Minimally Invasive Hip Replacement India
Minimally Invasive Hip Replacement India
Hip
replacement is one of the most successful operations in all of
medicine, which prompts many orthopedic surgeons to think, as one leader
in the field put it, “Why change something that doesn’t need fixing?”
The technique these
surgeons use is called anterior hip replacement, one of several
minimally invasive operations that are associated with a shorter
hospital stay, smaller incision, less trauma to muscles, less pain and
blood loss, reduced risk of dislocation after surgery, faster healing
and a quicker return to normal activities.
Another minimally invasive form of hip replacement,
the PATH technique, was developed by a Los Angeles orthopedist, Dr. Brad
L. Penenberg.
The usual reasons for hip replacement are osteoarthritis,
rheumatoid arthritis and traumatic arthritis, all of which can cause
pain and stiffness that limit mobility and the ability to perform
activities of daily living. Most patients try less drastic measures —
physical therapy, medications (pain relievers, anti-inflammatory drugs
and glucosamine supplements), injections of hyaluronic acid and walking
aids — before deciding that surgery is their best hope for escaping
chronic pain and disability.
To appreciate the potential benefits of minimally invasive methods, it helps to know how hip replacements are usually done.
General
or spinal anesthesia is used for the operation, which typically takes
one to two hours. An incision 10 to 12 inches long is made through the
muscles on the side of the hip to expose the hip joint, and the diseased
bone tissue and cartilage are removed. An artificial socket is then
implanted into the pelvic bone and a metal stem is inserted into the
thigh bone, the top of which is replaced by a metallic ball to create a
ball-and-socket joint that mimics the function of a natural hip joint.
The
average hospital stay is four or five days, followed in most cases by
extensive rehabilitation. Patients are told not to cross their legs or
bend at the hip more than 90 degrees after surgery — in some cases
indefinitely, because these motions can cause dislocation of the
replaced joint that requires a repeat operation.
Possible
complications of the surgery include blood clots, infection, fracture
and a change in leg length. Possible delayed complications include
dislocation of the new joint, breaking or loosening of the prosthesis
and stiffening of the tissues around the joint. Although modern
materials have extended the life of implants to 20 years or so, they can
eventually wear out and require replacement.
Studies comparing long-term results of minimally invasive
hip replacement with more traditional surgery have had mixed results,
and all forms of hip replacement have benefited from improved anesthetic
and pain management techniques. Surgeons who routinely use less
invasive methods maintain that there are decided advantages for most
patients, even though the operation itself can take somewhat longer.
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