What is Total Hip Replacement (THR)?
The hip joint is a ball-and-socket joint which involves an articulation between the femoral head (the ball) and the acetabulum (the socket).
Total hip replacement is a surgical procedure designed to relieve pain and restore function in a severely damaged or arthritic hip joint. This procedure involves removing the damaged portions of the hip joint and replacing it with an artificial joint made from advanced materials like metal alloys, polyethylene (plastic), or ceramic.
Total hip replacement could be cemented (where bone cement is used to fix the implants), or uncemented (implants with specially coated surfaces are used without any bone cement). Also, there are various options of the articulating interface available like metal-on-metal, metal-on-poly, ceramic-on-poly and ceramic-on-ceramic.
Types of Hip Replacement
Partial Hip Replacement (Hemiarthroplasty)
This involves replacing only the femoral head (the ball) using a metallic implant. This is usually done for patients with fractures of the hip (fracture neck of femur) especially in older patients. This can be either a cemented or an uncemented implant.
Total Hip Replacement (THR)
This involves replacing both the femoral head (the ball) and the acetabulum (the socket). This is usually done for patients where the hip joint is damaged or destroyed due to arthritis, avascular necrosis (AVN), infection or an injury.
Common Hip Conditions Requiring a Hip Replacement
1. Severe Arthritis
Osteoarthritis (arthritis of wear and tear), rheumatoid arthritis (an autoimmune disease), or a severe infection (infective arthritis) can cause significant damage to the hip joint, leading to pain, stiffness, and limited movement.
2. Avascular Necrosis
This is a unique condition where the blood supply to the hip bone is disrupted, causing bone of the femur head to necrose (die), potentially leading to joint collapse of the head leading to arthritis. This condition is quite commonly seen in the younger and middle-aged patients.
3. Ankylosing Spondylitis
This is type of an inflammatory arthritis which is typically seen to affect male patients at a younger age. It leads to progressive stiffness involving the spine and hip joints, and can be very disabling.
Total hip replacement can help relive pain and regain movement in their hip joints.
4. Hip Fractures
Some hip fractures involving the femoral head and neck especially in the older patients, may require hip replacement surgery to restore function.
5. Bone Tumours
Tumours, both benign and malignant, involving the bone(s) of the hip joint can lead structural damage, sometimes requiring a hip replacement.
Benefits of Total Hip Replacement
1. Pain Relief
The primary benefit of total hip replacement is the substantial reduction in pain. By replacing the damaged joint surfaces with a new, smooth prosthetic joint, most patients experience a significant decrease in discomfort.
2. Improved Mobility
After recovery, many patients find they can move more freely and comfortably. This enhanced mobility can help you return to activities you enjoy and improve your overall quality of life.
3. Enhanced Quality of Life
With reduced pain and increased mobility, you’ll likely find it easier to perform daily tasks and engage in activities that were previously difficult or impossible.
4. Durable and Effective Solution
Modern hip implants are designed to be durable and long-lasting, offering a reliable solution for managing hip issues and providing long-term benefits.
Direct Anterior Approach (DAA) THR – an innovative technique for THR surgery
Total hip replacement surgery involves opening the hip joint by making an incision on the hip. The traditional method uses either the postero-lateral approach or the antero-lateral approach to expose the hip joint. Both these techniques involve cutting through some muscles and/or tendons surrounding the hip joint.
Dr. Korday specializes in using an innovative approach called the direct anterior approach (DAA) which is a ‘muscle-sparing’ approach and a minimally-invasive technique, as it does not involve cutting through any muscles around the hip joint. This leads to smaller incisions, significant pain reduction and faster recovery after THR surgery.
This, along with aggressive post-operative pain management in collaboration with his anaesthesia team ensures that patients have pain-free recovery and early return to function after hip replacement surgery.