Know the reasons, types, precautions and tips associated with hip replacement surgery
Hip replacement or medically known as arthroplasty, is a surgical procedure done to re-align, reshape the bony contours of the hip joint to correct the deformity of the joint. The hip replacement surgery is becoming as prevalent these days as the knee replacements, the most common reason being sedentary lifestyles and less of active exercising.
Indications of hip replacement
While some people may settle down with hip pain over a period of time without any surgical interventions, some people may adopt surgical methods to ensure a more active life and quick relief of pain especially the elderly. However, there are certain signs a surgeon will look for, before a hip surgery is advised. These are:
- Failure of conservative treatments like medications and other therapies
- Limited movement and gross instability of the joint
- Severe hip pain with restriction of daily activities
- Extensive destruction of the joint surfaces, eg: osteoarthritis of hip or rheumatoid arthritis.
- Visible deformity like slanting of legs, limping etc.
- Failure of previous surgical methods.
Traditional hip surgeries versus metal hip replacement
As age progresses, the bony surfaces of thigh bone and hip bone rub against each other and produce friction. This results in continuous damage within the joint and hence a need for surgery. Traditional surgery was ‘excision arthroplasty’ where one or both the bony ends were excised and shaped so that a gap is created between them which is filled by fibrous tissue. This was a minor procedure but served the purpose by ensuring an improved movement to the joint.
The metal hip replacement surgery is of two types:
- Partial hip replacement – Only one of the bony ends is removed and replaced by an artificial metal prosthesis.
- Total hip replacement – Both the bony ends are removed and replaced by prosthesis.
An exception being the cases of elderly patients, the total hip replacement surgery is done using cement to provide more stability to the joint.
Role of physiotherapy in total hip replacement
It is extremely important to start the physical therapy immediately after the replacement as the muscles become already weak after the surgical procedure. A good session of exercises including the isometrics, the weight bearing ones and training to walk along with practicing stair climbing will generate confidence in the patient and early mobilization out of the bed.
The Dos and Dont’s after hip replacement
Always lie down with legs apart, use a high toilet seat, wear stockinet for 6 weeks and exercise regularly. Avoid lying down on the operated site, never sit crossed leg or sit on stuffy sofas etc, no twisting or turning of hip or knee and never use an Indian style toilet.
Adopting simple techniques to protect your joint will not only reduce the pain but also exert less pressure on the joint surfaces. They are:
- Respect your pain.
- Balance between work and rest.
- Avoid awkward positions and staying in one position for too long.
- Keep shifting body weight from one leg to other.
- Simplify your work and do not lift heavy weights.
- Use self care aids (walker, stick etc.)
- Ensure proper safety of own self.
- Modify the occupation which demands more stress on the joint.
- Derive self motivation and improve social participation.