Tag Archives: best orthopaedic in Delhi

Hip Replacement

Hip Surgery – Indications, Description of the Procedure, Complications

What is hip joint degeneration?

Contrary to appearances, degeneration of the hip joint is not a disease that affects only the elderly, because the first symptoms of this disease may be felt even in people over 45, and sometimes even earlier. If the disease is not properly treated, the accompanying symptoms worsen over time and cause pain in patients, mainly in the groin, hip and buttock, gait disturbances in the form of limping and rocking to one side while walking, such as also the stiffness and limitations of movement that are most troublesome in the morning.

Additionally, patients report to best orthopaedic in Delhi with symptoms such as jumping and crackling in the hip, and complaints of weakening of the thigh and buttock muscles on the degenerative side. All these ailments result from the weakening of the regenerative capacity of the articular cartilage, which due to the influence of various factors becomes thinner and loses its elasticity and, above all, ceases to act as a shock absorber. As a result, the surface of the head and acetabulum rub against the surface of the hip joint and secondary inflammation is formed in and around the joint, leading to reduced mobility.

The causes of hip osteoarthritis

Degeneration of the hip joints can be both primary, where the disease is mainly caused by natural wear and tear. The secondary causes responsible for the accretion of degenerative changes include: congenital defects of the hip joint (dysplasias), inflammation of the hip joint caused by e.g. rheumatoid arthritis or gout, acute injuries of the hip joint such as fractures and dislocations leading to the disturbance of the anatomical conditions of the hip. In addition, overloads that occur as a result of the nature of the work performed or the overweight or obesity of the patient are also important.

Hip osteoarthritis diagnosis

In most cases, a detailed medical history combined with an examination and an X-ray image are sufficient to make a diagnosis, on the basis of which the symptoms of degeneration are assessed, such as e.g. bone tissue thickening, bone spurs (osteophytes) on the edges of the acetabulum or narrowing of the joint space due to the loss of cartilage thickness. In some cases, the orthopaedic doctor in Delhi also orders an MRI of the hip, which allows him to assess in detail any damage to the labrum and cartilage of the hip joint.

When is a hip endoprosthesis necessary?

The indication for hip arthroplasty is critical and irreversible damage to the joint, which causes permanent and resting pain, the importance of limiting the range of motion. These ailments do not respond to treatment with other therapeutic methods. In these cases, arthroplasty is the only effective solution. Additional indications for the procedure are rheumatoid diseases, consequences of fractures in the area of ​​the hip joint, fractures of the femoral neck, early forms of sterile bone necrosis as well as neoplastic diseases.

What is a hip endoprosthesis?

An endoprosthesis is an artificial joint that replaces our natural one in the form of an implant. Thus, the endoprosthetics procedure consists in removing degraded and worn out elements of the hip joint and replacing them with artificial parts. Endoprostheses are made of metals inert to the patient’s body, such as titanium, which minimize the risk of implant rejection. The endoprosthesis consists of a shaft that is inserted into the medullary canal of the femur and the spherical head is mounted on it, which allows for movements. Additionally, the endoprosthesis includes an acetabular component in the form of a hollow hemisphere, which is implanted in the place of the diseased natural, bony acetabulum and it is between the acetabulum and the head that moves.

What types of hip endoprostheses are there?

Hip joint endoprostheses can be divided due to the way they are bound to the bone base, and they are:

  • cement prostheses where it is attached to the bone with the so-called bone cement. In most cases, this type of prosthesis is used in procedures in the elderly as well as in patients suffering from osteoporosis or rheumatoid arthritis.
  • Cementless endoprostheses, which are implanted directly into the bone and are used in the case of young patients who have not had bone degeneration
  • Hybrid endoprostheses, which are a combination of both previous types, because one element of the prosthesis, which is most often the cup, is embedded with the cementless method and the other element of the implant with the cement method

What does hip arthroplasty look like?

The duration of the hip replacement surgery in Delhi depends on the degree of deformation of the hip joint and lasts from 1 to 2 hours. The procedure is performed under spinal or epidural anesthesia, during which the feeling in the legs is turned off. After the surgical approach is performed, the orthopaedic surgeon in Delhi reveals the affected area and proceeds to resection of the head and neck of the femur, which creates space for an artificial joint element. In the next stage of the operation, the bone bed is prepared for the hip joint endoprosthesis and the endoprosthesis is fixed. At the beginning of implantation, an artificial acetabulum is implanted into the iliac bone, and then the endoprosthesis stem is inserted into the femoral canal. The stage that ends the procedure is the reconstruction of soft tissues, placing a layered suture on the surgical wound,

Does hip replacement surgery pose a high risk to the patient?

