Hip Surgery

Hip replacement surgery Bangkok, Thailand

A total hip replacement or hip arthroplasty is a surgical procedure where the damaged hip joint is replaced with artificial materials.

The surgery may be considered if other treatments are no longer working, the hip is stiff and painful and normal activities are no longer possible.
The cause for hip diseases can be; Osteoarthritis, Osteotomy, infection, trauma or other rare diseases of the hip joint.

Surgery
A total hip replacement takes up to 3 hours. The surgery will be performed under general anesthesia.

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1.) 2.) The specialist will separate the ball of the femur from the socket and removes the head with a saw. A special drill and reamer is used to remove the cartilage from the acetabulum and shape it to fit the part of the prosthesis. The new part is a rounded piece of metal with a plastic or ceramic lining. The artificial new component may be cemented and the surgeon will attach the component to the bone with an epoxy or may also be secured by screws.

3.) 4.) To replace the femoral head, the surgeon first drills a hollow core inside the thighbone to accept a stem for the femoral component. The stem may be cemented in place by the exact fit. A metal or ceramic ball to replace the head of the femur is then attached to the stem.

5.) 6.) After the new joint is fitted, the incision is closed with stitches or clips and removes 10 – 14 days after surgery.

A preparation is recommended at least one month before surgery. Tests are done; including a full physical examination. A preoperative physical therapy is recommended to measure the current pain level, abilities and movement strength of the hip. The therapist will instruct some exercises for the use after surgery. The use of walker or crutches may be temporarily needed.

The structure of the hip joint is a ball and socket joint. The socket (acetabulum) is formed in three areas; theilium, the ischium and the pubis. The head (ball) is on the upper end of the femur. The hip joint is stabilized by strong ligaments in the front of the hip and both the femoral head and the acetabulum are covered with a layer of cartilages. Various muscles play an important role in the stability of the hip.

Side-effects may be, feeling sick as a result of the general anesthetic. A visible scar on upper thigh.

Risks can be short or long term. Short term risks may be; dislocation of the new prosthesis, deep vein thrombosis or infection. Long term risks may be; inflammation, heterotopic bone, changed length of leg, loosening or damage to the prosthesis itself.

After the hip replacement is completed, the hospital stay will be approximatly five to ten days. Medication for pain and to prevent infection will be prescribed. Physical therapy is an important part of recovery for the first four to five months following surgery.
Minimally invasive surgery (MIS) for total hip replacement is a new technique that allows the orthopedics to insert new reliable hip replacement implants through a shorter incision only 2 – 3.5 inch (5 – 9 cm). The specialist removes the damaged bone and inserts the parts of the new prosthesis. MIS hip replacement can be performed in less time, less bleeding and less hospital stay.

Arthritis in Hip Joint

Osteoarthritis is a problem for many people after middle age. It is sometimes referred to as degenerative, wear and tear arthritis. Our Orthopedist specialists have many ways for treatment, so patients have less pain, better movement and improved quality of life.

Anatomically the hip joint, also called a ball and socket joint has an articular cartilage which is a lining that covers the surfaces of the ball and socket joint. Just below the articular cartilage is a layer of bone called subchondral bone. When the articular cartilage degenerates the bone is uncovered and rubs against the bone. Bone spurs or osteopytes may form in the joint.

Different causes can lead to Osteoarthritis. Hip injury earlier in life, movement changes or alignment of the hip. Scientists believe for some patients it can be genetics.
Another cause of hip degeneration can be avascular necrosis (AVN). Conditions where the ball portion of the hip loses its blood supply and dies; this leads to degeneration of the joint.
The symptoms of Osteoarthritis are usually pain and limping. A loss in the range of motion can lead to a stiff and tight hip joint.

The diagnosis of hip Osteoarthritis can be made on the basis of the initial history and examination. A blood test and X-ray is required. Magnetic resonance images (MRI) may be needed to clarify whether the hip condition is from problems with avascular necrosis (AVN).
Treatments
Medication
Anti-inflammatory medication and pain killers may be prescribed. 
Medical studies have shown that glucosamine and chondroitin sulfate can also help. These supplements have nearly the same benefits as anti-inflammatory medicine with fewer side effects such as stomach upsets.
Cortisone injection may be given.
Physical Therapy
The Therapist will teach you how to how to control symptoms, learn ways to relieve the pain including the use of rest, heat or topical rubs.
Surgery
In cases of advanced hip Osteoarthritis surgery may be necessary.
The Orthopedist can use an arthroscopy procedure to look at the condition of the articular cartilage. Arthroscopy is a surgical procedure in which a small optic TV camera is inserted into the hip joint through a very small incision. While checking the condition of the cartilage, the specialist can also clean the joint by removing loose fragments of cartilage. Flushing the hip joint with saline solution can be another option to relief the pain.
Osteotomy
This procedure may be performed if the alignment of the hip joint is caused from a trauma or a disease. Osteotomy is a procedure to realign the angels of the thighbone to shift the pressure to the healthier part of the hip joint. The benefit for this method is, to still keep the own hip joint. This operation will allow time before a total hip replacement is necessary.

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