total hip replacement


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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Healthbase has helped an uninsured American patient get double hip resurfacing surgeries in India. The high cost of Birmingham hip resurfacing surgery in the United States plus the lack of expertise in this procedure in the country continues to drive scores of Americans to India.

Nov. 21, 2008, Boston, MA. Healthbase Online Inc., an award-winning medical tourism facilitator based in Boston, Massachusetts, helps an Arizona-based former ballet dancer treat her hip osteoarthritis in India. 53-year old Katharine Frey who had arthritis in both her hips traveled to Apollo Hospitals, Chennai to have her hips resurfaced and availed of the 85% discount on the cost of the surgery.

“I have appreciated everything we have experienced and received at the Apollo Hospitals . Everyone has been very kind, supportive and helpful,” says Katharine after her hip resurfacing surgery last winter. She was so happy with the quality of care she received at her overseas hospital that she went back a few months later to have her second hip resurfaced.

Being uninsured, the $60,000 required to have a single hip resurfaced in the US seemed out of reach for Katharine. This led her into researching her other option – surgery overseas – and contacting Healthbase who coordinated both her surgeries in India for $8,000 each. The price included doctor’s fees, physical therapy and a week in the hospital.

According to Saroja Mohanasundaram, CEO of Healthbase , “Our clients prefer going abroad for Birmingham hip resurfacing because it is a fairly new procedure in the US but has been in use, say, in India, for many years. Being a major procedure it demands years of practice on the surgeon’s part to gain proficiency. The fact that Katharine went back to have her other hip resurfaced in India speaks volumes about the high level of satisfaction with our service and that of our partner hospitals and surgeons.”

Katharine Frey taking off on a paragliding flight just weeks after her hip resurfaicng surgery in India
Katharine Frey taking off on a paragliding flight just weeks after her hip resurfacing surgery in India

Katharine returned to work merely two and a half weeks post operation and to teaching ballet twenty days post operation. Katharine actively participates in swimming, yoga, hiking, paragliding, and cross-country road trips. “She has no pain in her hips and is moving and functioning like a normal human. I am so grateful and am enjoying watching Katharine return to life,” remarks Scott Martin, Katharine’s husband.

Katharine was operated upon by Dr. Vijay Bose and his team. Dr. Bose, a specialist in Birmingham Hip Resurfacing, Joint Replacement and Sports Medicine, has over a thousand BHR surgeries under his belt.
“Beyond the cost savings, the attention given was remarkable. Dr. Bose and his qualified staff will always be remembered for this,” adds Katharine.

Impressed by the high quality of care in India, even Scott, who accompanied Katharine to India addressed some of his periodontal issues through dental scaling and crowns at Apollo Hospitals while Katharine recuperated after her second Birmingham hip resurfacing surgery.

“It has been a positive life changing process for both of us. Thank you, Healthbase, for being so receptive, supportive and professional,” acknowledge Katharine and Scott.

Healthbase connects patients from across the globe to health care facilities in India, Singapore, Thailand, Malaysia, South Korea, Philippines, Turkey, Belgium, Hungary, Costa Rica, Panama, Brazil, Mexico and United States. Healthbase has over 45 providers on its network.

About Healthbase Online Inc.:

Healthbase, an award-winning Boston-based medical tourism and dental tourism facilitator, is a one-stop source for global medical and dental choices, connecting patients to leading healthcare providers around the world. Healthbase coordinates over 200 procedures in various categories like orthopedic, spinal , cardiac, bariatric, urology , oncology , dental , cosmetic and general surgery . Some of the common procedures offered are Birmingham hip resurfacing , total hip replacement , knee replacement , ACL repair , rotator cuff surgery , spinal fusion , spinal disk replacement, heart bypass surgery , lap band , gastric bypass , cancer treatment , liposuction, dental implants, crowns, bridges, etc. for a fraction of the cost in the US with equal or superior outcomes. Healthbase’s partner healthcare facilities are located in Thailand, India, Singapore, Malaysia, Philippines, South Korea, Turkey, Belgium, Hungary, Costa Rica, Panama, Brazil, Mexico and USA, and are expanding to Canada, UK, Jordan, Taiwan, Argentina, New Zealand, Australia, El Salvador and Guatemala. To ensure that patients receive the best care possible, Healthbase works mainly with hospitals that have international accreditations like JCI, JCAHO and ISO. Healthbase caters to the needs of individual consumers, self-funded businesses, insurance carriers, benefit consultants, insurance agents, and third party administrators seeking affordable medical travel and dental travel options. To learn more, call 1-888-691-4584, email info.hb @ healthbase.com or visit http://www.healthbase.com.

