Surgical methods of Hip Replacement involve the following approaches:
1. Direct Anterior Approach: An incision is given on the front of the hip
2. Anterolateral Approach: An incision is given on the side of the hip, towards the front of the body
3. Posterolateral Approach: An incision is given on the side of the hip, towards the back of the body
Based on the condition, the surgeon decides which approach would be minimally invasive to access the hip joint in 1 or 2 small incisions.
Steps to Hip Replacement Surgery:
Pre-Surgery:
The patient’s medical history is taken, and a physical examination is done. Blood tests and X-rays may be prescribed by the doctor. Tobacco interferes with the healing process. Discontinue the use of tobacco for at least a month before a scheduled surgery. Avoid dental work two weeks before surgery.
Surgery:
Typically, the procedure lasts a few hours. An IV line is inserted in the hand or arm. A urinary catheter is also inserted. Anaesthesia is administered. The type of anaesthesia (general anaesthesia, spinal block, epidural block, or regional nerve block) is determined by the anesthesiologist and the orthopaedic surgeon. Based on the type of surgical approach, the patient is appropriately positioned for easy access to the hip joint, and an incision is made. Layers of tissues are cut to access the hip joint and the damaged/diseased bone and cartilage are removed.
The head (ball) of the femur is removed, and an opening is made on the top of the femur. The stem of the ball prosthesis is then inserted with or without cement. Likewise, the prosthetic socket is inserted into the pelvic bone. A tube is placed in the hip for drainage before closing.
Layers of tissue are stitched back with dissolvable stitches, and skin is closed with surgical glue.
Post-Surgery:
Moved to the recovery room, where vitals are monitored. After the anaesthesia wears off and if the vitals are stable, the patient is moved to their allocated hospital room. Pain medications are prescribed to manage the pain. Patients are encouraged to get up and move around as soon as possible post-surgery with the support of a cane, walker, or crutches (to prevent blood clots). Physical therapy/rehabilitation is recommended to regain muscle strength and a good range of motion.
Recovery period post-surgery:
During the recovery period, the patient should
- Ensure the surgical site is clean and dry
- Take medications, diet as prescribed
- Attend physical therapy and do home exercises
- Elevate the leg and use ice to control the swelling
- Driving after full recovery noted as per the doctor