July 2010


If you have heard of medical tourism then you know it is the phenomenon that can buy you top-notch medical care at rock bottom prices with virtually zero waiting times. And you are probably also aware that India is one of the most popular medical travel destinations. What is great about India is you can get not only high quality care for low price but also certain unique treatments that not many other nations in the world offer, especially if you also factor in the unbeatable price. In the article below we talk about hip resurfacing surgery in India – a unique medical breakthrough technique for the treatment of hip pathology.

THE NEED FOR HIP RESURFACING
Your hip is a ball and socket joint. Both the ball and socket are covered by a protective layer of cartilage which makes the joint smooth and hip movements swift.

Any condition that damages this cartilage leads to pain, dysfunction and eventually arthritis. Injury, infection, rheumatoid arthritis, osteoarthritis and bone dysplasias are some reasons that can cause damage to this cartilage thereby necessitating a hip resurfacing surgery.

Traditionally, such issues have been addressed by a total hip replacement (THR) which is a surgery to replace the hip joint by a prosthetic implant. A THR removes part of your healthy bone so the implant can be fixed deeply into the femoral bone. Patients also have certain movement restrictions following a THR surgery.

By contrast, resurfacing, which is a less invasive bone-preserving technology, replaces only the worn, diseased and damaged surfaces of the hip joint, and places an all-metal “ball and socket” implant in the hip joint. Resurfacing allows return to normal and sporting activities post-surgery, reduces the risk of dislocation and makes revision easy (if at all needed).

These reasons make hip resurfacing more favourable over hip replacement in certain specific cases. The anatomy and bio-mechanics after resurfacing mimic a normal hip very closely making it an ideal choice for young or more active patients with non-inflammatory degenerative hip joint disease.

HOW IS A HIP RESURFACING SURGERY PERFORMED?

Birmingham hip resurfacing implant

Birmingham hip resurfacing implant (Image source: Smith & Nephew)


After separating the femur or thigh bone from the hip socket, your surgeon reshapes the head of the femur. Next, the diseased bone and cartilage are removed from the hip socket.

Then, the implant, which comprises of two parts – the metal shell component for the hip socket, and the metal ball component with a short stem for the thigh bone, is placed.

First, the metal shell implant is firmly pressed onto the hip socket. After this the surgeon drills a hole in the femur (so the stem of the femur implant can be fitted into it), fills the metal ball component with bone cement, and fits the ball on top of the thigh bone with its stem into the drilled hole.

Finally, the femur with its new metal head and the hip socket with its new metal shell are put together to form a new resurfaced ball and socket hip joint that looks and functions like a normal hip.

HIP RESUFACING SURGERY AND INDIA
In India, hip surgeons have been practicing the hip resurfacing procedure for over a decade while orthopaedic surgeons in most of the rest of the world are still new to this procedure.

In the United States, for instance, where this procedure is still not commonly performed, FDA approved the first hip resurfacing system only in 2006. It is no wonder then that surgeons in India are much more experienced in this procedure than their counterparts in America.

Today, the majority of hip resurfacing operations are performed in India on Indian as well as foreign patients. Each year thousands of hip resurfacing medical tourists from all across the globe head to India to not only be in safe hands but also enjoy a tremendous amount of savings.

You can find top hip resurfacing hospitals in India that are Joint Commission International (JCI) accredited. Additionally, several of the best Indian orthopaedic doctors are also either educated or trained internationally.

Taj Mahal, India

Taj Mahal, India

Hip resurfacing costs about USD8000 in India . This is so less compared to what U.S. hospitals charge for the same kind of service and quality that you can bring a companion along, spend on sightseeing and still save thousands of dollars.

OVERSEAS PATIENT TO INDIA FOR HIP RESURFACING
Richard, who hails from California, USA, had been suffering from osteoarthritis in his hips for a long time but was unable to get surgery in the United States, earlier because of unavailability of the procedure in the country and later because of the extravagant price tag it came at.

