Category

Hip Replacement

Category

Introduction

Joint pain is a common condition affecting many people at some point in their lives. It can also be a symptom of other conditions. The causes of joint pain vary from person to person and often depend on the specific joint involved. Painful joints are usually caused by overuse, injury, or inflammation. Treating joint pain requires addressing the underlying cause and reducing any aggravating factors that could lead to further problems in the future. 

What is joint pain?

The medical term for joint pain is arthralgia and must not be confused with arthritis (means inflammation of the joint). Joint pain is a generalized discomfort in the joints. It is generally felt in the joints and surrounding tissues such as muscles. The joints most commonly affected by joint pain are the hip, knee, and shoulder joints. The intensity and duration of joint pain can be influenced by genetics, age, gender, and lifestyle (such as diet and exercise). 

Kinds of joint pain

There are 3 categories of joint pain, namely the following,

1. Non-displaced pain – The most common type of joint pain affecting around 70% of the population is non-displaced joint pain. It occurs due to wear and tear of the joint, injury, or arthritis and is often a result of ageing. 

2. Displaced, subluxation and pathologic joint pain – Displaced pain is pain that is located outside of the joint. Subluxation is joint pain that results from the abnormal movement of the joint, and pathologic pain is pain that is caused by an underlying disease and typically results from inflammation.

3. No joint pain – Joint pain that does not have a specific cause is known as “no joint pain.” It is uncommon and can occur due to systemic diseases such as kidney stones or hormonal changes.

Causes of Joint pain

The possible causes of joint pain will depend on age and activity. The joint pain reasons in children will differ from the causes of joint pain in adults. The commons causes are 

1. Overuse or repetitive joint movements – Over time, the muscles around a joint can become weak or damaged. This can lead to joint pain due to the inflammation that the damaged muscles try to repair themselves. 

2. Articular cartilage damage – Overuse and repetitive movements can damage the cartilage in the joints, leading to pain and inflammation.

3. Muscular injuries – Unintentional or overexercised muscles can become too tight, causing pain and signals to the brain. 

4. Arthritis – Joint inflammation is the common cause of joint pain. It can occur due to an injury, joint damage, or an underlying disease such as arthritis.

5. Infectious diseases – Joint inflammation caused by an infection can occur due to an existing injury, damage to the joint, or a viral infection like COVID.

6. Congenital joint abnormalities – Joint abnormalities at birth (congenital) can lead to pain and disability.

Symptoms of Joint Pain

The symptoms of joint pain depend on the cause of the pain. The symptoms of joint pain can vary depending on the person but may include:

1.      Swelling – This is a common symptom of joint pain and accompanies periods of inflammation. 

2.      Pain – Joint pain is the most common symptom of joint inflammation.

3.      Weakness – Joint pain can also result in muscle weakness, preventing the person from performing joint-related activities such as walking or standing. 

4.      Reduced range of motion – Joint pain can restrict joint movement, preventing full movement in the joint.

 

Risk Factors of Joint Pain

The factors that can increase one’s risk of developing joint pain include: 

1.      Overuse or repetitive joint movements – Overuse of a joint can damage muscles and ligaments that support the joint. This can result in pain and reduced joint movement. 

2.      Age – As people age, their joints become more susceptible to damage and inflammation, causing joint pain.

3.      Injury – Joint damage can also cause joint pain.

4.      Arthritis – People with arthritis are more likely to develop joint pain. 

5.      Heredity – Certain genetic conditions can predispose people to joint pain. 

6.      Smoking – Smoking dramatically increases the risk of developing joint pain.

Foods and activities that cause Joint Pain

The following are some foods and activities that we must avoid to curb joint pain,

1.      Overeating – Excessive weight and overconsumption of certain foods are both associated with an increased risk of joint pain. 

2.      Lack of sleep – Sleep is essential for the repair and maintenance of the joints. Lack of sleep can lead to joint pain. Heavily exercised muscles – Exercising a joint leads to muscle damage, which can result in joint pain.

