HIP REPLACEMENT SURGEON IN INDORE WHAT IS HIP REPLACEMENT SURGERY? Hip replacement surgery, also known as hip arthroplasty, is a surgical procedure in which a damaged or worn-out hip joint is removed and replaced with an artificial joint (prosthesis) made of metal, ceramic, or plastic. This is usually done to relieve severe pain, stiffness, and loss of mobility caused by conditions like osteoarthritis, rheumatoid arthritis, fractures, or avascular necrosis. The surgeon replaces the ball-and-socket parts of the hip joint: the head of the femur (thigh bone) and the hip socket (acetabulum). Hip replacement helps restore normal movement, reduce or eliminate pain, and significantly improve quality of life when other treatments like medication, physiotherapy, or lifestyle changes no longer work. MAIN CAUSES OF HIP REPLACEMENT 1. Osteoarthritis The most common reason. Caused by age-related wear and tear of the hip joint cartilage.Leads to pain, stiffness, and reduced mobility. 2. Rheumatoid Arthritis An autoimmune disease that causes chronic inflammation of the joints. It Destroys cartilage and bone, leading to severe joint damage and deformity. 3. Hip Fractures This is Especially common in older adults after falls. If the bone can't be repaired properly, hip replacement is often needed. 4. Avascular Necrosis (AVN) It Occurs when the blood supply to the hip bone is reduced, causing the bone to die and collapse. It Can be due to steroid use, alcohol abuse, trauma, or certain medical conditions. 5. Childhood Hip Diseases (e.g., Developmental Dysplasia, Perthes' disease) Improper hip development can cause long-term joint problems. These conditions may eventually lead to early joint damage and arthritis, requiring replacement in adulthood. TYPES OF HIP REPLACEMENT SURGERY 1. Total Hip Replacement (THR) – Most Common Both the ball (femoral head) and the socket (acetabulum) are replaced with artificial components. 2. Partial Hip Replacement (Hemiarthroplasty) In this surgery Only the femoral head (ball) is replaced and the socket is left as it is. 3. Hip Resurfacing In this surgery The femoral head is not removed, but instead it is reshaped and capped with a metal cover. The socket may still be replaced. 4. Revision Hip Replacement A repeat surgery is done when a previous hip replacement has failed or worn out. This is More complex and may involve replacing only part or maybe all components. It is Needed due to implant loosening, infection, fracture, or wear. WHO NEEDS HIP REPLACEMENT Hip replacement surgery is recommended for people who have severe hip joint damage that causes chronic pain, stiffness, and difficulty in movement, and does not improve with medicines. Who needs it : 1.People with Advanced Osteoarthritis 2.Patients with Rheumatoid Arthritis 3.Individuals with Avascular Necrosis (AVN) 4.People with Hip Fractures (Especially Elderly) 5.Those with Childhood Hip Disorders. Common signs that you may need hip replacement surgery : 1.Constant hip pain, even while resting 2.Stiffness and limited range of motion 3.Limping or difficulty standing/walking 4.No improvement with physiotherapy, medication, or injections. HOW IS HIP REPLACEMENT DONE? Hip replacement surgery is a procedure where a damaged hip joint is replaced with an artificial implant to relieve pain and restore movement. It usually takes 1.5 to 2 hours and is done under spinal or general anesthesia. How is it done? 1.Anesthesia The patient is given spinal anesthesia (numbs the body below the waist) or general anesthesia (makes you sleep during surgery). Sometimes a combination is used. 2. Incision A cut is made over the side, front, or back of the hip, depending on the approach used. Traditional approach: larger incision (20–30 cm) Minimally invasive: smaller incision (8–15 cm) 3. Removing the Damaged Bone The femoral head (ball part of the hip joint) is removed. The damaged cartilage and bone from the socket (acetabulum) are also cleaned out. 4. Inserting the Artificial Implants A metal or ceramic cup is placed into the hip socket. A metal stem is inserted into the thigh bone (femur), and a ball (metal or ceramic) is attached to the top. These parts together form the new artificial hip joint. 5. Fixing the Implants Implants may be cemented into place (common in older adults) or left uncemented, allowing bone to grow onto them Sometimes a combination of both methods is used. 6. Closing the Incision Muscles and tissues are repaired, and the skin is stitched or stapled. For more details on total hip replacement/ DAA total hip replacement, please visit our dedicated website for hip joint issues created by Dr Vikas jain- www.hipreplacementindia.in https://hipreplacementindia.in/treatment/bikini-hip-replacement/

