19 Jun Total Hip Replacement with Ceramic

I would like to tell the true story of a person Mr. Ram.

He is a mechanical engineer and was happily working till a day. Four years back his back started hurting him ,then it slowly moved to his hip joints. When he presented to me he was just good enough to take few steps only and that too with severe pain.

I ran him through tests like x-rays of the joints and blood tests to find out why his joint is worn out at such a young age . Meanwhile I got to know his father had similar problem but the severity is not that worse. His father developed spine pain symptoms only at his sixth decade. But he developed at his third decade. He is married recently and his sexual life has deteriorated rapidly because of the low back and hip joint pain. His family worsened financially also as he was the only bread winner in the family.

After a day he came back with the x-ray and blood test reports. X-ray showed destroyed hip joints and fused spine bones. His blood test came as HLAB27 positive which narrowed my diagnosis to Ankylosing spondylosis . When I drilled into his past history how he was managing this problem. He said he was taking pain killers , because of which around 6 months back he had developed kidney problems and worst problem of stomach ulcer perforation . That is, stomach ulcer has gone so deep that it punctured the wall of the gut draining out the contents to Abdomen cavity . This is a life threatening condition for which Surgery was done . He had great escape from the near death .

For the Joint Replacement surgeon, Joint Replacement in Ankylosing spindlylosis is challenging one. As it is associated with complication not only during the procedure but also after the surgery. This is because something thatis working against the joints is inherently in their blood. Usually bleeding during the surgery is higher, also the bones would be weak can break during procedure. Its like putting the new joint in wafer strength bones . Also the chance of the dislocation of the new joint is quite high. He also had the problem of 3 cm shortening of the limb .So he had all these problems in one place those are pain, worn out joint, shortening, weak muscles, weak bones.

One stop solution for his problems. I offered him Total Hip Replacement . Hip joint is a ball and cup joint .In Total Hip Replacement the cup and the ball is replaced either by a metal or a ceramic. In ceramics the recent one is DELTA-Ceramic which is more sturdy and produces less wear. Recent advances show that Ceramic components in Total Hip replacement has produced less wear and longer durability of its components .And that too with bigger size implants has given the better results in the research studies. I suggested him this combination and he underwent the same .

Before the surgery I educated him what he can expect out of the surgery. I taught him the exercises he needed to do post surgery and the exercises regimen was started even before the surgery for much better post surgery outcome.

He underwent total hip replacement under local spinal anesthesia + Epidural Analgesia .The beauty of this is the after surgery patient would have very good pain relief for 48 hours. I screened him for the implant position by post surgery x ray. He underwent the procedure with out blood transfusion with painless new joint .