Birmingham Hip resurfacing – American patient story

American patient talks about his high value medical treatment in India. He received a Birmingham hip by Dr.Venkatachalam for a very affordable cost in Chennai, India.

Sufferin from hip pain? Hip resurfacing a solution

People dread getting old. If you are Caucasian and approaching your forties, you may have already noticed that some of the things you did as a teenager aren’t that easy anymore. As a general rule, if you take care of yourself when you are young, getting old will be easier. Joint pains develop and progress to restrict your life style and stop you enjoying outdoor activities.

A lot of people will have to face as a part of the aging process one of those things is hip replacements for hip pain.

According to The National Institue of Arthritis and Musculoskeletal and Skin Diseases there are over 193000 hip replacements performed in the U.S. each year. In the UK, the numbers are about 5, 00000 per year.

Hip resurfacing operation

Hip resurfacing operation

Hip arthritis – Types & solutions

Hip arthritis is of two types. Young and middle aged persons suffer from secondary osteoarthritis. Primary osteoarthritis can affect middle aged and elderly. Surgery in this group of relatively younger patients requires newer techniques like hip resurfacing.

Hip Resurfacing is the preferred option in young & middle aged males with primary

Types of Hip arthritis

Hip arthritis is classified as Primary and secondary Osteoarthritis.

Primary osteoarthritis is age related wear and tear arthritis. It is rare in India.

Secondary osteoarthritis occurs at a younger age and is more common. Rheumatoid arthritis, avascular necrosis, traumatic arthritis and other connective tissue disorders like SLE, Psoriasis etc. all lead to secondary osteoarthritis.

Rheumatoid arthritis is an auto immune disorder, affects all joints particularly the small joints but also does not spare the hip and knees.

Avascular necrosis is a condition that reduces the blood supply to the end of the bone. It affects patients with excess alcohol intake, consuming steroids, connective tissue disorders like SLE. Systemic lupus erythematosus (SLE) is a connective tissue disorder affecting mainly young women A photo sensitive rash on the cheeks, renal involvement and arthritis are some notable features. Avascular necrosis affects a proportion of the patients with SLE.

Gaucher’s disease is a rare genetic storage disorder.

Post traumatic arthritis occurs after a severe injury to the hip. Fractures of the ball (top of the femur) or socket (acetabulum) can lead to arthritis after inadequate treatment.

Hip arthritis is very disabling as it is a small ball and socket joint. In advanced disease a total hip replacement was recommended by Orthopaedic surgeons until recently. The ideal age for a hip replacement is 74 years.

Surgical solutions

are the mainstay of treatment as conservative measures fail to relieve pain. Total Hip replacement (THR) is a time tested operation and has a success rate of 93 % survivor ship at 10 years.

Who needs a hip resurfacing?

In India, many young patients with ankylosing spondylitis, avascular necrosis, post septic arthritis, post injury suffer from hip arthritis and are advised a hip replacement for disabling pain. Thus many hip replacement operations are performed in younger patients. The surgery should cater to the enhanced demands on an artificial joint by younger and more active patients. Naturally an operation designed for Western elderly patients is not suitable for younger patients.

Hip resurfacing vs replacement

Hip Resurfacing vs Hip Replacement

In this operation the ball shaped upper end of the thigh bone (femur) and the socket (acetabulum) are replaced. The ball is replaced with a long metal stem that is fixed into the upper end if the thigh bone. Its upper spherical end articulates with a cup shaped polyethylene socket that is cemented into the pelvis.

Conventional hip replacements sacrifice a great deal of normal bone as the head, neck, and upper part of the thigh bone is removed for implantation of the prosthesis. Moreover wear debris from the poly-etheylene liner lead to osteolysis and bone loss. When this first hip is to be changed or revised after its lifespan more bone loss occurs. Conventional hips have a small ball to reduce friction and wear, but the ill effect of this is an increased risk of dislocation. An average dislocation rate of 3- 4 % has been reported. These implants do not last very longer than 20 years and revision rates of 50% at 20 years have been reported. Survival rates are less satisfactory for the relatively younger active patients. Thus a total hip replacement is not an ideal implant for younger patients less than fifty years old who need a new hip.

