General Questions about Hip Replacement:

Que.: At what age do people usually get a hip replacement?
Ans.: The majority of patients receiving a total hip are between 55 and 85 years old. Younger patients who have had childhood hip problems and healthy patients over 90 years old are also candidates. However, with success increasingly being obtained in both younger and very elderly patients, there is a very wide range of ages of patients undergoing joint replacement surgery. Joint replacement surgery tends to be performed in younger individuals when they have inflammatory arthritis, osteonecrosis, or arthritis that is related to a childhood joint problem.

Que.: Is hip replacement surgery covered by insurance?
Ans.: Hip replacement surgery is covered by most insurance companies as well as Medicare and Medicaid. You should contact your insurance provider to see whether hip replacement is covered under your plan.

                                                                          Can you Benefit from keyhole Hip Surgery? 

Do you have these problems?
When the joint becomes affected, in the initial stages, the lining becomes swollen, red and inflamed. This is Synovitis. If left untreated this leads to progressive loss of the smooth surfaces of the joint, resulting in arthritis. Advanced arthritis can be treated only by surgery. 

The common causes requiring surgery of the hip are:

1. Rheumatoid Arthritis
2. Ankylosing Spondylitis
3. Avascular Necrosis
4. Tumours in the joint 

Surgery involves providing new surfaces for both the sides of the joint – Total Hip Replacement.

Conventional total hip replacement involves removing the entire ball shaped head of femur and the cup shaped acetabulum and putting in an artificial ball and socket. This is anchored deep in the thigh bone and involves removal of a large amount of bone. If it fails, the patient becomes crippled. 

The Safer Option
In contrast, Minimally Invasive Hip Surgery (articular resurfacing) involves only removal of the damaged lining of the head of femur and the cup. Specialized instruments are available for this operation that enable surgery to be performed through a small opening – a keyhole surgery. Since the surgery is a resurfacing only, the natural diameter of the head and acetabulum are maintained. (In conventional total hip replacement, smaller head sizes are used). This has important implications – range of movement is near normal. 

Other Advantages
The components that are used form a metal-on-metal articulation (i.e.) both the sides of the artificial joint are made of metal, which, in comparison to the conventional total hip replacement (a metal on polyethylene articulation), has better survival and durability and less wear. This means it can last for many more years. Metal-on-metal has better lubrication, less friction. 

Summing up the benefits

+ Better soft tissue and bone preservation means less trauma from surgery which translates into faster recovery, less pain and less
    complication.
+ Restoration of full movements – normal physical activity including sports.
+ Better lubrication and metal-on-metal articulation means better survival rates. 

All these factors make keyhole surgery of the hip, the ideal choice for the young and old.
 

Arthroscopy – Keyhole Surgery of the Joints

Inside the kneeThe knee joint is formed by the articulation of the thigh bone (femur), the leg bone (tibia) and the knee cap. The meeting surfaces of the bones are covered with a special smooth tissue, known as cartilage. These two bones are held together by two ribbon like structures inside the joint which cross each other. They are called cruciate ligaments. Then there are two washers in between these two bones which act as shock absorbers. 

Do you have these problems?
All these structures can be visualized with an arthroscope. Most of the times after an injury when there is no fracture, injury to these structures are neglected. Usually injuries to these structures give rise to pain, instability, knee giving way, locking, audible clicks and swelling in the knee joint. If unattended these will lead to arthritis of the joint at a later date. All these injuries can be easily diagnosed by doing arthroscopy.

The Keyhole Solution
Usually these injuries are treated by opening the joints which result in post-operative pain, prolonged recovery and risk of infection.
But, now-a-days all these problems are treated with keyhole surgery. The cruciate ligaments can be reconstructed through arthroscopy. The torn washers can be sutured. When there is a tear in the cartilage, the cartilage can be transferred from one part of the knee joint to the affected part arthroscopically. It is also helpful in removing loose foreign bodies from the knee joint. 

Treating Recurrent Dislocation
In case of the shoulder joint, the head of the arm bone and the cup of the shoulder blade are held together by a cover of soft tissue (capsule). When the shoulder joint dislocates, the ball not only comes out of the cup but also peels the soft tissue envelop from the face of the cup. This results in a redundant pouch in front of the cup to which the ball dislocates often (recurrent dislocation). In olden days the shoulder joint had to be entirely opened to repair this. This results in pain, prolonged recovery and in some cases, stiffness of the shoulder joint. But now-a-days with two (or) three keyholes, it can be done using arthroscopes where patients can get a full range of movements in 4-6 weeks. Similarly torn muscles around the shoulder joint (rotator cuff) can be reattached arthroscopically. 

Advantage Arthroscopy
Arthroscopic surgeries are far superior to conventional surgeries in many ways. The damage to your tissues is less. So, post operative pain will be negligible. The recovery will be quicker. Most of the procedures are done as day care surgeries where you need not stay overnight in the hospital. This reduces the cost of the surgery. Last but not the least it leaves you with a very small scar.