Partial Hip Replacement Surgery: Procedure, Recovery Time

Hemiarthroplasty is a surgical procedure used to treat hip fractures or severe arthritis in the hip joint. The term "hemi" refers to "half," indicating that only part of the hip joint is replaced.  It involves replacing only the ball portion of the hip joint, leaving the socket intact. This partial hip replacement is done to improve mobility and alleviate pain.

The hip joint plays a crucial role in weight-bearing activities and is essential for overall mobility and stability. It is located where the thigh bone (femur) meets the pelvis bone (acetabulum), forming a ball-and-socket joint. 

The femoral head, or the "ball," fits into the acetabulum, or the "socket," allowing for a wide range of motion. The anatomy includes:

1. Articular Cartilage: It covers the surfaces of the femoral head and acetabulum, providing smooth movement and cushioning.

2. Ligaments: These surrounding the hip joint provide stability and support, helping to hold the bones together.

3. Muscles and Tendons: It is placed around the hip joint help with movement, including walking, running, and bending.

4. Synovium: The synovial membrane lines the joint capsule, producing synovial fluid to lubricate and nourish the joint.

Hip joints exhibit considerable strength and stability. Contact sports and frequent running can increase the risk of hip joint injuries due to the significant force exerted on the joints. 

The conditions that require hemiarthroplasty surgery are:

1. Fractured Hip: This procedure is frequently recommended for individuals who have sustained a fractured femoral neck or head. 

2. Osteoarthritis: It helps patients suffering from degenerative joint disease by replacing the damaged femoral head while preserving the acetabulum.

3. Rheumatoid Arthritis: In cases where this condition primarily affects the femoral head, hemiarthroplasty can provide relief. It replaces the damaged portion of the joint with an artificial component.

When understanding bipolar hemiarthroplasty vs total hip replacement, it is imperative to understand the advantages of each. 

Hemiarthroplasty surgery restores joint function by replacing damaged joint surfaces, allowing for increased mobility and range of motion. It enhances joint stability, reducing the risk of falls and instability-related injuries. 

Below are the benefits of hemiarthroplasty:

1. Faster Recovery: Compared to more extensive joint replacement procedures, hemiarthroplasty typically involves a shorter recovery time, enabling patients to return to their daily activities sooner.

2. Minimally Invasive: With advancements in surgical techniques, hemiarthroplasty can often be performed using minimally invasive approaches, resulting in smaller incisions and reduced tissue damage.

3. Preservation of Healthy Tissue: This surgery preserves healthy bone and tissue, minimising the need for extensive bone removal and preserving natural joint anatomy.

4. Long-Term Durability: Hemiarthroplasty implants are designed to be durable, providing long-term joint function and stability for years to come.

Hemiarthroplasty takes 60 to 90 minutes under general anaesthesia. Below are the procedure steps in the operation theatre:

1. Anesthesia Administration: General anaesthesia is administered to keep the patient comfortable during the procedure.

2. Patient Positioning: The patient is positioned on their side, known as the lateral decubitus position. It provides optimal hip joint access while ensuring comfort and safety.

3. Surgical Site Preparation: The surgical team sterilises and prepares the area around the hip joint to minimise the risk of infection during the procedure.

4. Femoral Neck Incision: An incision is made at the top of the femur, specifically at the femoral neck, to access and treat the damaged portion of the bone.

5. Templating the Implant: A test implant is temporarily positioned to check fit and alignment.

6. Femur Preparation: The femur is prepared to receive the implant, which may involve removing damaged tissue and shaping the bone to accommodate the implant securely.

7. Cement Application: Once the optimal position is confirmed, cement is applied to the femoral canal to secure the implant. The final implant is then carefully positioned for optimal function and longevity.

8. Attachment of Head and Neck Implants: The artificial ball and socket components are attached to complete the hip replacement, ensuring proper joint function and stability.

9. Range of Motion Testing: The surgeon assesses the range of motion of the new hip joint to ensure smooth movement without any issues.

10. Muscle Repair: Any muscles or soft tissues are repaired and reattached to restore stability and function to the hip joint for a smooth recovery.

The incision is closed, and the patient is sent to the recovery room for further observation.

Understanding what happens before and on the day of hemiarthroplasty surgery can prepare a patient both physically and mentally. This minimises the risks and optimises outcomes.

Before Surgery 

Before undergoing hemiarthroplasty surgery, patients undergo several preparatory steps to ensure a safe and successful procedure.

On the Day of Surgery

Patients undergo essential pre-operative procedures on the day of surgery to ensure their safety and readiness. This ensures a smooth transition into surgery, with patients fully informed.

After hemiarthroplasty surgery, patients can expect a full recovery in 6 weeks. The doctor will make rehabilitation plans based on the patient's individual needs. 

The Recovery Process in Hospital 

During this phase, patients receive specialised care and support for a smooth transition towards mobility. The key aspects of the recovery process in the hospital are:

1. Pain Management: Patients are closely monitored, and appropriate pain relief medications are administered as needed.

2. Physical Therapy: Therapists initiate early mobilisation and rehabilitation exercises to prevent stiffness and regain mobility.

