The past decade has seen a big jump in the number of hip replacements that are performed each year worldwide. This number has increased significantly over the years as did the success rate, primarily due to the improvement in joint replacement technology and the quality of implants. People have begun to think of hip or knee replacements as a common orthopedic procedure, while they still are major surgical procedures. The surgery still has some risks and complications, and therefore must be avoided if possible.
There are various reasons for needing a hip replacement, but the most common one is osteoarthritis or the breakdown of cartilage located on the surface of the hip joint. The damaged cartilage results in inflammation and pain in the hip, causing symptoms such as pain and restricted movement. When these symptoms become unbearable and physical therapy or other non-invasive fails to improve the situation, the doctor generally suggests hip replacement surgery.
There are other conditions that may make a hip replacement unavoidable, including genetics, rheumatoid arthritis, or trauma to the hip, such as a hip fracture. The orthopedic surgeon may assess the patient’s condition with imaging and other tests. The choice of surgery will also depend on the patient’s age and general health. Hip replacement surgery in India is inexpensive compared to other nations and has an excellent success rate. However, one must always try to avoid such major surgeries if possible.
Here are some tips that may help patients keep their joints strong and prevent the need to undergo a hip replacement surgery:
Maintaining appropriate body weight:
Excess body weight will put undue pressure on the joints – hip as well as knee. It may cause the cartilage over the joint to break down more quickly. Therefore, weight loss to have a proper BMI and fit body is of high importance to avoid a joint replacement surgery. Patients who start having hip and joint pain are recommended to lose appropriate percent of their body weight to relieve excess pressure on the joints. Although, losing weight may not replace the damaged cartilage, it will help reduce the amount of stress that is being put on their joints.
Physical therapy and exercise
Physiotherapy and regular exercise can play an important role in avoiding joint surgery. It helps strengthen the muscles that support the hip joints. The quadriceps in the thigh, hamstrings in the back part of thigh and lower back can help maintain hip and knee strength.
The patients are usually asked to focus on strengthening these muscles with appropriate exercises. Studies in reputed journals such as the New England Journal of Medicine have mentioned that physical therapy can play an effective role in relieving knee pain as some surgeries. Other researches have also indicated that a therapeutic exercise program may help improve the symptoms of osteoarthritis of the hip.
There are many exercises that aid in building muscle strength, such as for quad muscles – exercising while lying down and tightening the quads with legs out in the front, or lying on the stomach and raising one foot into the air to strengthen the hamstrings. Gradually one may progress to standing exercises including the leg lifts and curls, and then exercise with the weight machines. The muscles in gluteus or the buttocks and flexors in the pelvis are also important for building the hip strength and flexibility. For this, one may start with various kinds of leg lifts, such as extensions and clamshells. Then gradually progress to exercises on weight machines.
Another important movement is stretching to keep the muscles flexible. Experts recommend doing this before and after exercising. Exercise increases the blood flow to the area and makes the muscle more amenable to changes such as stretching.
Changes in the muscles can be seen after four to six weeks of routine exercises. A person may move to more rigorous forms of exercises for two to three times a week, but it is highly advisable to not cutting off on exercise or go back to a nonactive lifestyle. Physical activity may not restore cartilage, but if a person stops the symptoms may come back.
Also limiting physical activity can make joint damage worse. This is because inactivity will cause the cartilage loss between bones and may also lead to more bone-on-bone contact or friction. This results in extreme pain. Exercise and physical activity also helps stimulate the release of a substance called synovial fluid. Additionally, it ensures adequate supply of nutrients to lubricate and loosen the joint. Aerobic exercises and low-impact activities such as the recumbent bike, walking and swimming for at least 3 times weeks are also good options that can help patients achieve optimal joint health.
Medications and supplements
Initially, the doctor may prescribe the dose of pain and medical supplements such as glucosamine and chondroitin. This helps relieve symptoms of osteoarthritis. Analgesics or NSAIDs help reduce severe pain if other forms of treatments do not improve the condition. These are non-surgical options and their use may depend on the patient’s level of commitment to make required modifications to lifestyle including weight loss and exercise.
These injections work by relieving the arthritis pain. Cortisone is a type of steroid that help reduce the inflammation and joint pain. Although, the injections may not work properly for everyone, it is a considerable option for many people.
Credit: Sachin Saini