Dr. Pawan Kamal
Dr. Pawan Kamal
The Hip joint is the largest weight bearing ball and socket joint between upper end of thigh bone (Femoral head) and the pelvic bone (Acetabulum). It is surrounded by thick layers of muscles, tendons and ligaments. Any damage to hip joint will lead to pain and limited ability to walk and weight bearing. Being a weight bearing joint Damage to hip joint can occur due to wear and tear, trauma, sports injuries, infections and some degenerative diseases. Hip pain is usually experienced in the groin area or it may be referred to knee joint without having groin pain at all. In Advanced cases you will have limitation in sitting cross leg squatting or even difficulty to sit on chair due to bony fixation of thigh bone with the pelvic bone. Your affected limb may appear shortened or lengthened on physical examination. After taking thorough history of your symptoms a clinical examination will be performed to find out the severity of pain, degrees of lost motion at hip joint. a. Various clinical test will be performed for quantification of deformities, limb length discrepancies if any. After this X-rays of hip joint will be done to see the status of hip joint. Sometimes an MRI or CT scan of hip is also needed to help in diagnosis and planing of your surgery.
Hip replacement is surgical procedure where the old damaged joint surfaces are removed and replaced with new artificial metal on metal or metal on plastic surfaces. Total Hip replacement can be done under regional ( where only your lower limbs are numb and you are awake) or General Anaesthesia ( where you are made to fall asleep till the surgery is complete ) one of these methods which is best for you will be decided by the Anaesthesiologist depending on your current health condition. You will be made to lie on operation table with the diseased hip upside. An incision will be given over the side of your upper thigh to expose the hip joint. The diseased part of the joint surface will be removed using saws and reaming instruments and a new joint will be created using the metal implants (femoral stem and head for thigh bone and acetabular shell and plastic liner for pelvic bone) in correct position. A metallic or ceramic ball and a plastic liner make the new bearing surface. Stem and shell can be fixed to your bone with or without cement depending upon the quality of your bone. Stability of the new joint is checked by moving your limb through full range of motion. Correction of Limb length is also checked. Once the surgeon is satisfied with the correct positioning and stability of hip joint the wound is washed with sterile fluid bleeding is controlled and incision is closed with or without a plastic tube left inside the joint to drain of excessive blood. A sterile bandage is applied over the incision and you are shifted to recovery room.