Facilitated by Healthbase, Richard had both his hips resurfaced through bilateral hip resurfacing surgery at Wockhardt Hospitals (now Fortis Hospital) in Mumbai, India, 3 years ago.

Richard after his surgery in India

Richard after his surgery in India (Image source: Healthbase Online Inc., http://www.healthbase.com)

Being an avid sportsperson that he was, barely 12 weeks after his hip surgeries, Richard returned to snorkelling in the sunny Southern Californian beaches. In the past, Richard had problems walking from his car to his front door.

MEDICAL TRAVEL TIPS FOR HIP RESURFACING PATIENTS
Here are the top 5 things every medical tourist needs to do or remember for a successful medical travel trip:

  1. Verify the credentials of the foreign doctor treating you.
  2. Don’t let cost be the driving factor; focus on quality.
  3. Keep your local doctor in the loop.
  4. Don’t keep your trip too short; allow time for recuperation as well as sightseeing.
  5. Engage the services of a medical travel facilitator like Healthbase. These are specialized medical travel agents that connect you with the hospital of your choice while providing all or some other valuable concierge services like detailed information about various procedures, detailed hospital profiles and surgeon profiles, medical records transfer, free surgery quote, pre- and post-consultation with the overseas hospital, feedback and testimonials from previous patients, medical and dental loan financing, passport and visa acquisition, airport pick-up and drop-off, hospital escort, tickets, travel insurance, hotel booking, sightseeing services in the destination country, etc.
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Getting a New Knee or Hip? Do It Right the First Time

An informative article on joint replacement by Lesley Alderman appeared in the New York Times recently. It talks about the things that a patient should keep in mind if considering a joint replacement (hip replacement or knee replacement) surgery. Following is the article as it appeared on the NY Times website.

THERE is nothing like a new hip or knee to put the spring back in your step. Patients receiving joint implants often are able to resume many of the physical activities they love, even those as vigorous as tennis and hiking. No wonder, then, that joint replacement is growing in popularity.

In the United States in 2007, surgeons performed about 806,000 hip and knee implants (the joints most commonly replaced), double the number performed a decade earlier. Though these procedures have become routine, they are not fail-safe.

Implants must sometimes be replaced, said Dr. Henrik Malchau, an orthopedic surgeon at Massachusetts General Hospital in Boston. A study published in 2007 found that 7 percent of hips implanted in Medicare patients had to be replaced within seven and a half years.

The percentage may sound low, but the finding suggests that thousands of hip patients eventually require a second operation, said Dr. Malchau. Those patients must endure additional recoveries, often painful, and increased medical expenses.

The failure rate should be lower, many experts agree. Sweden, for instance, has a failure rate estimated to be a third of that in the United States.

Sweden also has a national joint replacement registry, a database of information from which surgeons can learn how and why certain procedures go awry. A registry also helps surgeons learn quickly whether a specific type of implant is particularly problematic. “Every country that has developed a registry has been able to reduce failure rates significantly,” said Dr. Daniel Berry, chief of orthopedic surgery at the Mayo Clinic in Rochester, Minn.

A newly formed American Joint Replacement Registry will begin gathering data from hospitals in the next 12 to 18 months.

Meanwhile, if you are considering replacing a deteriorating knee or hip, here are some ways to raise the chances of success and avoid a second operation.

EXPERIENCE COUNTS Choose – or request a referral to – an experienced surgeon at a busy hospital. “The most important variable is the technical job done by the surgeon,” said Dr. Donald C. Fithian, an orthopedic surgeon and the former director of Kaiser Permanente’s joint replacement registry.

Ask for recommendations from friends who have had successful implants and from doctors you know and trust. When you meet with the surgeon, ask how many replacements he or she does each year.

VOLUME MATTERS A study published in The Journal of Bone and Joint Surgery in 2004 found that patients receiving knee replacements from doctors who performed more than 50 of the procedures a year had fewer complications than patients whose surgeons did 12 procedures or fewer a year.