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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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Healthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: http://www.healthbase.com Login to get FREE quote. Access is free.Healthbase Logo

Medical Tourism – Avoid Years of Unnecessary Debt

Americans – uninsured, underinsured and even insured – are taking advantage of the low cost, high quality healthcare overseas and saving tons

A Hip Resurfacing Surgery for only $7,500! When Kathie Thornton’s medical tourism facilitator, Healthbase, informed her she could get her hip replaced for only $7,500 she wondered if it was too good to be true. The only catch was she would have to travel to India for her treatment – a move which eventually saved her over 80% off the price tag in the US.

Aware of the potential benefits of medical tourism – quality as well as savings – Americans are traveling increasingly to countries like India, Thailand, Singapore and next door, to Mexico for medical care. Surgeries in the US that can lead to years of debt and even bankruptcy are available at a fraction of cost outside the US. But some questions still remain – “How can it be so much cheaper there?” and “Is the quality as good as at home?”

The high administrative and labor costs in the US help explain the high cost of medicine in the country. Other countries like India and Thailand that are on Healthbase’s network have much lower cost of labor and so are able to offer a cheaper price.

Quality is of utmost concern when it comes to healthcare. But when you log on to Healthbase.com, you see that the international hospitals on its network are internationally accredited with JCI, JCAHO or ISO certifications. This essentially means that the same organization that monitors service quality and care in US hospitals also watches over those that are abroad. So the quality of care delivered is either the same or superior when compared with that back home.

According to Kathie Thornton, a 53-year old Indiana-based medical tourist, “The quality of care is beyond excellence. On every level, from the first thing in the morning till bedtime, it’s personal and excellent.”

Medical tourism is the solution for those who have been waiting for a health miracle and for those who think good quality care is not affordable. For Kathie, it meant the beginning of a new life. Healthbase gave her hope when she had lost all hope. She exclaimed after her successful rehab, “I feel like this is the first day of the rest of my life. I went from having no quality of life back to a 100% life. The overall experience – I wouldn’t trade it for anything.”

Medical tourism with Healthbase – It is your gateway to affordable healthcare.

Contact:
Healthbase Online Inc.
287 Auburn Street
Newton, MA 02466, USA
Phone: 1-888-MY1-HLTH
Phone: 1-888-691-4584 (Toll Free)
Phone: 1-617-418-3436 (International)
Fax: 1-800-986-9230
Email: media.hb@healthbase.com
Website: http://www.healthbase.com

Healthbase is a medical and dental tourism facilitator that connects patients to leading JCI/JCAHO/ISO accredited hospitals and dental offices overseas through a secure, high-tech, information-rich web portal. Healthbase provides a wide range of medical procedures through its partner hospital network. Over two hundred medical procedures are available in various categories: cosmetic and plastic, orthopedic, dental, cardiac, and many more. The savings are up to 80 percent from typical US prices even after adding up the travel costs, hospital stay and other related expenses. Healthbase offers more than just procedural availability; we also provide customers with extensive information on medical treatments, hospital and doctor profiles to help them make an educated decision regarding their treatment; travel planning and booking; applying for medical/dental loan and much more.

To learn more, visit http://www.healthbase.com and login to view our extensive hospital profiles including pictures of operating rooms, patient rooms, doctor qualifications, and lots more. Get a FREE quote now!!

Note: All information presented here has been obtained from publicly available medical resources and is here for reference purposes only. Healthbase does not claim to be a medical professional and does not provide any advice on any issues relating to medical treatment.

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 Hip Replacement

More than 270,000 hip fractures occur in the United States each year, with about 90% of them occurring in people older than 60. Hip fractures are more common in older people because of osteoporosis and because older people are more likely to fall. Use of some drugs increases the risk of hip fractures in older people (see Aging and Drugs). One in three women and one in six men who reach age 90 will fracture a hip during his or her lifetime.

