Difference Between Fibromyalgia and Arthritis
Anatomy of Hip Joint:
The Hip is a ball (referred to as femur head)-and socket (referred to as acetabulum) type of joint that enables your leg to move forwards, backward and sideways. Soft tissue called cartilage covers this joint to ensure the movement of the ball-and-socket is smooth. When the movement of the ball-and-socket is rough/not smooth (due to conditions mentioned below), routine activities are painful.
Why Is It Done?
Recommended when the Hip Joint is damaged to interfere with one's daily routine activities to the extent that it can not be corrected or managed non-surgically
Conditions that make one more prone to hip damage requiring surgical intervention include:
1. Osteoarthritis: ‘Wear and Tear Arthritis' The cartilage which cushions/cover the joint gets damaged, causing hip pain and stiffness
2. Rheumatoid Arthritis: 'Inflammatory Arthritis' Autoimmune disease wherein prolonged (chronic) inflammation damages the cartilage, eventually causing hip pain and stiffness
3. Osteonecrosis: ‘Avascular Necrosis. An injury/fracture or dislocation may limit the blood supply, which damages the hip joint, causing arthritis
4. Post-Traumatic Arthritis: Hip injury or fracture may damage the joint, requiring surgical intervention
5. Childhood Hip Disease: Hip does not grow normally affecting the joint surfaces hence hip replacement surgery may be needed to rectify the condition
Types of Hip Replacement Surgery:
1. Total Hip Replacement: 'Total Hip Arthroplasty' A plastic cup replaces the socket of the joint (may or may not include a titanium shell), and a ball made of ceramic or metal alloy replaces the femoral head. This is the most common type
2. Partial Hip Replacement: 'Hemiarthroplasty' Only one side of the hip is replaced - the femoral head - instead of both sides compared to total hip replacement. Recommended in older patients with a fractured hip
3. Hip Resurfacing: ‘Surface Replacement’ This procedure involves preserving more of the natural bone by retaining the natural femoral head. The femoral head is resurfaced to fit a metal cap with a short stem. Commonly done in younger, active patients
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:
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.
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.
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
Risks associated with Hip Replacement:
Questions To Ask Your Doctor Regarding Hip Replacement Surgery
Although the below questions have a generalized answer, every patient and their condition is different. Make sure you ask your doctor the following
Difference Between Fibromyalgia and Arthritis