3.      Back pain – Weak or injured muscles in the back can lead to back pain and joint stiffness.

4.      Obesity – Excess weight can contribute to joint pain through damage to muscles and ligaments.

5.      Foods – Sugar, Alcohol, Processed Food, Salt, Processed Meat, and Gluten-rich food.

 

Foods and activities that relieve Joint Pain

The following are some foods and activities that relieve joint pain,

1.      Rest – Resting the joint after exercise or performing joint-related movements like walking.

2.      Ice – Ice applied to the joint can reduce inflammation and pain by reducing swelling.

3.      Heat – Warmth applied to the joint has anti-inflammatory properties, reducing pain and swelling.

4.      Elevation – Keeping the joint above the heart level can prevent damage to the joint and reduce pain. 

5.      Gentle movements – Gentle joint movements, such as rotating the joint instead of swinging it, can prevent damage to the joint.

6.      Foods – Omega 3 Fatty Acids rich foods, Nuts and Seeds, Lentils, Colourful Fruits, Whole Grains and Root Vegetables

Prevention, Treatment, and Recovery From Joint Pain

You should immediately see a doctor if you experience joint pain with swelling, redness, tenderness, and warmth around the joint.  While joint pain can be frustrating and inconvenient, it is essential to remember that it is usually not a severe life-threatening health problem. It can also signify a serious underlying condition such as arthritis or covid in the backdrop of the pandemic. The underlying cause will determine the mode of treatment.  

The analysis of pain will also determine the next steps like

– Losing weight (for overweight and obese patients)

– Regular exercise and physiotherapy

– Avoiding overuse or exertion of the affected joint

– Healthy nutrition 

– Regular massage to help relieve the pain until resolution

-Rehabilitation exercises, medical treatment, and joint strengthening to restore joint function and prevent further damage

By taking appropriate steps to treat the underlying cause and strengthen the muscles around the joint, joint pain can be easily resolved without treatment or with medicines and some self-care. Some joint pains may require long-term treatment and involve a rheumatologist, orthopedic surgeon, or physiotherapist. 

FAQs

1. What is the leading cause of joint pain?

Answer – The leading causes of joint pain are Overuse or repetitive joint movements, Articular cartilage damage, Muscular injuries, Arthritis, Infectious diseases and Congenital joint abnormalities.

2. How to stop joint pain due to age?

Answer – We can delay joint pay due to age by adopting Moderate Exercise, Adequate Rest, Healthy Nutrition and avoiding excess sugar, salt, processed food and alcohol.

3. What is the best treatment for joint pain?

Answer – The best treatment for joint pain is rest, ice, compression and elevation of the affected joint in terms of self-care. 

4. What foods cause joint pain?

Answer – Sugar, Alcohol, Processed Food, Salt, Processed Meat, and Gluten-rich food.

5. What foods to avoid in joint pain?

Answer – Sugar, Alcohol, Processed Food, Salt, Processed Meat, and Gluten-rich food.

6. Will drinking water help in relieving joint pain?

Answer – There is no scientific evidence that drinking water relieves pain though it can keep the joint sufficiently hydrated to ease inflammation.

7. Is sunlight good for joint pain?

Answer – Yes, sunlight is good for joint pain. Though they don’t help reduce inflammation, they improve muscle health.

Do you suffer hip discomfort that makes it difficult for you to move? You’re not alone if you feel this way. Arthritis is one of the most common ailments that patients discuss with their doctors. Anyone who has ever suffered from hip pain understands how vital these joints are to leading a normal life. Arthritis of the hip affects a variety of activities, including walking, bending, and sitting.

What Happens When You Get a Hip Replacement?

Hip replacement surgery is a medical operation in which a doctor removes affected part of arthritic hip joint and replaces it with an artificial joint components made of metal and plastic materials. When all other treatment options have failed to offer significant pain relief, it is frequently done. The operation should alleviate pain in the hip joint, allowing you to walk more easily.

