October 2008


What is a total hip replacement?
A total hip replacement surgery or THR (also known as total hip arthroplasty, full hip replacement and complete hip replacement) is a procedure performed in order to treat:
• osteoarthritis of the hip joint (bone on bone)
• severe pain in hip joint
• loss of motion in hip joint
• deformity of the hip joint
• hip injuries
• rheumatoid arthritis
• bone tumor
• bone loss due to insufficient blood supply (avascular necrosis – AVN)

What are the components of a hip implant in a total hip replacement?
total hip replacement surgery implant photo xrayIn a total hip replacement surgery, the painful parts of the damaged hip are replaced with artificial hip parts called a prosthesis, a device that substitutes or supplements a joint. The prosthesis consists of steel components: a socket, ball, and stem.

The outer shell of the socket is usually made of metal and the inner shell consists of plastic, or the entire socket may be plastic. When the metal ball is joined with the socket, the new hip can allow for smooth, nearly frictionless movement.

What are the different hip replacement implant options available?
The materials used in the implant depend on several factors, including the age of the patient, the activity level of the patient, and the surgeon’s preference.
Below are brief generic descriptions of some of the most commonly used hip replacement implants.

• Metal and Plastic Implant
These are the most commonly used hip replacement implants. Both the ball and the socket of the hip joint are replaced with a metal prosthesis, and a plastic spacer is placed in between. The metals used include titanium, stainless steel, and cobalt chrome. The plastic is called polyethylene.

• Metal-on-Metal Implant
In this case there is no plastic piece inserted in between. Metal-on-metal implants do not wear out as quickly as the metal and plastic materials.

• Ceramic-on-Ceramic Implant
Ceramic bearings are available in 2 configurations: a ceramic femoral head (ball) with a polyethylene liner, or a ceramic femoral head (ball) with a ceramic liner. These are designed to be the most resistant to wear of all available hip replacement implants and they wear even less than the metal-on-metal implants. Ceramics are more scratch resistant and smoother than any of these other implant materials.

• Metal and Highly Crosslinked Polyethylene
One of the more commonly used implants are new types of plastic that are designed to be more resistant to wearing out. These so-called highly crosslinked plastics are manufactured in a way that they wear out less quickly than the traditional plastics. However, since these implants have been available only for a few years, no long-term data is present to establish how well they work compared to the traditional plastic implants.

How is the implant affixed in the body?
This is achieved in one of three ways:
• Bone Cement: A special type of bone acrylic cement may be used to secure some or all of the implant components to the bone. If used, the bone cement takes about 15 minutes to set.
• Press-Fit or Cementless: The implants may be “press-fit” into the bone. Press-fit components may have a special porous coating that allows bone tissue to grow up to it for fixation.
• Combination: Depending upon the implant components and condition of the pelvic and thigh bone, a combination of cement and press-fit attachment may be used.

Who are some of the hip replacement implant manufacturers?
Some of the hip replacement implants manufacturers are:
Johnson & Johnson DePuy
Stryker
Biomet
Zimmer
Smith & Nephew

What activities can I do or not do after receiving a hip joint replacement?
• Typically, patients are advised to avoid high impact sports such as jogging, basketball, racquetball, gymnastics, etc.
• Safer activities may include walking, golf, swimming, and bicycling.

What is the MIS (minimally invasive surgery) approach in total hip replacement surgery? What are its benefits?
The MIS approach (also known as “keyhole surgery”) in total hip replacement (THR) is an alternative to the traditional total hip replacement surgery. Traditional surgery involves a long incision and the surgeon has to cut muscles, tendons and ligaments to access the hip joint. The more tissues that are cut, the longer it usually takes patients to heal. The MIS approach is a less invasive approach of doing a hip replacement surgery in which the size of the cut is reduced. Newer surgical techniques and tools allow MIS surgeons to place the same hip implant in a manner that allows muscles and tendons to be avoided or separated, rather than cut. This makes rehabilitation faster and less painful and causes less scarring.

Some of the potential patient benefits of the MIS procedure are:
• A single, smaller incision
• Less tissue trauma
• Spares muscles and tendons, allowing for the possibility of a faster recovery
• Faster and less painful rehabilitation
• Shorter hospital stay
• Smaller scar
• Reduced blood loss and less need for pre-surgery blood donation
• Faster return to work and daily activities

Is there an alternative to total hip replacement?
Hip replacement is usually considered for patients who are older than 60. For younger active patients, a different surgery called Birmingham hip resurfacing is a better alternative. Compare hip replacement with hip resurfacing.

How much does a total hip replacement surgery cost?
Check out:
Hip replacement in India
Hip replacement in Belgium
Hip replacement in Mexico

Who are some of the well-known surgeons who perform the hip replacement surgery?
Dr. Vijay C. Bose
Dr. Kaushal Malhan
Dr. Yash Gulati
Dr. Raju Vaishya
Dr. Sanjiv KS Marya
Dr. Koen De Smet
Dr. Dario Garin

Check out patient stories here.

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Now you can get medical tourism type price and quality for procedures received in the US.

How is that possible?
Because Healthbase has partnered with several US healthcare providers that offer procedures at very competitive prices that are comparable to what American-accredited foreign providers offer.

So now affordable high quality medical care is made available closer to home for patients from the US, Canada and Mexico. Patients from European countries and other nations looking for top quality care in the United States also stand to benefit from this partnership.

According to Saroja Mohanasundaram, CEO of Healthbase,

Majority of our clients from North America are drawn to medical tourism for the cost advantage it offers. However, some may not be able to take advantage of it due to the travel involved. So Healthbase has negotiated with US-based providers to offer the same top US-standard quality of care to our customers at a much reduced rate than what is prevailing. Hence, those who need quick access to top quality healthcare can avail of the low prices right here at home.

We all know that US providers charge a much higher rate to uninsured patients than they do to insured patients or insurers. But not anymore. A heart bypass tagged at over $100,000 (for uninsured patients) can now be had for an 85% discount. Such rates also closely match the lower foreign rates.

Mohanasundaram adds,

Our US providers offer a complete slew of services in all departments of medicine including cardiac (heart bypass, valve replacement, aneurysm repair), orthopedic (hip replacement, total knee replacement), general surgery, diagnostics, and so on

Who to contact for discounts on major procedures conducted within the US?
Healthbase

Further reading:
News release from Healthbase about this partnership

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