its types by Dr. MS Narula

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Total Hip Replacement surgery and its types by Dr. MS Narula 

In this video, SimpliHealth expert,  Senior Consultant Orthopaedic Spine, and Joint Replacement Surgeon at Apollo Clinic and CHD city hospital Chandigarh, Dr. MS Narula is talking about total hip replacement and it’s types. 

This procedure is known as kulhe (the hip joint) replacement surgery in a more familiar language. It is unique and challenging because unlike knee replacement is a very common surgery; everyone is aware of it. But hip replacement surgery is slightly rare as compared to knee replacement. We see it more commonly in younger age groups than knee replacement. There are a few challenges to the longevity and efficiency of this procedure. 

So today, the doctor discusses some developments pertaining to this topic. Our hip joint is like a ball-socket joint. This socket is mobile in the joint and is comparatively a strong joint. It is also like the knee and ankle weight-bearing joint and is a central axis of our body weight. Some reasons leave us with a choice of hip replacement. As I told you, hip replacement surgery is less common in comparison to knee replacement, and it occurs more in younger age groups. That’s why we face a few challenges during this surgery. 

WHAT REASON COMPELS US TO GO FOR HIP REPLACEMENT SURGERY? 

Fracture in elderly people 

One reason is injury or trauma; more commonly, we see the aged 40-50 have fractures near the hip joint. Furthermore, we can’t construct the fractures with the aid of implants or screws, or after a particular age, we opt for hip replacement. Another thing is if we have any old pelvis or acetabulum fracture that we could not reconstruct appropriately and is causing trouble now. So trauma is one of the main reasons. It can be an old injury or a fresh injury. 

Wear and tear of the hip joint 

The second is the wear and tear of the hip joint, like the knee joint. This condition is called osteoarthritis, and it is one of the indications for hip joint replacement. Finally, at a younger age, we see avascular necrosis. In this condition, the ball of the ball-socket joint becomes dead for some reason; there is a complete loss of blood supply to this joint. 

Lifestyle choices 

Many factors contribute to this condition, like alcohol, smoking, and intake of steroids, and in 80-90 percent, it occurs without any reason. In the younger age group, in their mid 40-50 start feeling pain in their hip joint, and after diagnosis by X-Ray, we infer that there is a loss of blood supply to that joint. 

So when the joint is dead, we suggest hip replacement surgery. There can be other reasons like infection and some diseases like arthritis, but broadly these are the most common reasons to opt for hip replacement surgery. 

TYPES OF HIP REPLACEMENT SURGERY

Hip replacements are of two types: 

  • One type is a partial hip replacement or hemiarthroplasty, and 
  • Another type is a total hip replacement in which both ball and socket

As mentioned before it is ball and socket joint, so sometimes we only require to replace the ball, but it is scarce. Mostly we replace both the ball and socket joint. This type of replacement is called total hip replacement. This is how hip replacement in the younger population is done. 

Unlike previous replacements, which don’t stay for much time, only 10-15 years, the patient takes time to walk. But with the new advances, we make small incisions for surgery which is more commonly known as minimally invasive procedures. It is bloodless, painless surgery, and we make patients walk the next day after surgery. 

Different varieties 

There are different varieties in this, like whether it is replaced by cement or not. In younger age groups, we prefer uncemented replacement because it is comparatively more straightforward if we need to change it after 15-20 years. 

These days we insert big-sized balls in ball-socket joints, and there is a change in the quality of metal that we use these days to increase the life of the hip by 25-30 years. 

New advancements 

With the new advances, this surgery has become very successful, a minimally invasive, bloodless, painless procedure. A patient can resume their regular activity within one month to 45 days. Hip replacement surgery is a very successful surgery if done timely. One more myth that I want to clear regarding hip replacement surgery is that earlier, people used to think that after surgery, they couldn’t sit on the floor or cross their legs. 

New techniques and implants 

As the doctor mentioned, they do this in the younger population, and with the newer techniques and implants, one can do all their activities like sitting on the floor cross leg and can do other similar work. You won’t face any problems in nearly 25-30 years. And God forbid if we need to change it again, it can change quickly. 

Thank you

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