Total Hip Replacement

Total Hip Replacement surgery

What is Total Hip Replacement Surgery?

This operation involves removing the arthritic part of the hip joint and replacing it with a socket and then replacing the ball joint with an artificial part which anchors in the thigh bone. The articulation between those is important and Mr Mahaluxmivala commonly uses a ceramic ball bearing surface which may be more expensive but is used when indicated.

What Are The Causes For Hip Replacement?

  • Osteoarthritis of the hip.
  • Patients who have had injuries to their hip in the past or undergone surgery for fractures previously to the hip joint and the residual sequel of that is now severe osteoarthritis of the hip or collapse of the fracture.
  • Other reasons for performing hip replacements are old conditions like dislocated hips when born, perthes disease, slipped capital femoral epiphysis and avascular necrosis. It is important to note that these conditions themselves are not the reason for doing a hip replacement. However these conditions lead to severe osteoarthritis of the hip at some stage and that leads to the need for a hip replacement.

Symptoms

  • Hip joint pain.
  • It is very important to ascertain that the pain is truly coming from the hip joint and is not referred pain from the back.
  • Pain in the region of the groin or complain of pain on the inner aspect or front of the thigh going all the way to the knee. Sometimes the patient presents with only knee pain however on examination and x-rays, the main cause is referred pain from the arthritic hip.
  • The pain can also be in the buttock but what differentiates it from sciatica is that hip pain does not normally travel below the knee and hip pain is not normally associated with pins and needles down the back of the thigh and leg.
  • The pain may be worse on getting up from a sitting position and going up or coming down stairs. The patient may complain that stairs are negotiated one at a time. In extreme cases patients may say they have to go up “on all fours”.
  • Complain of locking or catching within the groin and hip area and that the hip “gives way or collapses” under them.
  • The pain is typically worse on activity, but may be present at rest as well.
  • The classical symptoms of severe hip arthritis are difficulty in cutting toe nails and getting in and out of a bath and car.
  • All the above factors are vital in ensuring the correct patient is chosen to have a hip replacement for a successful outcome. If not and surgery is offered and performed for wrong or incorrect reasons the success is limited. Hence every patient has to have a complete history of complaints and duration, with a thorough examination of the knee, hip and back.

Diagnosis

  • Diagnosis is made from medical history and full examination.
  • It is confirmed by an x-ray of the hip which includes two specialised views.

Treatment

The surgery involves removing the arthritic part of the hip joint and replacing it with a socket and then replacing the ball joint with an artificial part which anchors in the thigh bone. The articulation between those is important and Mr Mahaluxmivala commonly uses a ceramic ball bearing surface.