Anterior Total hip replacement - A hip replacement surgery with Zero precautions. A hip replacement which can get you back to a completely pain-free life with normal walking. The biggest problem with old techniques of hip replacement are 1. 4 percent patients have high chances of hip dislocation (hip ball coming out & where resurgery is needed to fix). In order to prevent it, patients are adviced multiple precautions & restrictions sometimes for lifetime. 2. The other major problem is unequal length of legs after hip replacement. Leading to permanent abnormal walking & limp. With Anterior total hip replacement both the above issues can be easily managed. With Direct Anterior(surgery from front) Total Hip replacement, patients have the following advantages- 1. Both legs will be completely equal in length- since pt is positioned straight on table & comparison with computerized arm while operating making comparison to the opposite leg easier helping in getting completely equal legs. In other technique like posterior or anterolateral since patient is placed on side, legs end up being unequal since comparison is not possible with opposite leg at all. Even imaging is not possible. 2. Minimal muscle pain due to minimally invasive -mis technique. The entire surgery is performed with an incision of around 10 cms & zero muscle damage. 3. Zero precautions after surgery leading to stress free life. . Patients can sit on floor/use Indian Toilets without worrying about chances of hip dislocation. In older techniques patients are told to follow precautions for atleast 3 months & sometimes even lifetime. 4. No restriction in Sexual activities. 5. Patients have quick recovery due to less pain & can even walk without walker with full weight bearing within 1-2 days. With older techniques, patients still have to use walker or wait upto 1.5 months to put weight & walk. 6. A small 10 cm line incision which gets hidden in groin crease & becomes just like a thin pencil mark in 2-3 months. With Direct Anterior Total Hip replacement, pts can even get Both total hip replacements performed in a single sitting. Even the choice of implants cemented or uncemented & can be dual mobility, ceramic on ceramic , ceramic on poly or metal on poly as per patients preference. Anterolateral & Posterior hip replacement - Both are older techniques of total hip replacements where patients are adviced multiple precautions after surgery. Older techniques posterior/anterolateral (incision of surgery from back- posterior & surgery from side - anterolateral) total hip replacements have limitations such as patients are adviced not to sit on floor or do any activity on ground because of risk of hip ball dislocation & even where patients end up having unequal leg lengths after surgery. Multiple research papers have proven Direct Anterior Hip replacement has significant advantages. In The US, Hip replacement by Direct Anterior technique is preferred by most of the patients due to its significant advantages. Though Direct Anterior Hip replacement technique has excellent advantages, it can be performed in obese patients with weight more than 130 kgs only after proper assessment. We regularly have patients visiting from various parts of the country for Total Hip replacement with Direct Anterior Technique be it cases of hip avn, ankylosing spondylitis or post traumatic hip failure. We have numerous patients from all over the country visiting our centre in Indore & Mumbai who have been suffering from Hip issues & have undergone Total Hip Joint Replacement by Direct Anterior technique. For your benefit, please see the explanation & results regarding anterior hip replacement on our YouTube page- TheJointSurgeon https://youtube.com/@TJSJoints https://youtu.be/mC-Sd52dxsw https://youtu.be/jAKbalLIL4A https://youtu.be/Y3cyQRl5v_U If you are suffering from hip joint issues & need a hip replacement, Anterior Total Hip replacement is the best technique for you to be pain free & walk completely normally. We can help you. For more details or appointment please feel free to contact us. +91 7760547341

INTRODUCTION This means that part or all of your previous hip replacement needs to be revised. This operation varies from very minor adjustments to massive operations replacing significant amounts of bone and hence is difficult to describe in full. Total Hip Replacement (THR) procedure replaces all or part of the hip joint with an artificial device (prosthesis) with a plastic liner in between to restore joint movement Why does a hip need to be revised? Pain is the primary reason for revision. Usually the cause is clear but not always. • Plastic (polyethylene) wear : This is one of the simpler revisions where only the plastic insert is changed. • Dislocation (instability) : means the hip is popping out of place. Repositioning of the implants has to be planned. • Loosening of either the femoral or acetabular component: This usually presents as pain but may be asymptomatic. For this reason, you must have your joint followed up for life as there can be changes on X-ray that indicate that the hip should be revised despite having no symptoms. • Infection usually presents as pain but may present as an acute fever or a general feeling of unwell. Such revisions may be performed in a single or two stages to prevent recurrence of infection. • Osteolysis (bone loss): This can occur due to particles being released into the hip joint that result in bone being destroyed. • Pain from hardware e.g. cables or wires causing