More About Bilateral Hip Replacement Surgery

Types of  Bilateral Hip replacement

• Simultaneous bilateral Hip replacement -When both the knees are replaced at same time in one surgery  its known as simultaneous bilateral  knee replacement ,

• Staged bilateral Hip replacement  - in this  both knees are replaced at different time interval it is called staged bilateral knee replacement.

• Hip resurfacing- Resurfacing the original socket and the ball of the  thigh bone. This type of surgery  has a lower risk of dislocation and the patient  may be able to return to a higher level of physical activity

• Minimally invasive total hip replacement – minimizes the soft tissue damage leading to shorter recovery time , less chances of post operative complications .

Diagnosis for Hip Replacement surgery :

• Osteoarthritis, is a degenerative joint  disease also known as wear and tear arthritis wherein the normal smooth surface of bone wears off resulting in bone to bone contact producing pain .

• Rheumatoid arthritis is an autoimmune disease, in which the synovial membrane becomes inflamed. This membrane then produces excessive synovial fluid, damaging the articular cartilage.

• Trauma - serious hip injury or fracture leading to damage of articular cartilage

• Necrosis - If there is inadequate blood supply to the ball portion of the hip joint, the bone may collapse and deform.

• Developmental dysplasia, congenital dislocation of hip 

Tests before Hip Replacement Surgery

• Medical history present and past  – to know about the extent and duration of  pain , past injury , surgeries performed if any

• Physical examination done to understand the motion , stability of the joint

• X rays and MRI to determine the extent of damage, condition of bones and soft tissue .

Symptoms for Hip Replacement

In spite of taking medication , physical therapy and other conservative methods

• Debilitating pain persists

• Limiting mobility

• Interferes with routine activities

• Makes it difficult to rise from a seated position 

Procedure for Hip Replacement 

Before surgery

• Preoperative evaluation to declare you fit for surgery which includes present past medical history , complete blood count , urine analysis , clotting factor testing , ECG ,

• X-ray and MRI scans to understand disease condition and choose treatment option .

• The doctor will also check your regular  medication and even stop few medications  before surgery .

During Surgery

• Surgery involves  Replacement  of femoral head and acetabulum with artificial component or prosthesis .

• The procedure can take up to 3-4 hours, Surgery performed under General / Spinal anaesthesia

• Skin incision is made  over hip ,surgeon  carefully separates muscles and ligament to access hip joint

• Next step surgeon  dislocates  the joint and removes  the femoral head from acetabulum.

• Damaged cartilage within acetabulum removed and discarded, Inner hollow surface of acetabulum  is reshaped for acetabular metal prosthesis  which is secured with special cement or screws .

• Femoral head is replaced with metal stent which consists of distal ball like structure and stem of metal shaft .

• The new ball part of the thighbone is then inserted into the socket part of the hip

• Once acetabular and femur component are in place , they are checked to see the movement and stability of hip joint , X ray done to verify if joint is properly positioned or not

• Subcutaneous tissue closed with staples

• Cast put for about 2 weeks

After surgery

• Transferred to recovery area and kept in observation

• Antibiotics and pain killer medicine will be administered .

• Patient will have to stay in the hospital for 6-8 days. Stitches or staples will be removed approximately 2 weeks after surgery. Patient will be able to resume his normal daily activities within 3 to 6 weeks following surgery.

• Physical therapy: within the first six weeks is very important. This is important to help strengthen  the hip joint .

Complications of Hip Replacement Surgery :

Hip replacement surgery like any other surgery carries a risk of complications

• Infection (Redness, swelling, bleeding, or other drainage from the incision site )

• Blood clots

• Nerve damage -Numbness and/or tingling in the affected leg

• A limp, or problem while walking, Grinding or clunking from the hip

• Unequal leg lengths

Factors Affecting the Cost of Hip Replacement Surgery

Following are the factors which will affect the treatment cost: 

1. The hospital patient is opting for.

2. Room –Standard single room, deluxe room, super deluxe room for the number of nights specified (including nursing fee, meals, room rate, and room service).

3. Operating room, ICU

4. Fee for the team of doctors (Surgeons ,Anesthesist ,Physiotherapist ,Dietician )

5. Medicines

6. Physiotherapy session 

7. Standard test and diagnostic procedures

8. Depend on the treatment options : 

• Type of Surgery staged /simultaneous bilateral

• Implant being used