Arthritis is a debilitating and painful condition. Joint Replacement Surgery allows total relief from pain and improved quality of life for the patient. Arthritic knee and hip joints are regularly replaced; elbow and shoulder are less commonly operated.
From our experience of more than thousand patients who have undergone Joint Replacement Surgery, we have answered commonly asked questions about arthritis and joint replacement surgery.
- Recurrent pain in the joint which needs medicines on an almost daily basis and/or pain not relieved in spite of taking medicines.
- Presence of night pain or pain on getting up from the chair or climbing downstairs & squatting.
- Pain affecting and limiting social, professional, personal life. (for the fear of pain you are now avoiding things which you normally would like to do)
A small cut is made on the side of your hip. The hip joint is exposed. It is a ball and socket joint (see diagram). The ball is removed and replaced with a metal ball fixed to the thigh bone with a special material called bone cement. The socket is cleaned and fixed with UHDP socket with cement (See Diagram). The muscles and ligaments are stitched back. The operation takes about one ad half hour. In some patients, an artificial hip joint with a special coating is used without cement fixation. Here the patient’s bone is expected to grow over its surface to hold it rigidly to the body. (Uncemented THR)
A small cut is made in front of the knee(about 8 to 10 inches). The knee joint is opened. The damaged surfaces of bones are removed and replaced with a metal surface on the upper side and plastic surface on the lower side. The surface of the kneecap is also replaced with a plastic button. These surfaces are fixed to the bone with bone cement. Muscles and ligaments are stitched back. The operation lasts for 1 1/2 hours.
The patient is followed up at one month, three months, and then every year to assess the joint function.
You can walk easily up to 1 – 2 miles if your other physical fitness allows it. Normal sitting in the chair without pain is possible. Patient SHOULD NOT sit cross-legged or squat on the ground (like using Indian toilet.)
Walking is possible unlimited, climbing up and down the stairs is also possible without pain. Squatting down and sitting cross-legged is prohibited.
Extreme precautions are taken to avoid this complication. Patient preparation, operation theater with clean air system, use of board spectrum antibiotics etc is one. Despite the care and diligence taken, about one percent of patients develop an infection in Joint. They can be treated with antibiotics. Those who do not respond will need removal of the joint to clear the infection. Another artificial joint can be implanted later.
Development of blood clots in self can occur in 5-6% patient. For their prevention, various techniques are used. Even if they develop, they can be dispersed using medicines. About 1% of the cases, the clot may go to the lungs. This needs treatment with blood thinning agents and a little longer hospitalization. Death of patient as the complication is extremely rare (<0.1%).
Wear, loosening, dislocation of Joint:
Prolonged use can cause loosening and wear of artificial joint. This usually happens over 10-15 years. If this happens and pain returns back, the joint can be changed. In exceptional circumstances, dislocation of the artificial hip in extreme position can happen for which special precautions are advised. The risk is more in the first 3-6 months and becomes less afterward. The dislocated joint can be reduced back and stabilized by the bed rest.