Q. How do I know if I need a hip replacement?
A. First your pain level must be sufficiently severe for you to seek a permanent surgical solution. Then the surgeon will perform a clinical examination to evaluate your condition. Finally x rays and other scans will be performed to assess the condition of the joint. Based on this the surgeon will inform you whether you need a hip replacement.
Q. Is there a bone preserving option if I don’t want to have a total hip replacement?
A. The short stem hip is a bone preserving implant. It is preferred in young patients who have advanced bone destruction, cavities or abnormal anatomy. In this procedure, more bone is saved than a total hip replacement. The chances of developing thigh pain are less than total hip replacement. I use Delta motion ceramic bearings with short stem and conventional total hip replacements.
Q. Can you provide brief guidelines about the healing process?
A. The skin incision takes two weeks to heal. The cut soft tissues take 6 to 8 weeks to heal. Since the acetabular component is uncemented, it takes 6 weeks to three months for bony fixation.
Q. What effect will this have on my activities?
A. There is a risk of dislocation in the early post operative period of 6 to 8 weeks. Hence you should not drive for this period. When getting in and out of a car, you should keep your leg straight and not cross the operated leg over the normal one.
Q. How long does the surgery take?
A. The operating time is about 2 – 3 hours. To this is added in anesthetic induction, positioning, prepping, draping and recovery times.
Q. Will I have lot of pain after the surgery?
A. With the systematic and comprehensive pain management protocol practiced by my anesthetist, you will not suffer much pain. This should allow a very quick recovery.
Q. When can I get into water to have a bath or shower?
A. You need to keep the wound dry for about two weeks till it heals. Then after the dressing comes off and staples or sutures are removed, you can have a shower. Till then you should manage with a sponge bath.
Q. Where will I have the surgery?
Q. What is the risk of blood clots developing in my leg and what precautions are used to minimize the risk?
A. We do take all precautions to reduce the chance of a blood clot forming. You will be taught exercises like calf pumps, tightening the buttocks and thighs before your surgery. You should start doing these soon after waking up or recovering from the anesthetic. You should do this for 5 minutes every hour for about twenty repetitions. The physio-therapist will mobilize you very early and get you on your feet when you can tolerate pain. This early mobilization goes a long way to cut down the risk. High risk patients are started on blood thinning agents (anti-coagulants) 6 hours after surgery. I also use pneumatic compression stockings and a mechanical foot pump in high risk cases.
Q. If I have to travel by air, will the metal set off a metal detector alarm at the airport?
A. Yes it usually does. However you can ask your doctor to document this during discharge from hospital.
Q. How long will I have to use crutches or walking aids?
A. This depends upon your ability and confidence to walk. Many people have discarded them within a week. Most people can manage without one by two to three weeks. Occasionally you may be asked to keep them for about six weeks.
Q. Will I be able to sleep on both sides?
A. You can sleep on both sides depending on your comfort level. Initially the operated side is sore for a few weeks.
Q. How long will my implant survive?
A. On the basis of present evidence hip resurfacing implants have a 95% chance of survival at 10 years. Despite the short follow up in comparison to total hip replacement, early results are good. Long term studies are awaited in the future. Survival depends on the wear rate of materials. Ceramic bearings can last for long periods.
Q. Post operative antibiotics.
A. When ever you need to have a dental, urological or gastrointestinal surgical procedure, you need to get antibiotic coverage to protect the prosthesis from infection.
Q. What is the cost of hip replacement?
A.The cost depends on the implant, room and individual case.