Intelligent Hip surgery

Dr Manuj Wadhwa

Total Hip Replacement has become one of the most frequently performed and successful reconstructive procedures in orthopaedic surgery since its introduction four decades back.  As outcomes following hip replacement continue to improve, the demand for less traumatic surgery has increased, shifting the challenge towards less invasive, yet equally effective techniques that reduce pain and lead to a quicker recovery. Hip replacement used to be an option primarily for adults age 60 and above but, recent technological advancements have led to longer lasting artificial joints that are feasible for active or younger people.
The hip replacement surgery involves replacing the femoral head – the “ball” of the thighbone – with an artificial ball and socket. They can be made of plastic, metal, or ceramic. They may be cemented into place or have a coated with a biological material where host bone will grow into it.
Many people delay hip replacement due to fear, misinformation, or a lack of awareness about their treatment options. They unnecessarily live with the physical pain, stiffness and reduced mobility. Recent studies have shown that Hip Replacement Surgery may be properly considered at an earlier stage than it has been in the past due to improved surgical techniques and joint implants. In India, the skeletal structure is generally smaller than the western countries; however the demand for high flexion activities like using the Indian toilet, sitting on the floor for religious activities etc. is significantly higher. What this mean, there is a demand of a high range of movement along with high stability and ability to withstand joint stress in the smaller Indian anatomies.
Intelligent Hip Surgery is an approach to patient treatment that places equal importance on maximizing survivorship, optimizing function and accelerating recovery. Its success is founded upon the development of high performance bearing surfaces that wear less and give more flexibility in movements, clinically established implants and responsible and effective minimal invasive techniques. Recent developments like gription coating and large head ceramic and highly cross linked plastic bearings as against the commonly used metal or plastic ones offer an excellent option due to the decrease in the wear and tear. This in turn leads to longer life of the implant and gives better movements.
Minimal Incision Hip replacement
A new technique is being used for some hip replacement surgeries. Minimal incision hip replacement uses the same prosthesis to replace the hip joint, but the surgery is performed in a way that requires only a 3 to 5 inch incision – a departure from the current 10 to 12 inch incision.
The potential benefits of this approach include:
* Less bleeding during surgery
* Less post-operative pain
* Shorter recovery time
* Smaller scars for improved cosmetics
With the above developments in technique and implant quality, hip replacement can be safely performed in younger patients. With technological advancements, the implant can last even up to 30 years or even a lifetime to avoid revision surgery. Now patients will be able to swim, play golf, walk or ride a bike again.
Benefits of  Intelligent hip surgery with large head uncemented Ceramic hips
* High-stability & greatly reduced risk of dislocation.
* Low-wear articulations, which are especially relevant for high-demanding Indian lifestyles.
It is indeed the Hip for the Lifetime!
(The author is Director & Head Orthopaedics Max Hospitals UNR-Mohali)