Hip replacement surgery can be done the old-fashioned way or with a minimally invasive procedure. The size of the incision is the key variation between the two treatments. You will be given general anaesthetic to relax your muscles and put you into a temporary deep sleep during conventional hip replacement surgery. This will keep you from feeling any pain or being aware of the process during the surgery. As an alternative, a spinal anaesthetic may be used to help prevent pain. To expose the hip joint, the doctor will make a cut along the side of the hip and move the muscles attached to the top of the thighbone. Following that, the ball component of the joint is removed by sawing the thighbone. Then, either with cement or a specific material that permits the remaining bone to adhere to the new joint, an artificial joint is attached to the thighbone.

Arthritis in the hip can be caused by a number of different conditions, but the most prevalent cause is osteoarthritis, or degenerative wear-and-tear arthritis. The smooth surface of this “ball-and-socket” joint can become uneven over time, producing pain and movement interruption. While osteoarthritis is the most prevalent cause, hip arthritis can also be caused by inflammatory arthritis (rheumatoid, lupus), avascular necrosis, and injury. As a result, you may have pain and dysfunction, which can have a significant impact on your quality of life. The good news is that, since the first hip replacement surgeries in the 1960s, it has become one of the most successful orthopaedic procedures available. But not everyone with hip arthritis requires surgery, what indicators should you look for to see if you need hip replacement surgery?

What Are the Signs That You Might Need a Hip Replacement?

How do you know which option is best for you? Take a look at the below indicators to see if you need hip replacement surgery.

1. You’re in excruciating pain that’s been bothering you for a long time

Damage to your hip joint, not only in your hip, but anywhere between your hip and knee, can cause chronic and substantial discomfort. If you have any of the following symptoms, you should see an orthopaedic specialist very away:

  • To deal with the pain, you take medications on a daily basis.
  • Despite taking pain medications, your pain keeps you awake at night.
  • It’s tough for you to walk or bend over because of your pain.
  • Resting during the day or night does not relieve your pain.
  • Your pain has not been relieved by conventional therapy.
  • You compensate for your discomfort by limping.
  • Your hip pain is relieved by using a walking assist.

2. Routine Tasks are Difficult for You Due to Your Hip Disability

When considering whether or not to have hip replacement surgery, the most crucial thing to consider is how much your injured hip is hurting your life. Even if the discomfort is manageable, substantial hip joint impairment can make even the most basic tasks difficult or impossible, such as:

  • Putting your shoes on or your socks on
  • Normal walking distances
  • Even with aid for balance, standing on one leg

3. Hip Stiffness Limits Your Joint’s Normal Range of Motion
Stiffness is another sign that your hip has been significantly wounded and has to be replaced. If you’re having trouble walking or bending your hip joint, or if you can’t lift your leg, see an orthopaedic specialist as soon as possible.

4. Conventional treatments for hip pain are ineffective.

Many persons with hip joint problems, such as arthritis, do not require hip replacement surgery right away. Initially, your doctor will most likely try conservative treatment alternatives, such as:

  • Physical therapy: Muscles surrounding the hip joint are strengthened and stabilised, and the hip’s range of motion is preserved.
  • Injections of steroids: Swelling is reduced, and pain sensations are blocked.
  • Medications that reduce inflammation: Reduces inflammation in the hip joint, resulting in pain relief.

These procedures are not effective in curing hip problems. They can, however, enhance hip function and make hip pain more bearable. Regrettably, there may come a time when these cautious methods are no longer helpful and provide no relief. Your doctor may recommend hip replacement surgery if this occurs.

Having hip pain can slow you down and can be mentally and emotionally heavy for an individual. Its important to recognise the severity and go ahead with the treatment. Sit down with your doctor and discuss about your symptoms and level of pain. So that they can help you with best possible results for your problem.

Many people suffering from arthritis of the hip find relief in medicines, exercises, and weight management programs. However, several patients experience intense pain and discomfort. Doctors may recommend hip replacement surgery for patients who do not get relief from other treatments.

Total Hip Arthroplasty (THA) is one of the most successful surgeries performed in orthopedics. THA provides reliable outcomes such as pain relief, restoration of the joint up to functionality, and overall improved quality of life.