Correctly performed hip joint prosthesis implantation is a routine operation with documented good results. As with any surgical procedure, postoperative complications may occur, the most common being mechanical loosening of implants, infections in the skin and tissues near the prosthesis, the occurrence of venous thrombosis, change in limb length or joint ankylosis.

Do implanted endoprostheses need to be replaced? 

Due to the fact that modern prostheses are made of good-quality, long-lasting materials, a properly implanted endoprosthesis can serve the patient for decades. However, it should be emphasized that a hip joint prosthesis is an artificial element in our body that can simply wear out in the form of loosening, displacement, falling out of the joint or cracking. Although such situations rarely occur, it is good news for patients because virtually every malfunctioning endoprosthesis can be replaced during the so-called revision replacement of the hip joint endoprosthesis.

What is the patient’s life like after the hip replacement surgery?

Hospitalization after hip replacement in Delhi is approximately 5 – 6 days. For each patient, an antibiotic shield is used for 3-4 days after the procedure, as well as thromboprophylaxis, which is applied until the 30th postoperative day. The next day after the surgery, the patient is upright and learns to walk on crutches and skillfully weight the operated side of the body. As a standard, on the next day after the procedure, it is possible to start walking with gradual loading of the operated limb. It takes about 3 months to recover. During this time, rehabilitation is recommended, followed by a gradual introduction of physical activity such as walking, cycling or swimming.

Hip prosthesis implantation procedures are actually a rescue operation that will damage but a very important part of our skeletal system, which allows patients to regain the correct quality of life, eliminate pain as well as return to everyday life and work activities.

Also Check:























Hip Fracture Treatment


The femur is the longest and strongest bone in the human body. For its fracture to occur, the effect of a sufficiently high force is necessary. One of these reasons could be, for example, a car accident.

The long, straight part of the femur is called the diaphysis. The fracture can occur at any part of it. Such fractures almost always require surgical treatment.


Depending on the energy of the injury, the nature of femoral fractures can vary greatly. Fragments may remain in their normal position (stable fractures) or significantly displaced (displaced fractures). The skin in the area of ​​the fracture may be intact (closed fracture) or it may be damaged, and the fracture may communicate with the external environment (open fracture).

Fractures are referred to by orthopaedic doctor in Delhi according to various classification systems. Hip fractures are classified according to:

  • Fracture localization (femur diaphysis is divided into thirds – distal, middle and proximal)
  • The nature of the fracture (the fracture line can be located in different ways: transversely, obliquely, etc.)
  • Damage to the skin and soft tissues in the area of ​​the fracture.

The most common types of hip shaft fractures are:

Transverse fracture. In this fracture, the line runs horizontally across the long axis of the thigh.

Oblique fracture. The fracture line is located at an angle to the axis of the thigh.

Spiral fracture. The fracture line is located in a spiral, as if surrounding the diaphysis of the thigh. The mechanism of such fractures is twisting along the long axis of the thigh.

Comminuted fracture. With such fractures, three or more bone fragments are formed. In most cases, the number of bone fragments is proportional to the severity of the traumatic effect that caused the fracture.

Open fracture. In such cases, the bone fragment can perforate the skin, or there is an open wound in the fracture area that communicates with the fracture zone. Open fractures are often characterized by greater damage to the surrounding muscles, tendons, and ligaments. These fractures have the highest risk of complications, especially infections, and usually take longer to heal.


Fractures of the femur in young people are often the result of some kind of high-energy impact. The most common cause of hip shaft fractures is car accidents. Other common causes are pedestrian collisions with a moving vehicle and falls from a height.

Low-energy injuries, such as falls from their own height, can cause hip shaft fractures in older people with poor bone quality.


A hip shaft fracture usually immediately results in severe pain in the affected area. The victim loses the ability to lean on the injured leg, the hip may look deformed – it may be shorter and take an uncharacteristic position.


The orthopaedic in Delhi must know the circumstances of your injury. This information will help the orthopaedic surgeon in Delhi assess the energy of the injury and the presence of possible collateral damage.

It is important that the orthopaedic in Dwarka knows about any comorbidities you have – hypertension, diabetes, asthma, or allergies. The doctor will also ask you if you smoke or take any medications.