irritation. Such procedures are amongst simpler revisions where patients can expect excellent results. PRE-OPERATIVE PHASE • Your surgeon will send you for routine blood tests to rule out infection, CT scan to look closer at the anatomy, and bone scans to help to determine if a component is loose. • X-rays and/or MRI will be considered. • Aspiration of the hip joint is occasionally done to diagnose or rule out infection • Patient will be asked to undertake a general medical check-up with a physician • Patient should have any other medical, surgical or dental problems attended to prior to the surgery in order to prevent a risk of infection. • Cease aspirin or anti-inflammatory medications 10 days prior to surgery as they can cause bleeding. • Any antiplatelet drugs / blood thinners such as clopidogrel, warfarin will be stopped 3-7 days prior to the date of surgery. • Surgical consent will be explained to the patient detailing the procedure as well as the risks involved, if any. • Blood transfusion, if required will be informed and done. Day of surgery • You will meet the nurses and answer some questions for the hospital records • You will meet your anesthetist, who will ask you a few questions and assess the risk factors for surgery. • You will be given hospital clothes to change into and have a shower prior to surgery • The operation site will be shaved and cleaned • Approximately 45 minutes prior to surgery, you will be transferred to the operating room • After explanation of the procedure, you will be asked to sign the consent for surgery. Occasionally, a high risk consent for surgery may be requested depending on the blood reports and clinical examination. SUGRICAL PROCEDURE Hip Revision will be explained to you prior to surgery including what is likely to be done. The surgery is often, but not always, more extensive than your previous surgery and the complications similar but more frequent than the first operation. It is difficult describing the steps of the procedure as each revision procedure is different based on the indication of surgery. Depending on the indication, the surgery varies from a simple liner exchange to changing one or all of the components and the operating surgeon will plan extensively regarding the planned procedure as well as certain associated complications which are often acknowledged during the complicated surgery. In certain cases bone graft may need to be used to make up for any bone loss. POST-OPERATIVE MANAGEMENT • You will wake up in the recovery room with a number of monitors to record your vitals. (Blood pressure, Pulse, Oxygen saturation, temperature, etc.) You will have a dressing on your hip and drain coming out of your wound. • Post-operative X-rays will be performed in recovery. • Once you are stable and awake you will be taken back to the ward. • You will have one or two IV’s in your arm for fluid and pain relief. • On the day following surgery, if inserted, your drains will usually be removed and you will be allowed to sit out of bed or walk depending on your surgeon’s preference. • Pain is normal but if you are having extreme pain inform your nurse. IV antibiotics as well as pain medications will be continued ranging from 1 to 4 days. • You will be able to put all your weight on your hip and your physical therapist will help you with the post-op hip exercises. • You will also be trained by the physical therapist regarding ascending/ descending the stairs as well as toilet training. • You will be discharged home or to a rehabilitation hospital approximately 3-5 days after surgery depending on your pain and help at home. • First dressing will be done on day 3-5, followed by suture/staples removal on 10-14th post-operative day. • A post-operative visit will be arranged prior to your discharge. You will be instructed to walk with crutches for two weeks following surgery and cane from then on until 6 weeks post-op. Special Precautions Remember this is an artificial hip and must be treated with care. AVOID THE COMBINED MOVEMENT OF BENDING YOUR HIP AND TURNING YOUR FOOT IN. This can cause DISLOCATION. Other precautions to avoid dislocation are • You should sleep with a pillow between your legs for 6 weeks. Avoid crossing your legs and bending your hip beyond right angle. • Avoid low chairs. • Avoid bending over to pick things. • Slippers are helpful. • Elevated toilet seats are helpful. • You may shower once the wound has healed. • You can apply Vitamin E or moisturizing cream into the wound once the wound has healed. • If you have increasing redness or swelling in the wound or temperatures over 100.5 degrees you should call your doctor. • If you are having any procedures such as dental work or any other surgery you should take antibiotics before and after to prevent infection in your new prosthesis. Consult your surgeon for details. A Revision Hip replacement is a complex procedure and requires a highly skilled surgeon with adequate expertise. Our Consultant in chief, Dr Vikas Jain is one of the few surgeons in the region who is trained from Europe and has adequate surgical experience in such complex revision procedures.