The traditional surgical approach to total hip replacement uses a single, long incision to view and access the hip joint. Another variation is a minimally invasive procedure in which one or two shorter incisions are used to reduce pain and promote a speedy recovery. But, it is not suitable for all patients. You need to discuss different surgical options with your orthopedic surgeon based on your condition.

Traditional hip replacement surgery involves making an incision of 12-18 inches along the patient’s thigh. The doctor then removes the diseased hip joint and replaces it with an implant. THA is a major surgery that requires ample time for the tissue in the body to adapt and adjust to the new implant. The point of the incision also needs time to heal as the muscles and tissue in the leg are disrupted.

Only an orthopedic surgeon can determine whether the patient can opt for a minimally invasive hip replacement procedure. Like every other surgery, a hip replacement procedure comes with its risks. Some of the most adverse events that occur post-surgery are loosening, deformation or infection, fracture of the bone or components, etc.

Advances and Innovations in Total Hip Replacement

  • Virtual Reality

Thanks to virtual reality, it is possible to replicate the exact feeling of being inside an operating room. The virtual simulation allows for unlimited practice, paving way for the surgical technique to be mastered with great precision, thus reducing potential errors in the procedure. Moreover, multiple operators can simultaneously work on the same surgery, remotely.

Virtual reality opens up new avenues in total joint arthroplasty as it can be used to try new surgical techniques and get familiarised with new instruments and devices.

  • 3D printing technology

In recent years, 3D printing technology is a major advancement in the field that has increasingly been used in total joint arthroplasty. The technology is used to create patient-specific guides, allowing the surgeon to position the implants with precision according to the pre-operative plan. This is called PSI or Patient-specific Instrumentation.

This technology uses CT scans to personalize a preoperative plan for each patient’s anatomy. It aids the operative surgeon to plan and execute with great precision the positioning of the acetabular implant while preserving hip stability.

The development of computer navigation and robotics has led to the minimization of human error and improved the accuracy of implant positioning and restoration of the native hip biomechanics.

  • Robotic Total Hip Replacement

Robots have different functions. While some operate autonomously, others are active-constrained, i.e the surgeon is in control. In the latter system, a 3D plan based on CT scans is handed over to the operating surgeon based on which they can optimize the surgery. The goal is to complete the procedure with precision to deliver patient-specific operative plans.

Although the role of the surgeon is critical, the robotic arm delivers surgeon-led procedural plans that are based on a complete understanding of the patient’s anatomy to give an accurate outcome to the patient. 

Benefits of new technology and advancements in Total hip replacement surgery

  • Precision

The new advancements in Total Hip Replacement Surgery have led to aiding the medical procedure to be completed with greater precision and hence, results derived for patients are better. The new technology is patient-centric and helps the surgeon understand the particular patient’s anatomy better, thereby delivering what the patient needs. Moreover, as compared to total knee replacement, total hip replacement surgery reduces stress on the bones and increases the life of the implants.

  • Long term results

Total hip replacement is a long-term solution that enjoys a higher success rate. Evidence shows that 80-85% of hip replacements still function after 20 years of insertion.

  • Less recovery time & minimally invasive technique

New advancements have resulted in minimally invasive surgeries that require less recovery time. It is likely that the patient may lose less blood and may experience less muscle damage or soreness.

  • Data from CT scans

Robotic technology presents the potential to capture data from CT scans for processing of the pre-op plan, and final execution of the hip replacement and implant positioning. Using this data and artificial intelligence allows us to tailor our approach to deliver personalized solutions.

  • Improved Quality of Life

With minimally-invasive and precise procedures becoming possible, thanks to these advancements, the patient can recover sooner and return to their normal lives faster as compared to traditional surgery. Lesser side effects and lower chances of complications also contribute to a fuller, speedy recovery and better quality of life.