After discussing with you the nature of the injury and history, the orthopaedic in Janakpuri will perform a thorough physical examination. In doing so, the doctor will assess your general condition and then the condition of the injured limb. In this case, the orthopaedic in West Delhi will pay attention to details such as:

  • Visible limb deformity (unusual angle, rotation, or shortening of the limb)
  • Damage to the skin
  • Hemorrhage
  • Perforation with bone fragments of the skin

After a visual examination, the best orthopaedic in Delhi palpates the thigh, lower leg and foot, not the subject of possible pathological changes, tension of the skin and muscles in the fracture area. Also, the doctor will assess the nature of the pulse on the foot. If you are awake, your doctor will evaluate sensitivity and movement in your lower leg and foot.


Radiation testing allows the doctor to obtain more detailed information about your injury.

Radiography. It is the most commonly used method for diagnosing bone fractures. It allows not only to see the fracture, but also to characterize its type and localization.

Computed tomography. If the doctor needs more information about the nature of the fracture than is shown on the x-ray, the doctor may prescribe a CT scan. Sometimes the fracture line is very thin and almost invisible on radiographs. CT can help visualize these fractures more clearly.



Most hip shaft fracture treatment in Delhi require surgical intervention and rarely can be treated conservatively. So, the method of plaster immobilization is sometimes used to treat hip fractures in young children.


The timing of the operation. Most hip fractures are best operated within the first 24 to 48 hours after injury. Sometimes the operation is postponed due to the presence of life-threatening conditions or the need to stabilize the patient’s condition. To reduce the risk of infection in open fractures, patients are given antibiotics right after hospitalization. During the operation, open wounds, tissues and bone fragments are treated from contamination.

During the waiting period between admission to the hospital and surgery, the orthopaedic surgeon in Dwarka may temporarily fix your leg with a cast or skeletal traction. This allows you to maintain a more or less optimal position of the fragments and the length of the limb.

Skeletal traction is a system of blocks and weights with which bone fragments are held in one position. It allows not only to achieve the correct position of the fragments, but also to stop the pain syndrome.

External fixation. During such an operation, metal wires or rods are inserted into the femur above and below the fracture site, which are fixed to an external fixation device. This allows you to keep the fragments in the correct position.

External fixation is most often used as a method of temporary stabilization of a fracture in patients with multiple injuries, whose condition does not allow performing a more traumatic operation of internal fixation of the fracture. The second stage in such cases is performed after the patient’s condition has stabilized. In some cases, the external fixator is left on until the fracture is completely healed, but this is not common.

Intramedullary osteosynthesis. Today it is the most commonly used method of internal fixation of hip shaft fractures. In this case, special metal rods are used, which are inserted into the medullary canal of the femur. The rod passes through the fracture zone and holds the fragments in the correct position.

An intramedullary nail is inserted into the medullary canal from the side of the hip or knee joint. Above and below the fracture site, the rod is locked with screws to exclude mobility in the fracture area.

Intramedullary rods are usually made of titanium. They come in various lengths and diameters to fit most of the thigh bones.

Plates and screws. In such operations, the bone fragments are repositioned first, i.e. returning them to their normal position, after which the fragments are fixed from the side of the outer surface of the bone with a metal plate and screws.

This method is used when intramedullary osteosynthesis is not possible, for example, when the fracture line extends to the hip or knee joint.


Most fractures of the femoral shaft will heal within 3-6 months. Sometimes, for example, with open or comminuted fractures, as well as in smokers, it takes longer.


Pain after injury or surgery is a natural component of the healing process. Your doctor and nurses will do whatever is necessary to reduce pain and make your recovery more comfortable.

Various medications are usually used to relieve pain after an injury or surgery. These are paracetamol, non-steroidal anti-inflammatory drugs, muscle relaxants, opioids and topical drugs. In order to optimize the analgesic effect and reduce the patient’s need for narcotic analgesics, these drugs are often used in combination with each other. Some of these drugs can have side effects that affect your ability to drive or engage in other activities. The doctor will definitely tell you about the possible side effects of the drugs prescribed to you.


Many doctors recommend starting movements in the joints of the operated limb as early as possible, but you need to load the leg when walking only in this way and only when and as your doctor permits.

In some cases, almost full loading is allowed immediately after the operation, but sometimes this is possible only after the first signs of fracture union appear. Therefore, we recommend that you strictly follow all the instructions of your orthopaedic surgeon in West Delhi.

You will need to use crutches or walkers when walking.


After surgery, the muscles in the area of ​​the fracture are likely to be significantly weakened, so exercises to help restore muscle strength are very important during the rehabilitation process. Physiotherapy in Dwarka will restore normal muscle strength and joint mobility. It can also help you cope with postoperative pain.

A physiotherapist in Dwarka will likely start working with you while you are still in the hospital. He will also teach you how to use crutches or walkers correctly.

Contact Best Orthopaedic in Delhi for all Orthopaedic Treatments.