The upper end of the femur (thighbone) has large bony bumps (trochanters) where powerful muscles attach, then a short neck, and finally a spherical head that forms the outer half of the hip joint. Most hip fractures occur just below the spherical head (femoral neck or subcapital hip fractures) or through the trochanters (intertrochanteric hip fractures).

Femoral neck hip fractures are particularly problematic because the fracture often disrupts the blood supply to the femoral head, which forms the hip joint. Without a good blood supply, the bone cannot heal and eventually collapses and dies. Intertrochanteric hip fractures tend to create large broken bone surfaces that cause internal bleeding.

Symptoms and Diagnosis

Most older people fracture their hips by falling while walking on level ground, often when indoors. They usually cannot move their leg, much less stand or walk. When a doctor examines the person, the leg appears shortened and turned outward because of the unbalanced pull of muscles and gravity. Swelling and a purplish bruise develop because of blood leaking from the fracture.

An x-ray usually shows an obvious fracture and can help a doctor confirm the diagnosis. However, faint fracture lines may not be seen initially on x-ray. Thus, when a person continues to have pain and is unable to stand a day or more after a fall, the x-ray may have to be repeated or a magnetic resonance imaging (MRI) or bone scan obtained.

Treatment

Most people with a hip fracture are treated with surgery. The type of surgery depends on the type of fracture.

 

Repairing a Fractured Hip

Repairing a Fractured Hip

There are two common types of hip fractures. Femoral neck or subcapital hip fractures occur in the neck of the femur. Intertrochanteric fractures occur in the large bony bumps (trochanters) where the powerful muscles of the buttocks and legs attach. When the fracture is not too severe, metal pins can be inserted surgically to support the femoral head. This surgical procedure preserves the person’s own hip joint.

Treatment of severe femoral neck hip fractures involves removing the broken pieces surgically because the blood supply to the femoral head has been damaged. If damage to the femoral neck is incomplete (the break does not go all the way through), metal pins can be inserted surgically to support the femoral head (internal fixation). This is a smaller surgical procedure and the person’s own hip joint is preserved.

Intertrochanteric hip fractures are treated with an implant, such as a sliding compression screw and side plate. This implant securely holds the bone fragments in their proper position while the fracture heals. The fixation is usually strong enough to permit the person to bear weight as tolerated. While the bone fragments generally heal in a couple of months, most people continue to improve in terms of comfort, strength, and walking ability for at least 6 months.

If partial hip replacement is needed, special metallic implants are used that have a polished spherical surface to match with the joint socket and a strong stem to fit within the central marrow canal of the thighbone. Some prosthetic implants are secured to the bone with a rapid-setting plastic cement. Others have special porous or ceramic coatings into which the surrounding living bone can grow and bond directly.

 

Replacing a Hip

Replacing a Hip

When the topmost part (head) of the thighbone (femur) is badly damaged, it may be replaced with an artificial part (prosthesis), made of metal. This procedure is called partial hip replacement. Very rarely, the socket into which the femoral head fits (forming the hip joint) must also be replaced. The part used is a metal shell lined with durable plastic. This procedure is called total hip replacement.

After joint replacement surgery, the person usually begins walking with crutches or a walker immediately and switches to a cane in 6 weeks. However, artificial joints do not last forever. The person, especially someone who is active or heavy, may need to undergo another operation 10 to 20 years later. Joint replacement is often advantageous for older people, because the likelihood that additional surgery will be needed is very low. In addition, older people benefit greatly from being able to walk almost immediately after surgery.

Sometimes the whole joint needs to be replaced. This procedure is performed rarely for fractures, but most commonly for osteoarthritis (see Osteoarthritis (OA)).

If people with hip fractures are forced by their illness to stay in bed, they are at increased risk for serious complications, such as bedsores, blood clots leading to pulmonary embolism, mental confusion, and pneumonia. A great benefit of surgical fixation is that it allows the person to get out of bed and begin walking as soon as possible. Usually, the person can take a few steps with a walker 1 to 2 days after the operation. Physical rehabilitation is started as soon as possible

Sources:

http://www.merck.com/mmhe/sec05/ch062/ch062d.html

http://www.healthbase.com

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Healthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: http://www.healthbase.com Login to get FREE quote. Access is free.

The contents or materials provided in this website are for general information only and are not intended as medical advice.