Total hip arthroplasty is a safe procedure, resulting in substantial improvements for patients. However, there is a significant increase in the number of THAs in the world, with an even more evident increase in younger patients undergoing the surgery. It is important to note that it is imperative to achieve the best functional outcomes as the population demands utmost functionality post-surgery. To achieve this, the advancements and innovations in the field showcase substantial potential, where improvements are still in process.

Hip replacement is a surgical procedure in which a surgeon removes the damaged and painful sections of the hip joint and replaces it with an artificial one that is usually made from metal, ceramic, and High density  plastic components. This procedure is undertaken to reduce pain and improve one’s joint movement and function. The artificial joint is known as a prosthesis.

Hip replacement is usually done when other, less invasive methods have failed to provide relief to the patient. Also known as Hip Arthroplasty, hip replacement is also considered if the hip pain interferes with one’s daily activities. Damage caused due to Arthritis is one of the most common reasons for Hip Replacement Surgery. Some conditions that may require hip replacement surgery to treat it are:

Osteoarthritis: Also known as wear-and-tear arthritis, this condition damages the protective cartilage that cushions the ends of your bones which helps the joints move smoothly.

Rheumatoid Arthritis: This is an autoimmune disease in which there is inflammation in the joints, which in turn leads to bone erosion and joint deformity.

Osteonecrosis: Osteonecrosis occurs when there is no adequate blood supply to the ball portion of the hip joint, which might occur due to dislocation of the hip bone or hip fracture.

Does an artificial hip work better after a hip replacement?

Hip replacement offers the greatest benefit of pain relief. Along with that, there is an improvement in movement, strength, and coordination of the lower body. It also helps you to get back to your active life. But, despite being highly effective, an artificial hip is associated with certain limitations.

1. Durability: Though majority the of the artificial hip implants last for 15 to 20 years, one cannot guarantee smooth functioning in every case of certain situations such as infections or trauma, an artificial hip can get worn out quickly, making it necessary for a second replacement. Normally, an artificial hip can work for up to 15 – 20 years, without any major trouble.

2. Susceptibility to allergy: Though these problems are rarely seen, they can occur. The patient may display signs of metal allergy after the surgery. This is characterized by skin rash, itching sensation, and discoloration in the area where the artificial joint has been fixed. 

3. Weather problems: In some patients, the natural bones surrounding the hip implant take more time to adapt to the metallic nature of the hip, leading to increased weather sensitivity in the patient. Due to this phenomenon, a patient may feel increased pain and stiffness in the artificial hip in certain seasons like monsoon or winter.

4. Caution in future dental visits: You need to take care while visiting your dentist after your hip replacement as you could catch an infection. Preferably, you should take a prophylactic antibiotic.

What type of permanent restrictions will one have after a hip replacement surgery?

Every patient’s experience with Hip Replacement Surgery is not the same. Hence, it is not possible to predict whether a particular patient will have permanent movement restrictions after hip replacement or not. Most of the patients can return to a normal daily routine without any permanent restrictions, albeit with less pain and discomfort. However, a risk always prevails regarding an implant getting worn out, in which case the patient might need a second replacement. Though there are no permanent restrictions in most cases, there are certain activities one has to avoid for a certain period. These restrictions are also known as posterior hip precautions. They are:

  1. Cross your legs: One should not cross their legs past the midline of the body after a hip replacement surgery. To avoid crossing your legs, the surgeon may also advise sleeping on your side or keeping a pillow between the legs.
  2. Forward bending: It is also important to ensure that you do not bend your hip beyond 90 degrees after a hip replacement. Your knee must be below your hip joint. You can utilize cushions and pillows to elevate your seat, to ensure that your knees are positioned lower than your hips.
  3. Positioning your feet: Ensure that you keep your feet and your knees pointed straight ahead, in the front. Do not try turning them in or out. Also, avoid sitting in the same position for more than 30 40 minutes.
  4. Seating arrangement: Make sure that you are using a firm chair with a straight back and armrests. Avoid chairs that are too soft, rocking chairs, recliners, and stools.
  5. Climbing the stairs: Avoid climbing the stairs very frequently, as it will put a strain on the artificial joint.

