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Written By: Editorial Team | Updated : February 16, 2015 6:23 PM IST
If you suffer from osteoarthritis and have been advised to undergo a hip replacement surgery, making up your mind might have taken a while. Although there are newage treatment options like stemcell therapy, hip replacement surgery remains the mainstay of treatment for this condition, so much so that even a 94-year-old man has been reported to have undergone this surgery. But once you have decided to go through with it, the process of getting ready for the procedure coupled with the anxiety of major surgery can often lead to bad outcomes. So to help you get your thoughts together and ask the correct questions Dr Avinash Date, consultant Orthopedic surgeon, Seven Hills Hospital tells you about the eight most important questions you should ask your surgeon before the procedure.
Question 1: What is involved in a hip replacement surgery ?
A hip replacement surgery can be of many types. It can be half the hip replacement where only the femoral side (the front part of your hip) is replaced. This type of surgery is done in the case of fractures in old people.
A half hip replacement again has two types
Then there is a total hip replacement which is done for primary osteoarthritis or secondary osteoarthritis. Primary osteoarthritis is rare in India, but is rampant in other countries. In the case of secondary oseteoarthitis, the head of the thigh bone is destroyed since it does not get enough blood supply (avascular necrosis). In this case a total hip replacement is essential.
In the case of a hip replacement surgery the material used are extremely high grade and do not get affected by the body. These days there are different materials that can be including chromium cobalt metal, ceramic and ultra high density polyethylene.
Question #2: What should a patient necessarily tell his/her doctor?
The first and foremost thing every patient should remember is that things they may deem irrelevant may be of utmost importance to the doctor.
You must inform your doctor about any general allergies to medication, metals like nickel, plaster, sticky tapes and certain foods. Also it is essential that you tell him/her about any medication you are on, including Ayurvedic or homeopathic medication. Few of these can contain steroids and this can cause avascular necrosis of the femoral head.
Moreover, since the leading reason for degradation of the hip bone is secondary osteoarthritis; which has multiple causes including sickle cell anemia, steroid use for conditions like asthma, chronic alcoholism, history of having a fall etc. any of these conditions that you might suffer from must be informed to your doctor. These details play an essential role in deciding the method of treatment your doctor will give you.
Question #3: How painful is the recovery after the procedure?
With advances in medicine, pain is well taken care of after any surgery. Usually for hip replacement surgeries an epidural catheter (small tube placed near spinal cord) is placed and you will be administered pain killers constantly. Alternatively there are analgesic patches that are used for pain control.
Question #4: How much time will recovery take after hip replacement surgery?
You will usually be advised to move only in bed for first 1 or 2 days. You will be able to walk, with the help of walker, from the third day onwards. Stitches or staples are removed after 2 weeks. You may commence walking without any help after about four to five weeks. In six weeks you can go back to driving a car.
Question #5: What are the chances of complications in this kind of surgery?
There is 5 per cent possibility of complication which includes thromboembolic complications (where a clot develops in the vein which is called deep vein thrombosis), chances of dislocation of the hip, 0.5 per cent chance of contracting an infection, neuro-vascular complications, difference in the length of the limbs and long term complication of loosening of the prosthesis which might require another surgery. While a doctor does take care to avoid these complications, it is important to know that these things can happen.
Question #6: How much time am I likely to be bed ridden?
You will be bedridden for a day or two. It usually does not take more time than that, unless there is some sort for complication.
Question #7: What other things could possibly go wrong during the surgery?
Cementing is a very important step of the surgery and cement has to be pressurized at the time of putting the implant in. In some cases the monomer component of the cement gets into the blood during this procedure and can cause drop in blood pressure. This is taken care of using different drugs by the anaesthetist who plays a crucial role in maintaining your vital parameters. Apart from that there is no other measures that might have to be taken.
Question #8: How long will the replaced part last?
Metal, ceramic and plastic parts can easily last for about 20 years or more. That being said the amount of time it lasts depends on the reason for the replacement, the amount of walking or moving around you do and how active you are.
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