Total Hip Replacement Surgery

A short and descriptive presentation on total hip replacement surgery. This presentation gives brief idea about the causes of arthritis of hip and its management. This presentation also provides information on total hip replacement procedure.

	Dr. A. Mohan Krishna, M.S. Ortho, MCh Orth(UK) is currently a consultant orthopedic surgeon at Apollo Hospitals, Jubilee Hills. He is part of the orthopedic team and he specializes in fracture management, arthroscopy, primary hip and knee arthroplasties, and paediatric orthopedics. He has presented papers in the orthopedic specialty.
Presentation used with permission from Dr. A. Mohan Krishna.

Presentation Transcript

1. TOTAL HIP REPLACEMENT
2. 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
3. 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
4. What causes it? Osteoarthritis Rheumatoid arthritis Worn-out cartilage Injury to the joint Avascular Necrosis Infections
5. 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
6. Diagnosis is made on X-ray of the Hip joint, Decrease in the joint space, Irregular and rough surface
7. Weight Reduction Pain Killers Tablets/ local gels Nutritional Supplements Glucosamine Physiotherapy Hip exercises, Injections Steroids/ lubricant, Key hole surgery TOTAL HIP REPLACEMENT CEMENTED / UNCEMENTED
8. 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
9. 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.
10. 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; Walking, Climbing stairs & Vehicle 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
11. 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
12. 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.
13. 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.
14. SURGICAL STEPS WOUND CLOSURE AFTER SURGERY
15. UNCEMENTED TOTAL HIP REPLACEMENT
16. CEMENTED TOTAL HIP REPLACEMENT RIGHT
17. Day 1: Exercises may be able to go home within 3 to 5 days after the operation
18. 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
19. Frequent deep breathing1 Pull your toes towards you and point away. 2 Circle your feet in both directions 3 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
20. 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
21. Raise and support your operated leg on a stool Do walk short distances initially As you get stronger increase the distance of walking
22. Neurological risks In previous neurological problems, Cardiac risks (elderly with uncontrolled blood pressures, Anaesthetic risks Infection of joints 2- 3% hip stiffness Clots in legs & lungs Damage to nerves & blood vessels Risks of TOTAL HIP REPLACEMENT
23. 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
24. CONTACT Dr.A.MOHAN KRISHNA M.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