Hip Replacement Surgeon - About Hip Surgery

Total hip replacement is often necessary after the cartilage between a patient’s femur and pelvis wears out. Osteoarthritis often results from the lack of cartilage and leaves patients with severe achy pain and immobility. Typically, a hip replacement is not performed unless nonsurgical methods fail to relieve hip pain. 

The commonest cause in India is Avascular necrosis resulting in arthritis. Sometimes there is no known cause for AVN to happen but more often than not its indiscriminate steroid use. 

While the patient is under anesthesia, the hip is cut open and the arthritic bone in the socket of the joint is cleaned out. The surgeon also removes arthritic bone from the femoral head, then inserts an artificial femoral head down into the femur. The joint is then complete and the surgeon shaves arthritic bone from the knee cap before replacing it and closing the incision.

Dr. Khemka will evaluate you and your X-rays thoroughly before deciding what implants to be used.  

The implants normally used can be divided into two categories as cemented and  uncemented implants. One is not necessarily better than the other, just depends what suited for your bone structure. 

Implants are also categorised on the basis of bearing surfaces. Ceramic on ceramic being the newer technology compared to Metal on Polyethylene. Ceramic tends to last longer than polyethylene bearings but ends up costing slightly more. Dual Mobility cups are quite often used when the sift tissues are not very good around the hip. The use of wither would be based on the surgeons discretion and your choice. 

Although patients are sore after surgery, most hip replacement patients report being completely pain-free after 1-2 weeks. Additionally, 95% of hip replacement patients reported having less pain one year after their surgery than before it, according to Total Knee Replacements. 

One can sit on the floor now normally six months after the surgery. This clearly depends on how one does the surgery and the use of certain implants. 

But it isn’t advisable to do so after a hip replacement keeping in mind the chances of a dislocation provided in an artificial joint. 

Under the care of Dr. Khemka stay for just 2-3 days, and then are back in the comfort of their own home to recover.  

Before you are discharged from care, you will need to accomplish several goals, such as: 

• Getting in and out of bed by yourself. 
• Having acceptable pain control. 
• Being able to eat, drink, and use the bathroom. 
• Walking with an assistive device (a cane, walker, or crutches) on a level surface and being able to climb up and down two or three stairs. 
• Being able to perform the prescribed home exercises. 
• Understanding any hip precautions you may have been given to prevent injury and ensure proper healing.

It is recommended that patients take 2-6 weeks off of work depending on their occupation. Patients who have a desk job can typically go back to work sooner than patients who have manual labor jobs or have to be on their feet often. 

Patients should be able to move around the house after 4-6 weeks without experiencing pain or using walking aids. After that point, the amount of time that is necessary for a full recovery varies between patients. Some patients recover extremely quickly—within a month or two—while others require a full six months before returning to their pre-surgery levels of activity. 

Yes. Physical therapy is an essential part of your total hip replacement recovery process. Physical therapy begins the following day of your surgery and will take place over the course of several weeks. At first, you will do some simple exercises like contracting and relaxing your muscles in order to strengthen your hip. You will also learn new techniques for movements such as sitting, standing, and bending, in order to prevent any possible damage to your hip replacement. Typically patients are in physical therapy for 6-8 weeks and have sessions twice/week. 

Some patients may drive as soon as 2 weeks after surgery, while others may need as long as 8 weeks. During this period, simply getting in and out of a car can be challenging, especially if the car’s seats are low to the ground. In order to drive a car safely, patients must meet the following requirements: 

• The patient must be off of narcotic pain medication while driving. If the patient takes pain medication at night only and not during the day while driving, that is acceptable. 
• The patient must be able to hit the brake quickly. 
• The patient must be able to get in and out of the car comfortably and safely. 

In addition, reflexes and muscle strength should have returned to their pre-surgical levels. 

Here is a list of potential post-surgery complications: 

• Blood clots 
• Infection 
• Fracture 
• Dislocation 
• Loosening 
• Need for second hip replacement 

Dr. Khemka and your physical therapists will evaluate your risk for complications and provide specific treatments to avoid these risks. 

While hip dislocation is the most common complication after hip replacement surgery, this only happens to less than 3% of all patients. Dr. Khemka uses the minimally invasive methods which drastically reduces the risk of dislocation post-surgery.

The cost of the surgery is normally divided in two parts. One of which includes the hospital stay, operating room charges, use of consumables, pharmacy, surgeon charges etc and the latter which includes implants depending on what is to be used. 

All these costs are normally covered by the insurance company, and we can organise packages with the hospitals where he operates to minimise your burden in the absence of insurance.  

Dr. Khemka would be happy to provide all the information to you during consultation.