Today's patient is more mobile, informed, and demanding. Active lifestyles lead patients to search for physicians with solutions that are on the cutting edge and can provide freedom from pain and rapid recovery from surgery.
The past: Minimally invasive surgery was developed to help patients recover from surgical procedures faster, with less tissue disruption, less pain, and improved cosmesis.
The present: Minimally invasive surgery has become a new standard in cardiovascular, neurological, spinal, arthroscopic, and general surgery.
The future: Minimally invasive techniques will set a new standard of patient care for orthopaedic surgery.
There is a new total hip replacement procedure intended to help make it possible for those suffering from hip arthritis to regain some of their lifestyle. The Mini-incision Total Hip Replacement utilizes an incision 75-100mm in length-approximately one third the length of a traditional incision, which is generally 200-250mm in length.
Total hip replacement surgery involves removing the damaged portion of the hip and replacing it with an artificial implant called a prosthesis.
This device is a substitute for, or a supplement to the natural joint, allowing for smooth and frictionless movement.
With the Mini-incision Hip Replacement, surgeons use a metal and plastic prosthesis, implanted without cement, to replace the arthritic hip. While individual results can vary, the goal of this procedure is for patients to experience less postoperative pain, a faster recovery period, and a shorter hospital stay. Patients may be able to return to their daily lives within 4-6 weeks, as opposed to the 3-4 month recovery period that is common for a traditional hip surgery
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TYPES OF HIP REPLACEMENT
In hip joint replacement surgery, the hip socket is fitted with Ultra highmolecular weight high-density polyethylene cup, and the head of femur (thighbone) is replaced with a metallic ball. This joint functions efficiently as a normal joint, giving the patient stability as well as mobility.
According to how these parts are fixed to the bone, hip joint replacement is classified as :
Cemented:
In this design, the parts are fitted to the patient bone with a substance called bone cement. The correct name for it is Poly Methyl Methacrylate. This design is still more commonly used.
Non cemented:
In this design, the parts are pressfit in the prepared bone and the bone is expected to grow in the fine crevices of the implant. This design is mainly used for younger individuals.
PAIN RELIF DURING & AFTER OPERATION
Most of us are afraid of surgery, because we associate surgery with intense pain. Hence it is natural for you to know the intensity of pain after the surgery.
Generally for hip replacement surgery Epidural anesthesia is preferred. This is continued for pain relief in the days following surgery.
Due to this advanced technique, the pain after the surgery is much reduced. Hence you do not require to take strong pain relieving medication.
Epidural anesthesia is a technique in which a very thin plastic tube is inserted in your back. Through this tube the anaesthetic agents are injected during Surgery. After the surgery, this tube is connected to a computerized infusion pump, which controls the dose of medication given to you for relief of pain. The concerned anesthetist will take the care of this equipment.
The advantages of Epidural anesthesia are: -
It is safe for the elderly and those who have diabetes, high blood pressure, heart and lung ailment.
The patient is awake during surgery if he/she so desires or can be sedated if required.
Oral feeds can be started within 3 hours of surgery
This anesthesia is converted to mild dose to control pain after surgery. This is continued for 3 days after the surgery, thus avoiding strong pain relieving medicines which usually cause indigestion, acidity and drowsiness
Since the pain relief is adequate by this technique patient can be put to early exercise program.
DAY OF OPERATION
If the surgery is scheduled for the morning, be ready after brushing your teeth. You will taken to the operation theatre at the time, which will be informed the previous night.
If your surgery is scheduled for afternoon, you may be allowed tea/coffee and light breakfast early morning of the operation day.
Some medicines may be required to be taken by mouth on the morning of surgery with few sips of water and some injections may be administered prior to being taken to the operation theatre.
At the appointed time you will be taken to the operation theatre.
While being taken to the operation theatre, please remember;
To remove your denture
To remove contact lenses
To remove spectacles
To remove jewellery
Not to carry cash or valuables
In the operation theatre the anesthetist would put you to various monitors and check-up your heart, oxygen saturation and blood pressure.
Before starting the anesthesia, an intravenous line in the forearm will be taken to administer various medications.
As discussed previously you will be administered the anesthesia most suitable for you. If it is going to be Epidural anesthesia, you will be made to sit and your lower back will the cleansed with an antiseptic solution. Then after numbing your skin, a thin tube will be inserted in your back with the help of a special needle.
Once you are anaesthetized, a catheter may be put to ease passing urine.
The actual preparation for the operation consists of thorough cleansing of the leg and covering it with sterile drapes
IMMEDIATELY AFTER SURGERY
On the day of the surgery you will lie flat on your back with the legs separated apart by a pillow.
You are not allowed to turn on side.
After some period of observation in the theatre complex, you will be shifted either back to your room, or to intensive care unit for observation for 24 hours.
If the surgery is carried out under Epidural anesthesia, you will be allowed to take oral fluids within 2-4 hours after being brought to the room.
On the day of surgery, you will continue to receive IV fluids.
For pain relief, the Epidural tube will be connected to a computerized infusion pump, through which you will receive continuous dose of pain relieving medications.
From time-to-time you will be administered injections and oral medications as per the doctors' instructions.
Some of the patients may require administration of oxygen for first 24 hours, while some patients may require monitoring in intensive care unit.
If you have difficulty of any kind, please do not hesitate to call a nurse or a doctor. They will be always available to help you.
CARE AT HOME
The exercises taught to you are continued at home. Majority of you will be able to do them yourself; some may require assistance by the therapist.
You are required to use commode always.
Never sit on the floor.
Avoid sitting cross-legged.
Avoid sitting on surface lower than 18 inches.
You may need a walking stick.
Avoid running, jogging and fast sports.
You may walk as much distance as you like.
You may swim.
Getting into car.
Keep the seat well behind.
Avoid turning the leg in while sitting or getting out.
Have enough leg room.
Keep the knee straight and the operated leg apart.