The researchers documented a similar trend when it came to hospital volume. Patients at hospitals that performed more than 200 knee replacements a year fared better than patients at hospitals that performed 25 or fewer.

ADJUST EXPECTATIONS Not everyone with joint pain will benefit from a joint replacement.

An implant can help reduce pain and improve mobility if the joint surface is damaged by arthritis, for instance. But a new joint will not help pain caused by inflammation of the surrounding soft tissue, said Dr. Berry, who is also vice president of the board of the American Academy of Orthopaedic Surgeons.

Some people with mildly arthritic joints, for instance, can manage well with the judicious use of medication. “Surgery comes with complications and risks, and should not be approached lightly,” Dr. Berry said.

Joint replacement is not a minor operation. If you have uncontrolled high blood pressure or another serious chronic condition, a joint operation may simply be too risky for you.

NARROW YOUR OPTIONS “There is no one best joint,” Dr. Berry said. “A successful replacement depends on selecting the right implant for the patient.”

A good surgeon will recommend an implant that makes sense for your age, activity level and the shape of your joint. Younger or very active people who place more physical demands on the implant, for instance, may benefit from newer hard-on-hard bearing surfaces, like those made of ceramic, said Dr. Joshua J. Jacobs, chair of orthopedic surgery at Rush University Medical Center in Chicago.

In general, be wary of the latest, most advanced new joint. There is little evidence to support the use of more expensive designs over basic ones, said Dr. Tony Rankin, a clinical professor of orthopedic surgery at Howard University. One recent study found that premium implants fared about as well as standard implants over a seven- to eight-year period.

Be skeptical, too, of advertising gimmicks. “I had a 78-year-old patient with a perfectly good knee replacement come in and ask if she should have gotten the ‘gender knee,’ which she had seen advertised on TV,” Dr. Rankin recalled. “She was doing well, but was swayed by the idea of a knee made just for women.”

GATHER THE DATA Once you have a recommendation or two from a surgeon, find out how well the joint has performed in others and if there are known complications. The newer metal-on-metal hip implants, for instance, are somewhat controversial and may cause tissue and bone damage in certain patients.

Ask if the hospital has a registry that tracks joint replacements. If so, ask to see the data on the implants you are considering.

It is also helpful to understand what the operation involves, including the materials that will be used and how the surgeon plans to fix the joint to the bone. You can learn more about your operation at the American Academy of Orthopaedic Surgeon’s patient information Web site, orthoinfo.org.

If you want to delve deeper, look at a large national registry from another country, like Australia. The annual report of Australia’s registry lists knee and hip implants that had a “higher than anticipated revision rate.”

A caveat: the information can be difficult to parse for a layperson. “A surgeon can provide perspective on information that, taken out of context, could be misleading,” Dr. Rankin said. So discuss it with your surgeon.

PLAN YOUR RECOVERY To avoid complications during your final stage of recuperation, discuss with your doctor in advance the support you will need when you return home, Dr. Berry advised.

Recovery takes a different course for each patient, depending on the type of procedure and implant. In general, expect mild to moderate pain for the first few weeks. Some patients are able to return to work in one to two weeks, but full recovery can take six to 12 months, Dr. Jacobs said.

Make sure you have the help you need in the initial stages of recuperation. Since you may have difficulty getting around and won’t be able to drive right away, you may want to have a friend or family member stay with you. You may even need to hire an aide or visiting nurse.

Follow your doctor’s orders, and don’t rush your recovery. You don’t want your new joint to fail because you couldn’t resist carrying loads of laundry up and down stairs, or felt compelled to rearrange the patio furniture.

If the new joint is given time to heal, you will find plenty of opportunities for all that in the future.

Related links

  • Affordable joint replacement surgery overseas
  • Cost of knee replacement or hip replacement surgery
  • What joint replacement surgery patients are saying
  • Medical tourism