With an increase in longevity, more number of senior citizens demands a better quality of life. A painful knee can seriously hamper a person’s capacity to walk freely and make him dependent not only on drugs to relieve pain but also on others for mobility. The solution to painful arthritic knee is now easily available in form of Knee and hip replacements. Modern medicine assures you 20-30 years of safe and near natural functioning with the replaced joints.
The evolution of mankind and its success over other fellow species is fast becoming the prime mortal on earth. He is essentially dependant on his ability to move around. When we reached the modern era, success and happiness in life has become totally dependent on motion.
Modern medicines, right from the beginning were interested in treatment of movement disorders. Earlier it was concentrating only on drugs and walking aids and fusing the painful joints. But early twenty-first century witnessed revolutionary changes in management of painful joints. This was possible because of volumes of research happened in biomechanics of human motion, newer drugs to treat arthritis, better knowledge in metallurgy, new successful design strategies of artificial joints like hip and knee, and improvement in developing new bearing surfaces.
Who needs Hip replacement?
After Knees, hips are the most common affected joints causing painful movements in arthritis. In India, knees are affected four times commonly than hips. But in some western countries it is in 1:1 ratio. This is essentially because of the weight bearing function of hips and knees. The fewer incidences of hip issues in Indians were earlier attributed to out sitting habits, habit of carrying our kids on the side and use of Indian toilets. Which means the trend may change in India also in coming generations.
A variety of causes can cause painful hips and most common one is the age related degenerative changes. Yet another cause is the Rheumatoid arthritis. A vascular necrosis of Femoral head (which means loss of blood circulation to the ball of the hip joint leading on to destruction of ball and wear and tear of hip joint) is a fairly common incident which leads on to hip replacements in young patients. Other major causes are fracture of pelvi – acetabular area and fracture neck of femur. Other less common causes include connective tissue disorders, congenital disorders involving hip, TB and certain infections and rarely cancers involving the joint.
In all of these cases, drugs and exercise will help the person in initial stages. Early diagnosis and timely start of medicines is crucial in cases like Rheumatoid arthritis, SLE etc. But in advanced disease when the joint is completely damaged beyond possible repair with drugs, then hip replacement becomes inevitable.
When is hip replacement done?
As I pointed out earlier hip replacement becomes inevitable when the joint is totally destroyed. This will manifest as either severe pain or severe stiffness both will prevent the person from movement. This will affect the daily routine activities of the person and also will prevent him from social engagements. This chronic pain and limitation may even psychologically depress the person in multiple ways and can keep him away from family and society.
What is hip replacement?
Hip replacement essentially means removal of the damaged moving surfaces of the hip joint and replacing it will an artificial bearing surface.
The artificial joint will consists of a cup which goes in to the socket of the hip joint and a stem which is fixed to the thigh bone. The stem will hold a ball and it will articulate with bearing surface which is fixed in to the cup.
The stem, cup and the bearing surfaces are made up of different materials which differ in fixation properties to bone and also in the longevity of the prosthesis. The cost of the process also differs with different materials used. Earlier we had only bearings made of metal and plastics.
But last ten years have witnessed a drastic improvement in joint replacements. We have a variety of options – both in design and materials – in hand now. Better joints, better instrumentation and better training facilities for surgeons across the world have really changed the scenario. These improvements have made the joint replacement surgery into a onetime affair for most of the persons undergoing this treatment.
(Read the full article in the March Issue of Safety Messenger Magazine 2016)