Even after the joint has completely healed strenuous physical activities like sports must be avoided. It is important to keep in mind that the prosthetic joint has only been designed to withstand day-to-day physical activities. You can work with a physical therapist to learn various techniques and guidelines while performing various activities. If you do not follow the above-mentioned restrictions, you may run the risk of dislocating your joint, leading to second replacement surgery. Hence, you must be well-informed and take precautions with utmost care as suggested by your surgeon.

Today, the healthcare industry is simmering with innovation and new ideas. Transformation is happening at an astonishing pace and redefining the way in which patients are treated for any health-related issues. New-age technologies have boosted the success rate and are also turning out to be less invasive as compared to older methods. Especially, when it comes to treating hip pain and improving patient’s quality of life, hip replacement surgery is one of the most advanced and successful procedures in today’s medical space. Traditionally, Orthopaedic surgeons use to prefer a total hip replacement surgery by incising back or on the side of your hip. However, in recent times, surgeons prefer incising a cut in the upper part of the front thigh. This approach is called an anterior approach or anterior hip replacement. These surgeries may likewise be called small mini, modified, minimally invasive, or muscle-saving surgeries. The procedure involves replacing a damaged hip joint with an artificial hip that can be of metal or ceramic.

Though there are various approaches to the hip that can provide an exemplary outcome, over the past several years, the anterior approach has become more popular because of its minimally-invasive technique. Also, it lowers the risk of complexity before, amid and after the surgery. However, adopting this technique is highly preferred in patients with arthritis, but can also be used for patients undergoing THR due to any other reason like hip fracture, disorders that cause unusual bone growth (bone dysplasias), etc. A lateral or posterior hip replacement surgery and anterior hip replacement approach vary in certain ways but both the approaches share the same objective. Both the approaches are devised to provide adequate pain relief from the hip joint and allowing the patient to perform their normal chores with great comfort. Now let’s take a look at some benefits of Anterior Total Hip Replacement.

Benefits of anterior Total Hip Replacement

  • Compared to ancient science, after anterior THR, a patient suffers from less pain without causing much damage to surrounding tendons and muscles, which leads to a rapid and smooth recovery.
  • The patient will no longer need to be kept under observation post-surgery and can be allowed to go home immediately as per doctor’s advice.
  • Once the surgery is completed, it allows an option for the patient to walk out of their bed and cover small distances independently using any walking aid as soon as it’s comfortable.
  • The patient can also navigate through stairs with ease and comfort. While pursuing the stairs, lifting the stronger leg first onto the steps and starting with the weaker leg when coming back down through the stairs helps in preventing dislocation of the new implant. It is common for the patients to use cane, walker or any other equipment for walking assistance immediately after the surgery.
  • With the lateral or posterior approach, patients have to avoid bending and even sitting with their legs crossed for 6 – 8 weeks as this could result in hip dislocation. But with anterior approach patients are not restricted from any of these activities.

Life after anterior Total Hip Replacement

After implementing a successful anterior THR surgery, patients are able to bear weight on their new hip and can walk easily using any walking aid as per their support. The only thing that patients need to make sure is that their home stairs have a guardrail or banister installed, as to avoid any temptation of walking up or down the stairs unsupported. However, patients will need a personal trainer to restore the strength and movement in their joints and surrounding muscles. Mostly it will take up to 4-6 weeks to gain ample strength for the movement and performance of the daily routine activities. One can resume work after anterior THR, as it allows the majority of patients to start working after a month but we would recommend waiting for up to 3 months if it involves physical labour. Patients can expect their lifestyle to be a lot like how it was before having surgery but without the pain.

Summing up, anterior hip replacement by far is less painful and leads to a faster recovery of mobility and strength compared to a lateral or posterior approach. However, the recovery process still involves distinct phases to ensure the tissue is healing properly which will allow optimum functionality. It is important for every patient to know that every case is unique and the progression will completely depend on their unique set of circumstances. But, an anterior hip replacement approach is mostly likely to add more quality to a patient’s life.