Problems with conventional total hip replacement:

  • Excessive bone sacrifice and loss
  • Increased risk of dislocation
  • Patients cannot squat or sit cross legged on the floor with out the risk of dislocation.
  • Range of movement is less
  • Patients cannot involve in sports
  • Poor survival in young and active patients they require earlier revision.
  • Revision surgery is difficult
  • The hip feels less like a normal hip
  • The cup wears with time and plastic from it harms bone
  • Change in length of the leg after surgery leading to leg length discrepancy.

Why remove normal bone when only the surface of the ball is bad?

This is the logic behind hip resurfacings. This bone preserving hip resurfacing involves replacing only the diseased bony surfaces of the head of femur and acetabulum. This involves sculpting the head of the femur and covering it with a metal cap and fixing an uncemented socket into the acetabulum to receive the head.

Hip Resurfacing- A bone preserving hip replacement!

Preservation of bone and less stress shielding makes it easy to revise this hip if needed. The large head size provides a very stable joint and recreates the sensation of a normal hip joint. Patients have gone back to playing Judo and Squash after this operation. Advances metallurgy makes the metal on metal articulation likely to survive longer in the young and active patient. With less metal inside the bone and less invasion of the medullary cavity of the femur, the risk of infection is reduced. Rehabilitation is faster and better.

Advantages of hip resurfacing:

  • Allows the patient to squat and sit cross legged on the floor safely
  • Allows a normal range of movement
  • Sacrifices only the surface diseased bone and preserves normal bone
  • Imparts a more normal sensation
  • The joint is likely to last longer even in younger and active patients.
  • Earlier and faster rehabilitation
  • Less risk of dislocation
  • Easier to revise if needed.
  • No leg length discrepancy.

In summary a Hip Resurfacing offers several advantages in young patients in young patients.

British patient’s Hip resurfacing with Dr.Venkatachalam

British Hip Resurfacing patient

A British gentleman underwent a hip resurfacing with Dr.A.K. Venkatachalam. He chose this surgeon for his expertise and affordability.

A 56 year old British gentleman Mr.Chris Browne, settled in Greece underwent a hip resurfacing in a Chennai private hospital. The operation was performed by Orthopaedic surgeon Dr.A.K.Venkatachalam. Mr.Browne learnt about Dr.A.K.Venkatachalam after his name was recommended by former patients in England and Greece. He chose India for his surgery rather than Britain for the reasons of high quality service and competitive cost. The surgery was performed in a state of the art operation theatre in a private hospital. Two days later the patient is thrilled by the surgery is totally pain free and has already started walking.

Hip resurfacing is the preferred operation for Hip arthritis in young and middle aged patients. It conserves bone and conversion to a total hip replacement is possible at a later date when this prosthesis wears out. A full range of movement is possible without any risk of dislocation.

Mr. Browne reckons that he wore out his hip through sports. Chris is eager to return to jogging, Yoga and Bungee jumping.

Medical treatment in India continues to attract patients even in the face of the world wide recession. Some Indian surgeons like Dr.A.K.Venkatachalam, offer high quality recent advances in surgery. Indian hospitals are also geared up to treat the discerning overseas patients with fantastic infra structure, top class service. Costs of treatment in India are the cheapest amongst world wide medical tourism destinations. Some Indian surgeons possess qualifications and skills acquired abroad in the UK and USA. Doctors and staff speak excellent English. Any Western patient can expect to get 60- 80 percent savings on a most advanced hip resurfacing. A Hip resurfacing procedure that costs about 50000 USD in the US costs only 8000 USD for a one week stay. A Total knee replacement is also available for 8000- 10,000 US dollars. Some of the latest advances like the Oxinium knee are available.

Hip resurfacing in India


new-6Young Omani patient underwent hip resurfacing. Pain from post traumatic hip arthritis was the indication.