When the articular surfaces of both acetabular socket and femur head is eburnated and worn out because of arthritis,trauma or avascular necrosis and patient is having severe pain and stiffness that is making activity of daily living difficult. When analgesic requirement is daily for carrying out routine activity, in such circumstances THR is done to give pain free,stable and mobile joint.

THR can be of three type 1- Cemented- where both components are fixed with bone cement 2- Hybrid- where one of the component is fixed with bone cement and other is without bone cement 3- Uncemented-where both the components are fixed without bone cement

Among numerous implant options available for THR, the choice of what specific implant to be used in an individual remains with surgeon. Looking at the disease process, age of the person who needs THR, functional demand, bone quality and available bone stock we have various permutation and combination available with us in operation theatre.It can be cemented stem,uncemented HA coated stem,cemented cup, uncemented cup with HA coating, ceramic and metallic femur head in various sizes,and acetabular liner of highly cross linked poly and ceramic liners. In majority of our cases we are doing uncemented THR with ceramic head especially 36mm size and UHMW crosslinked polyliner. It has shown best clinical outcome with less wear and allergic reactions. It is considered as the safest option and can be done in younger age group female who has to give birth to their child in near future. We also use modular stems and tantalum implants in complex cases where bony deformity is there due to previous surgery or some other reasons. Even most complex cases can be handled with ease with the help of modern prosthesis available.

Despite the excellent outcomes, there are some current areas of concern with regard to THA surgery. Some analyses of data have suggested an increase in mortality associated with cement use in hip replacement surgery as compared to cement-less fixation.

Younger patients and active older patients typically suffer from increased wear and higher dislocation rates compared with less active older patients following conventional THA with small bearing surfaces (28mm). Metal-on-metal (MoM) devices were developed to address these problems, given the increasing demand for arthroplasty in this younger and more active population In 2006 the first major MoM-related problem was reported in a resurfaced hip. Subsequent case series demonstrated that failure of MoM devices was often associated with large masses and/or cysts visible on magnetic resonance imaging (MRI) or ultrasound.At revision surgery these masses were found to be associated with local soft tissue and bone destruction due to their locally destructive nature these masses were initially labelled ‘inflammatory pseudotumours’. They have subsequently been variously described as metallosis. Because of all these adversities MOM implants are not in use in current situations.

The advantages of ceramic components for the articulation in primary THA include their relatively inert properties in body fluids, negligible amounts of toxic degradation products, and their resistance to wear. Concerns regarding ceramics frequently involve their brittle nature and mechanical properties in high load applications. As bio engineering evolving, now we have best quality ceramic that is resistant to wear,allergic reactions and fractures. We have used this bearing in more than 200 cases till the time and we can say that it is the answer to present day problem that requires THA in younger and more active age group.

Due to increased cosmetic concern and functional demand we are getting more patients asking for minimal incision surgery.We are doing this in properly selected patient with clear cut indication using our own wisdom and acumen. As you know a properly positioned implant is of paramount importance rather than length of skin incision.

Following a hip replacement it is important to follow these hip precautions to minimise the risk of your new hip dislocating. These precautions must be followed for at least 3 months after your operation. 1. Do not bend your hip more than 90 degrees (a right angle) When you sit down, your knees should never be higher than your hips. This means that you must avoid sitting on low beds, chairs or toilets. You must take care when standing up and sitting down to ensure that you do not bend forward too far. 2. Do not move your operated leg across your midline Imagine a line from your nose to your tummy button to between your feet. Your operated leg must not cross that line. When getting in and out of bed you should be particularly careful about this. You must not cross your legs, either at your knees or ankles. When sleeping, lie on your back or on your operated hip. You should not lie on the other side as this can cause your operated leg to fall into the wrong position. 3. Do not twist your operated hip When you are standing do not twist your leg fully inwards or outwards. If you need to turn around, step around slowly rather than swivel on your operated leg. You should also be careful not to twist your upper body around when you are standing or lying as this also causes too much rotation at your hip. 4. Do not pick anything up from the floor If you drop something try to ask someone else to pick it up or use your ‘helping hand’ grabbing device.

You will see a physiotherapist on the first day after your surgery. They will check that you are able to use your thigh muscles and move your hip before helping you to get up. Initially you will use a walking frame for support but this will quickly be progressed to walking with crutches and possibly sticks before you go home. How quickly your walking improves varies from person to person. Most people will be allowed to put as much weight on their leg as feels comfortable to them. However, sometimes people will be told not to put all their weight on the operated leg (partial weight-bearing) and your physiotherapist will instruct you on how to do this.

It's a procedure where damaged hip joint that is a ball-and-socket joint is replaced by artificially designed prosthetic joint.

When you are not able to perform daily activity of living on your own without much pain and need some support either walker frame or medications for control of pain on daily basis then this procedure is performed for a painful worn hip joint.

All surgery carries an element of risk. Hip replacement surgery is a very successful pain-relieving and function-restoring operation in approximately 99% of cases. The main risks are infection (1%), dislocation (1-2%), Deep vein thrombosis and embolism (3-4%). Dr. Amit takes all the precautions to avoid these complications.

The implants are made up of stainless steel, titanium, chrome-cobalt alloy, ceramic, metal and polyethylene. It is going to be Dr. Amit's decision to choose the best combination in the best interest of patients after seeing clinical condition of patient, his/her age and functional need.

First of all you need to undergo “pre anaesthesia assessment”. These are routine pre-operative investigations including blood tests, blood pressure measurement and x-rays. You will usually be admitted a day prior to the day of surgery and be starved for 6 hours prior to the operation. The anesthetist will talk to you about the kind of anaesthesia which may involve a spinal-epidural and/or general anaesthesia.

It varies person to person and what kind of bone strength one has. Usually it is very next day to surgery that you will be out of bed. The physiotherapists in my supervision will help and train you to get you up and starting to mobilize the next day.

Most patients will be able to leave at 6 or 7 days.

You will usually be able to bear full weight through the leg. The physiotherapists will help you to understand and make you walk with the help of a frame if need be. They will ensure that you are able to mobilize adequately and will train you for toilet activity as well. Supervised physiotherapy will also continue for several sessions at your home. Your skin staples will need to be removed about 14 days following the operation.

This depends on the nature of your work. In general, you will be able to drive for six to twelve weeks following the operation. Most people would probably require a similar time off work. However, working from home would be possible after a couple of weeks.

The main precaution is avoiding bending your hip beyond your waist while twisting your knee inwards. This is to avoid dislocation. Avoid squatting and cross leg sitting as far as possible.

Please contact us if you have any other questions about this or any other procedure.