Indian hip arthritis affects young people and middle-aged and elderly people, unlike the west, where premenstrual hip arthritis predominates. The surgical operation of this group of relatively young patients requires newer techniques and implants. In this article we will clarify the current state of disease and treatment.
Type of hip arthritis
Hip arthritis is classified as primary and secondary osteoarthritis. Primary osteoarthritis is age-related scrapes and arthritis. It is rare in India. Secondary osteoarthritis occurs at early age and is more common. All other connective tissue disorders such as rheumatoid arthritis, avascular necrosis, traumatic arthritis and SLE, psoriasis all lead to secondary osteoarthritis.
Rheumatoid arthritis is an autoimmune disease and affects all joints, especially small joints, but also does not protect hip joints and knees.
Avascular necrosis is a condition that reduces blood supply to the distal end of the bone. It affects patients with excessive alcohol intake, steroid consumption, connective tissue disorders such as SLE. Systemic lupus erythematosus (SLE) is a connective tissue disorder affecting mostly young women. Cheek light sensitive rash, kidney involvement and arthritis are noteworthy features. Avascular necrosis affects a portion of SLE patients.
Gaucher disease is a genetic memory impairment. Post traumatic arthritis occurs after severe injury of the hip joint. Fractures of the ball (top of the femur) or socket (acetabulum) may not be able to treat arthritis adequately.
Hip arthritis is a big thing Unlike the knee joint, it is very incompetent because it is a small ball and socket joint. Until recently, total hip replacement surgery was recommended by orthopedic surgeons in advanced illness. Advances in orthopedic surgery are addressing the specific requirements of these young patients.
Surgical solution
Because conservative measures are not related to pain, these are the mainstream of treatment. Total hip replacement surgery (THR) is a surgery that tested time and has a success rate of 10 years survival rate of 93%.
If the hip joint is irreversibly damaged and can not be relieved by another operation, it must be replaced with an artificial joint. Patients complain of pain and movement restrictions. Pain often does not touch the knees, feel at the knees, feel the symptoms of the back. Naturally, the pain can be felt more in the buttock region, not in front of the inguinal part.
Who needs hip replacement surgery?
In India, many young patients suffering from hip arthritis, ankylosing spondylitis, avascular necrosis, septic arthritis, and postoperative surgery are recommended for hip replacement surgery to relieve pain. Therefore, many hip replacement surgeries are performed in younger patients. Surgery should respond to growing demands on young and active patients' artificial joints. Of course, the operation designed for the elderly in the West is not suitable for young people.
What is total hip replacement?
In this operation, the upper end of the spherical shape of the femur (femur) and the socket (acetabulum) are exchanged. In the case of the femur the ball will be replaced with a long metal stem secured at the top. The spherical end on it is connected with a cup-shaped polyethylene socket adhered to the pelvis.
Conventional hip replacement surgically sacrifices many normal bones because the head, neck and top of the femur are removed for implantation of the prosthesis. In addition, abrasion of debris from the polyether liner liner results in osteolysis and bone loss. More bone loss occurs when this initial hip is changed or revised after its lifespan. There are small balls on the conventional waist to reduce friction and wear, but this adverse effect is an increase in the risk of dislocation. A mean transposition rate of 3-4% has been reported. These implants do not last for more than 20 years and a correction rate of 50% after 20 years has been reported. Survival rate is not satisfactory for young, active patients with high reliability. Therefore, hip replacement surgery is not an ideal implant for young patients under the age of 50 who need new hips.
Problems of conventional total hip replacement surgery:
Excessive bone sacrifice and loss
o Increase the risk of dislocation
o Patients can not lie down or sit on the floor without the risk of falling
o The range of motion is narrow
o Patient can not participate in sports
Low survival rate of young active patients
o Revision surgery is difficult
o Hips are hard to feel like ordinary hips
o The cup wears over time, and the plastic from it will hurt the bone
o Mismatch in leg length due to change in leg length after surgery
When only the surface of the ball is bad, why remove the normal bone?
This is the logic behind hip resurfacing. This bone-preserved hip resurfacing involves replacing only the pathological bone surface of the femoral and acetabular head. This involves engraving the head of the femur, covering it with a metal cap, and fixing the unforgettable socket on the acetabulum and accepting the head.
Hip Resurfacing - Bone to maintain hip replacement!
By preserving bone and shielding with less stress, you can easily correct this hip joint as necessary. The large head size provides a very stable joint and reproduces the feeling of a normal hip joint. After this surgery, the patient returned to do judo and squash. Progressive metallurgy has the potential that metals on metal joints will survive longer in young and active patients. There are few metals inside the bone, and the invasion of the medullary cavity of the femur is less, so the risk of infection is reduced. Rehabilitation is faster and better.
Benefits of hip resurfacing:
o Allow the patient to squat and allow you to sit safely with a cross on the floor
o Allow normal travel range
o Sacrifice only the affected bone on the surface and preserve normal bone
o Improve the normal feeling more
Joints tend to last long even for young people and aggressive patients
Early and prompt rehabilitation
o Less risk of dislocation
o Easily fix as necessary
o Leg length mismatch
Proxima Hip Replacement - Is Full Bone Maintaining Hip Replacement?
This is the latest addition to Indian hip surgeon memorial monument. It is a bone that maintains hip replacement. In this operation, the entire lesion head of the femur is removed. The lining of the hip socket is re-surfaced with a metal cup. A small absent hip joint with a short stalk called Proxima's hip collides with the upper end of the femur or femur.
The size of the implants is consistent with the natural one, so there is little risk of translocation. It is recommended when bone destruction progresses and it is not suitable for resurfacing and excess hip arthroplasty is over.
The advantages of Proxima are as follows.
Suitable for minimally invasive surgery
o No thigh pains
Metallic Metal - Gives Longevity
o Adapting to normal size eliminates the risk of dislocation
The ability to remediate biomechanical abnormalities, this is called surface reconstruction
o Improve the normal feeling more
o Enable normal range movement and normal activity
