Introduction

The natural aging process changes the body, biologically, physiologically and psychologically, along with other changes increasing older people’s susceptibility to disabilities and diseases. The term Geriatric means “of old age” and often refers to older people’s health conditions such as osteoporosis and dementia and healthcare. There is an increased risk for fractures in older people due to the bones getting weaker and losing strength and density. That’s why it is essential to know the signs of a fracture in the elderly so you can take action before an injury becomes more serious. If you have an older family member or friend, they’ve likely experienced a broken bone or two. After all, an estimated 71% of adults will break a bone at some point. However, this doesn’t mean that everyone experiences fractures in the same way or at the same rate as others.

What are Geriatric Fractures?

Geriatric fractures are broken bones that affect older people more often than not. There are several different types of geriatric fractures, each associated with a health condition and resulting in different symptoms. Fractures more often than not happen due to falls, accidents, or as a result of a direct impact or trauma to the affected body part.

Types of Geriatric Fractures

The two most common geriatric fractures are osteoporosis-related fractures and falls-related fractures. Osteoporosis-related fractures occur when older adults with osteoporosis have low bone mass, bone strength, and low bone density. This makes their bones more likely to fracture. Falls-related fractures occur when an older adult has low bone density and falls because they are not as strong as they used to be. This can happen because their balance is affected by a related medical condition such as dementia or the side effects of medication. Other types of geriatric fractures include fractures associated with poor muscle function and bone infections.

Symptoms of Geriatric Fracture

The most common symptom of a bone fracture in the elderly is pain and impairment of mobility. However, if the fracture is causing other symptoms, it’s necessary to see a doctor.

• Pain in the limb that is difficult to explain, for example, or pain that goes away when the limb is bent, can be a sign of a fractured bone.

• Limping or having a hard time walking can be a sign of a more serious injury and should not be ignored.

• Redness, swelling or warmth, or bruising around the broken bone can indicate a more serious injury and should be a concern.
• Loss of strength in the arm or leg can indicate a more serious injury.

• A feeling of obvious deformity or change in how the broken bone feels can indicate that the bone has shifted or moved inside the joint, which can signify a more serious injury.

Risk Factors for Geriatric Fractures

Geriatric fractures like hip fractures can be debilitating with increased mortality, loss of independence, and long-term disability. Hence, we must pay enough attention to the risk factors for Geriatric Fractures and work towards fracture prevention and patient education.

Poor bone health: People with osteoporosis and low bone mass are at an increased risk for
fractures. Osteoporosis is a condition that occurs when bones lose too much bone density. 
The bones become weak and more fragile, leading to associated disorders like low body weight, malabsorption syndromes like chronic liver disease (CLD) and inflammatory bowel disease, primary hyperparathyroidism, rheumatoid arthritis, and long-term immobility.

• Dementia: People with dementia lose the cognitive functioning of the brain. They become forgetful, and their thinking gets impaired, affecting their daily life. These people are more prone to accidents and falls and are also likely to have low bone density, thereby increasing the risk of fractures.

• Medication side effects: People who take medication to control blood pressure, reduce glucose levels, or control seizures are at an increased risk of fractures due to changes in their balance and strength.

• Obesity: Obese are at an increased risk of osteoporosis and fractures. Obesity affects more than just your looks and is also associated with an increased risk of fractures.

• Poor Lifestyle and Behavioral Factors: Sedentary lifestyle, poor eating, sleeping, lack of physical activity, and unregulated drinking and smoking contribute to poor bone health and associated complications. Those with low calcium intake, vitamin D deficiency and lack of physical activity are equally at risk.

How are Geriatric Fractures Diagnosed?

It is often difficult to diagnose a geriatric fracture with/without any health conditions causing them. The doctor will ask about signs and symptoms, complete medical history of both patient and general family health to determine if there are underlying health conditions or any other risk factors for fractures associated with advancing age, and physically examine and try to determine the type of fracture by ordering for the following tests to help make the diagnosis,

• an X-ray
• a magnetic resonance imaging (MRI) scan
• or a Computed tomography (CT) scan

Prevention of Geriatric Fractures

It is beyond our control to prevent or predict geriatric fractures caused by falls, accidents, and other injuries. As a silent epidemic, increasing fractures among the elderly are becoming a major public health concern. It is a priority to prevent fractures in older people or people over 65. The challenge is to identify those at most risk, especially those who have previously had a fall, intervene and assess risk levels, and ensure timely and cost-effective treatment. Awareness about improving bone health and reducing any risk of injury is a must.

• A calcium and Vitamin D-rich diet to keep bones healthy and strong.
• Follow a weight-bearing exercise regime to keep bones strong.
• Complete abstinence from smoking. Tobacco and nicotine increase bone fracture risk and slow down the healing process.

