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Total hip replacement (THR) surgery is considered as one of the most valued developments in the history of orthopaedics. Ever since the first modern successful Total hip replacement, which was first pioneered in the 1960s by Sir John Charnley, this procedure has seen some amazing developments over time. It is recognised as a life changing procedure as it relieves pain, restores function and mobility in patients whose joints have been worn out by osteoarthritis and destroyed by trauma. Major improvements in the materials provide excellent outcomes over the long term and the modern surgical techniques enable faster rehabilitations.
A number of studies of hip and knee replacements have shown that after 20 years, 90 percent or greater are still functioning after 20 years, and after 30 years the rate is around 70 percent.
The surgery involves making an incision around the hip and the femoral head (ball) and the acetabulum (socket) is exposed. The femoral head and neck of the femur are removed and the cup is cleaned and sequentially prepared for the artificial cup-shaped component. A channel inside the femur (thigh bone) is prepared to the correct size so that femoral stem can be fitted inside the femoral canal. This is followed by fitting a ball over the femoral stem and putting the hip back in position and reattaching the capsule of the hip joint and suturing the tissues and the skin.
The hip can be reached through the back of the hip (posterior approach), the side of the hip (lateral or anterolateral approach), the front of the hip (anterior approach), or through a combination of approaches. Mr Jalgaonkar performs Hip replacements through posterior approach, and recently also through the anterior approach known as AMIS. He specialises in the minimally invasive procedure (MIS), through small incisions whilst maintaining safety and effectiveness of the technique. The MIS approach can potentially decrease surgical trauma to the tissues, post-operative pain, length of hospital stay and enables faster recovery to daily activities.
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Majority of Mr Jalgaonkar's hip and knee replacements are done under spinal anaesthesia and sedation. This avoids the complications of general anaesthesia and enables quicker recovery. The patients are expected to start their rehabilitation program on the same day of the surgery. For faster recovery, it is important to work closely with the specialist physiotherapists. Most patients are discharged in 2 -3 days with appropriate instructions and a follow-up plan. Usually there are no restrictions in the mobility but patients are provided with crutches for the first few weeks for stability. You will guided by the physiotherapist and Mr Jalgaonkar regarding when to discard the crutches. Generally, patients are expected to walk independently in 4-6 weeks.
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Patients are usually advised not drive for 6 weeks and until they have the strength and the speed to make an emergency stop. You should inform your insurance company regarding the surgery. Flying should be avoided for 12 weeks following the surgery due the increased risk of thromboembolism (blood clot).
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Total Hip replacement surgery is a major surgery and has potential surgical risks. Although the success rate for this procedure is very high, some of the risks include infection, bleeding, nerve injury, thromboembolism (blood clots), fracture, dislocation, loosening or wear of the components over time, leg length discrepancy and the general risks of anaesthesia. Pre-operative computer templating aids in planning surgery and maintaining leg lengths and the correct muscle tension.
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Mr Jalgaonkar only uses ODEP rated implants with best track records. He performs uncemented, hybrid and cemented hip replacements, and prefers incorporating a ceramic bearing surface as it is best wear characteristics and is much smoother than other bearings. The decision on approach and type of hip replacement differs from patient to patient and Mr Jalgaonkar will discuss the options with you during the consultation.
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