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HIP REPLACEMENT

Though hip replacement is one of the most successful orthopaedic surgeries performed, however, replacement of an artificial joint which is also known as revision surgery is also becoming common.

Doctors consider revision surgery for some reasons which include:

  • Poorly done primary surgery which can result in
    • Recurrent hip dislocations (most common cause)
    • Early wear and tear of artificial joint
    • Infection of the joint
  • Wrong selection of techniques or implants
  • Poor or sub standard quality of implant
  • Poor hygiene & sanitation leading to post operative infections.
  • Poor postoperative rehabilitation & misuse of the joint

Recently, a 67years old male patient was admitted in Jhansi Orthopaedic Hospital with pain in hip since last 6 months. Pain was insidious in onset, gradually progressive and has increased severe in last 6 months as he was unable to walk. The patient got his right hip fractured on 14th July, 2014 for which he underwent Hip Replacement Surgery in some other hospital.

Then, he came to Dr. Gaurav Kumar, Joint Replacement Surgeon, Jhansi Orthopaedic Hopsital for the treatment, as his pain was not relieved. He reported to the OPD with complaint of inability to put weight on his right lower limb, inability in performing his day to day activities (self care and other basic needs) and was unable to keep his right lower limb straight.

He conveyed that after the hip replacement surgery, since he was made to walk for the first time, he has had unbearable pain. His treatment continued for about 5-6 months but his pain did not subside. His knee joint was stiff with only less than 50 % range available; he was unable to walk due to inability to put weight on his right lower limb. On examination, patient had pain and tenderness around hip joint and on palpation, the alignment of hip joint was not proper. After examination, X-Ray was done which was showing the failure of his earlier hip replacement with complete distortion of anatomical alignment of the joint. After clinically examining the patient and reviewing his x ray, team advised him to go for a revision hip replacement surgery. The primary surgery failed because of wrong selection of implant and technique. So, they took consent of the patient on this and revision surgery was planned.

Revision hip replacement surgery is a tedious job. During surgery, the surgeon removed his earlier implant, restored the normal alignment of hip joint & then placed a new implant. Post surgery patient recovered well as the physiotherapy team kept a critical watch on him. His rehabilitation and exercises were started from day 1 after surgery to avoid atrophy (weakness) of his thigh muscles and to avoid any DVT problems. Before discharge patient was able to sit on bed with his leg hanging out, was able to move his knee to a much greater range (0-90) and straighten his leg fully. As it was a revision hip replacement patient was made to walk on the 6th week (usually they ambulate the hip replacement patient on very first day of the surgery).

By the end of 6th week post surgery, patient was able to walk on his own with good thigh muscle strength, was able to sit on a chair without support and his knee movements were much better (0-110) with no extension lag. Above all, the patient was free from his pain and was able to do his day to day activity without much assistance. Patient was not allowed to sit in squatting position as a precaution in order to increase the life of the implant as it was a revision hip replacement.

This is all because of the team at well known hospital famous for just orthopaedics treatment who followed a high standard protocol and were able to put that very same patient back to his normal life. At Jhansi Orthopaedic Hospital, all are very strict about the quality of the treatment techniques, sterilization and sanitation. And, this is the reason that none of their performed primary THR required any kind of revision in past 10 years or more.

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