3. Wound Care: Healthcare providers check the surgical incision site for signs of infection.

4. Assistive Devices: Patients may be provided with walkers or crutches to aid mobility.

Recovery Process/Expectation After Hospital Discharge 

Upon discharge from the hospital, patients continue their recovery at home, adapting to the daily life post-surgery. Proper nutrition and hydration are emphasised to support the healing process. 

Patients are encouraged to consume a balanced diet rich in vitamins and minerals and stay hydrated to aid tissue repair and recovery. The following are post-discharge recommendations for recovery at home:

1. Wound Care Instructions: Patients receive detailed instructions on how to care for the surgical incision at home, including keeping it clean and dry, changing dressings as directed, and monitoring for signs of infection.

2. Pain Management: Doctors prescribe pain medication to be taken as directed to manage post-operative discomfort. Patients are advised on the proper dosage and frequency of medication.

3. Physical Therapy Exercises: Patients are provided with specific exercises to perform at home to improve joint mobility, strength, and flexibility. These exercises are essential for facilitating recovery and restoring function in the affected joint.

4. Mobility Aids: During the early stages of recovery, assistive devices such as crutches, walkers, or canes can be used to aid in walking and prevent falls. The doctor explains the proper usage and adjustment of these aids.

5. Activity Restrictions: Guidelines are given on which activities to avoid during the recovery period, such as heavy lifting, high-impact exercises, and certain household chores. Following these restrictions helps prevent complications and promotes healing.

First Follow-Up Appointment

The doctor evaluates the patient's progress and inquires about any post-operative concerns. The key aspects are:

1. Incision Assessment: The surgical incision site is examined for signs of healing, infection, or complications.

2. Physical Examination: Healthcare providers conduct thorough tests, such as straight leg raises, to assess range of motion and strength.

3. Imaging Studies: X-rays may be performed to evaluate the position and stability of the prosthetic implant.

While bipolar hemiarthroplasty is generally a safe and effective procedure, it's essential to understand the potential risks involved. The risks  associated are:

1. Infection: There is a risk of developing a surgical site infection, which may require antibiotic treatment or additional surgery.

2. Dislocation: The prosthetic hip joint may disconnect, particularly in the early postoperative period, requiring revision surgery.

3. Implant Loosening: The prosthetic may wear out over time, necessitating surgery.

When to consult a doctor?

Knowing when to seek medical attention after hemiarthroplasty surgery is crucial for ensuring prompt treatment. The signs and symptoms that warrant a visit to the doctor are:

1. Persistent or worsening ache in the hip joint or surgical site, especially if not relieved by prescribed pain medications.

2. Swelling, redness, or warmth around the incision site may indicate an infection.

3. Increased difficulty walking, bearing weight on the operated leg, or performing daily activities.

4. Any other concerning symptoms, such as numbness, tingling, weakness, or drainage from the operated site.

Chronic joint pain and functional limitations can have a significant impact on overall physical and mental health, leading to decreased mobility, increased dependency, and reduced quality of life.

Below are the risks of delaying the procedure:

1. It can worsen joint pain and discomfort, make daily activities more challenging, and affect quality of life.

2. Over time, the underlying joint condition may deteriorate further, leading to increased joint damage and deformity, which can complicate surgical outcomes.

3. Delaying treatment can decrease joint mobility and range of motion, making it more difficult to perform everyday tasks and activities.

4. Reduced joint stability and mobility increase the risk of falls and related injuries, such as fractures or dislocations, especially in older adults.

5. Advanced joint degeneration and associated complications can make surgical intervention more challenging and increase the risk of post-operative complications.

Cost of Hemiarthroplasty

The cost of hemiarthroplasty varies based on several elements. Understanding these factors is essential to make informed decisions. The general overview is as follows:

Note: The above values are approximate and subject to change. Contact HexaHealth for the pricing structure.

Factors that may affect the cost of hemiarthroplasty include:

1. Hospital Fees: The cost of the surgical facility, including operating and recovery room charges, contributes significantly to the overall bill.

2. Doctor's Fee: The expertise and experience of the orthopaedic surgeon performing the procedure may impact the price of hemiarthroplasty.

3. Implant Cost: The type and quality of the prosthetic implant used in hemiarthroplasty surgery can vary, leading to different expenses. Unipolar hemiarthroplasty is the preferred option over bipolar hemiarthroplasty due to its lower cost.

4. Diagnostic Tests: Preoperative examinations such as X-rays, MRI scans, and blood tests may incur additional costs.

5. Postoperative Care: Expenses related to follow-up appointments, physical therapy sessions, and medication costs should also be considered.

Hemiarthroplasty is one of the most advanced solution for hip joint replacement. It minimises surgical trauma, resulting in lower blood loss. By specifically targeting the damaged femoral head, it enhances a patient's quality of life. 

HexaHealth can guide you for the best hemiarthroplasty surgery with its wide network of doctors and advanced hospitals. We ensure seamless access to quality healthcare every step of the way. Get in touch!

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