Treatment of Geriatric Fractures

As an older person, if you’re concerned about your symptoms or have a broken bone that doesn’t cause other symptoms, don’t wait to see a doctor. Do not attempt to treat the fracture yourself. The most important thing to do is protect the injured limb, put the broken pieces of the bone back in place, expedite medical intervention to heal to reduce the pain and trauma, and avoid any complications.

Treatments typically include –

• putting the fractured bone in a splint or cast
• medication to reduce/control the pain
• traction to stretch the muscles and tendons around the injured bone to help alignment and healing, and
• surgery to fix certain types of fractured bones into place. Surgery involves the installation of metal rods or pins inside the bone or outside the body to hold the bone fragments in place for them to heal.

The prognosis for Geriatric Fractures

The prognosis for a geriatric fracture is good if the fracture is diagnosed early and treated properly. But if it is not managed properly, it can result in serious complications. It’s crucial to protect an injured limb and see a doctor. In many cases, the fracture can be treated with medication, surgery, or a combination of these procedures. It’s important to know that even when the fracture heals, some changes in the bone may be permanent.

Conclusion

Fractures are a serious risk for older adults, especially those with low bone density, a fall-related or osteoporosis-related fracture, or a fracture associated with poor muscle function. For these reasons, it’s important to know the signs of a fracture and protect yourself from injury. If you notice any sign of a fracture, don’t hesitate to see a doctor. They can help protect your health and avoid serious long-term damage.

FAQs

What type of fractures is most common in the elderly?

Older people are at high risk of bone fragility, falls, and fractures. The most common fractures among the elderly are hip fractures, accounting for at least 90 percent. Typically, all appendicular fractures are precipitated by a fall.

Why are fractures common in the elderly?

Fractures are most common in the elderly because of advancing age, bones getting weaker and brittle due to osteoporosis, and an unfortunate fall. The bones get more fragile with age with the natural bone tissue changes. For women, especially after menopause, the bones get weaker and thinner with the decline in the female hormone estrogen.

Why do the elderly take longer to heal fractures?

The elderly usually take longer to heal fractures because of the declining count of stem cells in the bone marrow due to old age. Recovery from a bone fracture requires sufficient vascularization and the formation of blood vessels in the tissue. Advancing age tends to hinder this process by preventing crucial bone healing sites.

Can the elderly recover from fractures?

When the elderly experience a fall and a fracture, many recover fully, get back on their feet, and lead normal lives. The key lies in prompt action and dealing with all kinds of falls and fractures with precision and timely medical intervention in the case of any type of fracture involving the upper leg, knees, pelvis, hip, skull, back and neck.

How do you know if a fracture is healing?

Never mind how big or small a fracture is, there are 4 tell-tale signs to tell if a fracture is healing or not.

1. Decreasing Pain – When the intensity of pain a fracture afflicted person experiences is on the decline.
2. Improved Mobility – The healing period of a fracture can render a fracture-afflicted elderly patient pretty immobile. As the healing takes over, the mobility of the affected limb will improve.
3. Lack of Bruising – When the area around a fractured bone shows no signs of bruising, the fracture is healing well.
4. Decreasing Swelling – When the area around a fractured bone displays less swelling, know that it’s healing well.

Can an old fracture cause problems years later?

An untreated bone fracture can result in either a nonunion or a delayed union. When the bone doesn’t heal at all, it is called nonunion fracture. As a result, swelling, tenderness, and pain will continue to worsen. Delayed union fracture is when the bone takes more than the usual time to heal.

Can broken bones cause dementia?

The quality of life after an older person suffers from a fracture significantly affects the onset of
dementia. The after-effects of a bone fracture can result in less mobility and decline in physical agility, chronic pain, and prolonged inflammatory cytokine secretion during fracture repair can end up contributing to dementia.

When does a fracture stop hurting?

After a broken bone fracture of an older person is fixed by the doctor without surgery, the pain may subside significantly right after. However, an elderly person may experience some pain for up to 3-4 weeks and mild pain for up to 6-7 weeks after surgery.

What happens if a fracture doesn’t heal?

After a bone fracture, the body gets into a healing mode. If the broken parts of the bones are not properly aligned, the bone will go on to heal with a deformity called a malunion. This happens when a new bone occupies the huge space between the displaced ends of the broken bone.

What slows down bone healing?

High glucose levels and habits like smoking and drinking delay bone healing. For all elderly patients with fractured bones, being immobile for some time is a crucial factor in the treatment process. The healing process significantly slows down with any movement of bone fragments.

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.