Hip replacement, also called total hip arthroplasty, is a surgical procedure to replace a worn out or damaged hip with a prosthesis (an artificial joint). This surgery may be considered following a hip fracture (breaking of the bone) or for someone who has severe pain due to arthritis.
Various types of arthritis may affect the hip joint. Osteoarthritis, a degenerative joint disease that affects mostly middle-aged and older adults, may cause the breakdown of joint cartilage and adjacent bone in the hips. Rheumatoid arthritis, which causes inflammation of the synovial lining of the joint and results in excessive synovial fluid, may lead to severe pain and stiffness. Traumatic arthritis, arthritis due to injury, may also cause damage to the articular cartilage of the hip.
The goal of hip replacement surgery is to replace the parts of the hip joint that have been damaged and to relieve hip pain that cannot be controlled by other treatments.
A traditional hip replacement involves an incision several inches long over the hip joint. A newer approach that uses 1 or 2 smaller incisions to perform the procedure is called minimally invasive hip replacement. However, the minimally invasive procedure is not suited for all candidates for hip replacement. The doctor will determine the best procedure for a person, based on that individual’s situation.
Occasionally, a patient may need both hips replaced. Depending on the condition of the patient surgeons may opt to perform both hip replacements during one operation. This is known as bilateral hip replacement. Patients who cannot tolerate a long procedure or anesthetic may be advised to have two separate hip replacements. A bilateral hip replacement takes double the time on the table and under anesthesia – about three to four hours. Be sure to talk with your surgeon about cardiovascular, pulmonary or other health problems which might make longer surgery inappropriate. The benefit of undergoing bilateral hip replacement is in having one procedure and one recovery. The precautions needed after bilateral hip surgery are the same as they are for a single joint replacement, unless your surgeon or physiotherapist tells you otherwise.
Hip replacement requires a stay in the hospital. Procedures may vary depending on your condition and your doctor’s practices.
Hip replacement surgery is performed while you are asleep under general anesthesia or sedated under spinal anesthesia. Your anesthesiologist will discuss this with you in advance.
Generally, hip replacement surgery follows this process:
- You will be asked to remove clothing and will be given a gown to wear.
- An intravenous (IV) line may be started in your arm or hand.
- You will be positioned on the operating table.
- A urinary catheter may be inserted (after you are asleep).
- The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
- The skin over the surgical site will be cleansed with an antiseptic solution.
- The doctor will make an incision in the hip area.
- The doctor will remove the damaged parts of the hip joint and replace them with the prosthesis. The hip prosthesis is made up of a stem that goes into the femur (thighbone), the ball (head joint) that fits into the stem, and a cup that is inserted into the socket of the hip joint. The stem and cup are made of metal. The ball may be made of metal or ceramic. The cup has a liner that may be made of plastic or ceramic. The 2 most common types of artificial hip prostheses used are cemented prostheses and uncemented prostheses. A cemented prosthesis attaches to the bone with surgical cement. An uncemented prosthesis attaches to the bone with a porous surface onto which the bone grows to attach to the prosthesis. Sometimes, a combination of the 2 types is used to replace a hip.
- The incision will be closed with stitches or surgical staples.
- A drain may be placed in the incision site to remove fluid.
- A sterile bandage or dressing will be applied.
The Estimate Includes:
1. Bed charges
2. Clinical Lab Charges
3. Professional Charges
4. Nursing Charges
5. Dietary Charges for the patient and an attendant
6. Operation Theatre charges
7. Anesthetist charges
8. Procedure charges
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The Estimate Excludes:
1. Stay outside the hospital, cost of the same is not included in the above estimate and is payable on actual.
2. Any outpatient consultations and medicines which are required during the follow-up will not be a part of the estimate.
3. The estimate cost is for the number of days indicated above, if situation demands to extend stay in hospital, the additional days stay would be charged accordingly.
4. Special Investigations referred by other departments or if situation demands any additional investigation would be charged accordingly.
5. Cost for the evaluation is not included in the above mentioned estimation