A short and descriptive presentation on total hip replacement surgery. This presentation gives brief idea about the causes of arthritis of hip and its management. This presentation also provides information on total hip replacement procedure. Dr.A.Mohan krishna Consultant orthopedic surgeon Apollo hospitals, Hyderabad Appointments: 9247258989 9441184590 www.drmohankrishna.com www.bonesandjointsclinic.com www.healthyjointclub.com

1. TOTAL HIP REPLACEMENT

2. Dr. A.MOHAN KRISHNA
M.S.ORTHO, MCh ORTH(U.K)
Consultant Orthopaedic surgeon ,
Trauma, Arthroscopy, Arthroplasty
Surgeon
Apollo hospitals, Hyderabad
Consultant Orthopaedic Surgeon at
www.drmohankrishna.com
www.healthyjointclub.com
www.bonesandjointsclinic.com

3. Smooth round head of thigh
bone articulates with cup like
bone of pelvis
CARTILAGE
Lining of the joint
Shock absorber
HIP JOINT IS BALL AND SOCKET
JOINT WHICH TRANSMITS WEIGHT
FROM UPPER BODY TO LEGS

4. What causes it?
Osteoarthritis
Rheumatoid
arthritis
Worn-out cartilage
Injury to the
joint
Avascular Necrosis
Infections

5. How common is it?
Commonly affected joint in the
body after knee joint
Nearly 15% of general
population
Risk factors
 Age - Uncommon under 40
years
1 in 5 over 60 years
 Overweight / obesity
Runs in families
Joint injury
Restriction of activities
like squatting, sitting
cross legged
Swelling of
the joint
Joint pain &
Stiffness
Difficulty in
walking/Limp

6. • Diagnosis is made on
X-ray of the Hip joint
• Decrease in the joint space,
•Irregular and rough surface

7. Weight Reduction
Pain Killers
Tablets/ local gels
Nutritional Supplements
Glucosamine
Physiotherapy
Hip exercises
Injections
Steroids/ lubricant
Key hole surgery
TOTAL HIP REPLACEMENT
CEMENTED / UNCEMENTED

8. Replacing the damaged cartilage
in the Hip joint with metal stem,
metal or ceramic ball and liner
with Plastic or Metal or Ceramic
combinations.
METAL
Cobalt-chrome or
Stainless steel
PLASTIC
Specialised
polyethylene
CERAMIC
Cemented Total Hip Cementless Total Hip

9. CEMENTED TOTAL HIP
REPLACEMENT
Cement is used to fix the
thigh and cup component
to the bone.
CEMENTLESS TOTAL HIP
REPLACEMENT
The cup component is fixed as
press fit with or without
augmentation with screws.
The thigh component is fixed
press fit with the bone.

10. Hundreds of operations
are carried out every
year in the INDIA
Needs General / Spinal /Epidural
anaesthetic
Operation may take up to 1 ½ hours
A cut is made on the side of upper
thigh.
The new joint can last
nearly up to 15 years
BENEFITS
Better quality of life Pain relief
Relief from PAIN/ SLEEP
disturbances
Improves mobility with daily
activities
oWalking,
oClimbing stairs
oVehicle driving
RISKS
Risks related to the anaesthetic
Infection of the joint (2 - 3%)
Clots in the legs and the lungs
Damage to the nerves and the
blood vessels

11. Weight Height (BMI)
Blood & Urine tests, ECG, Chest X-
ray,
2D Echo
Check up by a General physician,
Cardiologist, anaesthetist
Details of medical
conditions/Allergies
Previous operations
List of medicines you are taking
To stop blood thinning drugs
(ASPIRIN , CLOPIDOGREL)
General examination : Dental
check
Discussion regarding operation
Sometimes a further check-up by an
Anaesthetist may be required

12. Continue regular medications if any for
Diabetes / BP /any long term drugs
Early Light dinner (Fat free) on the
night before surgery.
Plenty of fluids on the day before
surgery.
Informed consent & site marking of the
limb.
Good bath
At least six hours of fasting before
surgery.

13. Take BP/Thyroid medications after consulting
the doctor. Normally you are advised not to
take medication for diabetes
IV lines and monitors will be placed in the
operation theatre.
Commonly General anaesthesia will be given
and other measures for post surgery pain relief.
Urinary catheter will be placed
Cleaning and draping of the leg will be done
prior to surgery & surgeon will proceed for
surgery
If you have any heart or other problem you
will be kept in ICU for a day.
At least six hours after surgery you will be
allowed to have liquids first & followed by
normal diet.

14. SURGICAL STEPS
WOUND CLOSURE AFTER
SURGERY

15. UNCEMENTED
TOTAL HIP
REPLACEMENT

16. CEMENTED TOTAL HIP REPLACEMENT
RIGHT

17. Day 1
Exercises for ankles and toes to prevent blood clots
You can sit on a chair or take a few steps with a
frame
Day 2
Removal of bandage and drain from the Hip joint
Knee exercises – straightening / bending
Cemented Hip: Full weight bearing walking with
frame.
Day 3
Walking up and down the stairs
Continue the exercises
You may be able to go home
within 3 to 5 days after the
operation

18. Stitches / clips removed
at 12 - 14 days
You can shower/ bathe after
removal of stitches / clips
Return to household work & other
day to day activities in 6-8 weeks

19. Frequent deep
breathing1
Pull your toes towards
you and point away.
2
Circle your feet in
both directions
3
Push knee down
Tighten thigh muscles
Count to 10 and relax
Do it 10 times / hour
4
Place a rolled towel
under your knee. Lift
your heel to straighten
knee. Count to 10 and
do 10 times / hour
5
Place a rolled towel
under your knee.
Push your knee and
heel down. Count to
10 and do 10 times /
hour
6

20. Sit at the edge of bed / chair. Bend
the operated leg and straighten
slowly. Repeat 10 times/hour.
7
Note: it is important to do frequent repetitions of all exercises for a short
time than spending more time on exercises once or twice a day. Do not
force any movements

21. Raise and support your
operated leg on a stool
Do walk short distances initially
As you get stronger increase
the distance of walking

22. • Neurological
risks In previous
neurological
problems
• Cardiac risks
(elderly with
uncontrolled
blood pressures
• Anaesthetic
risks
Infection
of joints 2-
3%
hip
stiffness
Clots in
legs &
lungs
Damage
to nerves
& blood
vessels
Risks of TOTAL HIP REPLACEMENT

23. SPECIAL CONSIDERATIONS
Inform other doctors about
artificial joint. As these
joints are risk of bacterial
infection from the above
mentioned procedures.
Dental
procedures
Urological
procedures
Endoscopic
procedures

24. CONTACT
Dr.A.MOHAN KRISHNA
M.S.Ortho., MCh Ortho(U.K).,
Consultant Orthopaedic Surgeon,
Apollo Hospitals,
Hyderabad.
Appointments: Secretary : 09247258989 / 09441184590
08332936085
www.drmohankrishna.com
www.healthyjointclub.com
www.bonesandjointsclinic.com
Email: bonesandjointsclinic@gmail.com