Rheumatoid arthritis (RA) is an autoimmune condition that causes chronic joint inflammation.
According to Dr. Dilip Mehta, an excellent orthopedic Surgeon from Jaipur from any joint in the body, including the hips, can be affected by this condition.
This inflammation can harm the joints over time, resulting in:
- Pain
- Swelling
- Stiffness
Medical treatments can help to slow the progression of RA and reduce symptoms.
If these treatments fail to relieve joint pain and improve mobility, a person with RA of the hip may be eligible for hip replacement surgery.
Who might need a hip replacement if they have RA?
According to Dr. Dilip Mehta, an outstanding orthopedic specialist from Jaipur, if a person’s RA of the hip no longer responds to conservative treatments like medications and physical therapy, they may need hip replacement surgery.
This surgery is usually reserved for individuals whose hip joint has become worn or injured to the point where it limits mobility, causes pain even when the person is resting, and interferes with daily activities.
The surgery aims to improve the following:
- Mobility
- Pain relief
- The overall quality of life
- Physical function
Hip replacement diagnostic criteria
A doctor will conduct a medical examination to determine whether or not a patient is a candidate for hip replacement surgery.
A person may be eligible if they have one or more of the following symptoms:
- joint pain that is so severe that it interferes with the person’s sleep and quality of life
- severe pain, swelling, and stiffness in the hip joint
- reduced range of motion in the hip and decreased mobility
- difficulty performing everyday tasks, such as:
- putting on socks and shoes
- getting out of bed
- climbing stairs
- shopping
- inability to work or have a social life
- depression due to pain and a lack of mobility
A doctor will also consider a person’s age and overall health.
In younger people, doctors may advise against the procedure.
This is because younger people are more likely to require a second hip replacement if their first one fails during their lifetime.
Surgical risks
Some possible risks of hip surgery for RA include:
Joint infection: Following surgery, people with RA may be more likely to develop the disease. People who take biologic disease-modifying antirheumatic drugs to control their RA may be at a higher risk.
Hip dislocation: RA can cause inflammation of soft tissues like tendons and ligaments, leading to hip dislocation. These tissues can become lax over time, putting you at risk of hip dislocation after hip replacement surgery.
Leg length differences: The specialist will stretch and tighten the soft tissues surrounding the new hip joint to keep it in place at the hip replacement surgery. This may result in a slight lengthening of the leg.
Fracture of the bone encircling the hip replacement: To fracture the bone encircling the hip replacement. This can occur before, during, or after surgery.
Bone loss: After hip replacement surgery, the following factors can cause or contribute to bone loss:
- debris in the hip joint
- bone remodeling in response to the prosthesis
- natural aging
Blood clots: Any surgery increases your chances of getting a blood clot.
Nerve damage in the hip: Surgery may cause nerve damage. This can cause numbness or weakness in a specific area.
Hypersensitivity reactions: A person’s immune system may overreact to particles from the implant, causing hypersensitivity reactions. This overreaction may result in complications like inflammation:
- implant loosening
- delayed healing
- implant rejection
Follow-up hip replacement: According to Dr. Dilip Mehta, an amazing orthopedic specialist from Jaipur, more than half of those with hip replacements live for about 25 years, but this is not always the case.
Benefits
A person who has had a hip replacement can expect to have less pain and more mobility after the procedure.
It’s possible that a person won’t resume all of their pre-surgery activities.
When comparing their pre-surgery and post-surgery mobility, they will usually notice significant improvements.
Before surgery, what to expect.
Before hip replacement surgery, a pre-op appointment is required to ensure that the patient is healthy enough to undergo the procedure.
They could be subjected to the following tests:
- blood tests
- a pregnancy test for females
- urine tests to rule out infection
- X-rays of the hip
- an electrocardiogram (EKG) to inspect heart health
- blood pressure checks
“Depending on their risk factors, some people may also need to see a cardiologist, a pulmonary specialist, or a rheumatologist,” says Dr. Dilip Mehta, Jaipur’s leading orthopedic surgeon.
What to Expect Before and After Surgery
A person will be given either general anesthesia or spinal anesthesia on the day of surgery.
A person under general anesthesia will be unconscious during the procedure, whereas a person under spinal anesthesia will be numb from the waist down.
The surgeon will incise the skin around the hip during the procedure and remove the diseased bone tissue and cartilage.
The new, artificial joints will then be inserted.
There are four types of hip implants available right now:
- plastic socket lining and metal ball joint
- ceramic socket lining and ceramic ball joint
- plastic socket lining and ceramic ball joint
- metal socket lining and ceramic ball joint
The average time for hip replacement surgery is one to two hours.
Preparation
A person should follow their surgeon’s and anesthetist’s advice when preparing for surgery. The surgical team will provide the following details:
- whether the individual needs to prevent taking specific medicines before the procedure
- whether the person needs to avoid eating or drinking in the hours before the operation
- what a person needs to bring with them to the hospital
- whether it will be essential to remain in the hospital overnight and, if so, for how long
In general, a person should prepare for surgery by doing the following:
- avoiding alcohol and recreational drugs, as these could affect how the body metabolizes the anesthetic
- quitting smoking, as smoking can increase the risk of complications during and after surgery
- arranging for someone to check in on them regularly after the surgery, if they live alone
- performing muscle-strengthening exercises to help aid recovery from surgery
- ensuring that their health insurance coverage is in order
- arranging for someone to take them home following the surgery
- ensuring that they have easy access to things they may need within the home when they return from surgery
- ensuring that they have meals ready to eat when they return from surgery
Recovery
According to Dr. Dilip Mehta, Jaipur’s expert orthopedic surgeon, Most people can return home within one to three days of hip replacement surgery.
Within twelve to eighteen hours of surgery, doctors usually recommend walking.
A physical therapist may propose workouts to strengthen the new hip’s tissues to reduce the risk of dislocation.
If a person’s recovery is taking too long, they may need to enter a rehabilitation facility.
Within six to eight weeks, most people can resume their normal activities.
They will be told when they can drive by a doctor, but they should double-check that their insurance coverage is still active.
People should also seek advice from their physical therapist or surgeon on which activities and sports they can safely engage in.
People with sedentary jobs may be able to return to work in as little as six weeks.
Those with more physically demanding jobs may be able to return to work in three months or less.
If a person’s job requires a lot of manual labor, they should try to switch to lighter duties if at all possible.
Summary
Rheumatoid arthritis is an autoimmune disease that affects the joints, causing:
- Inflammation
- Pain
- Stiffness
Any joint in the body, including the hip joints, can be affected by this condition.
If RA of the hip causes severe pain and mobility loss, people with the disease may need hip replacement surgery.
A surgeon will remove the damaged or diseased joint during the procedure and replace it with a new, artificial joint.
People can usually return home within a few days, though it may take weeks or months for them to recover fully.
The success rates for hip replacement surgery are generally acceptable.
However, anyone considering the procedure should speak with their doctor about the risks and benefits.
A doctor can also guide the steps to take to prepare for surgery.
