Treat Hip Fractures from Osteoporosis with Total Hip Replacement

Osteoarthritis is one of the most common age-related joint problems that cause pain and difficulty in movement. As more people are increasingly becoming affected by symptomatic OA, primarily due to aging and lifestyle issues. The majority of the female hip osteoarthritis problems were related to osteopenia or osteoporosis with signs of increased bone turnover.

There are a number of reasons and factors, local and systemic, that may lead to osteoarthritis. Total Hip Replacement surgery has been a successful treatment for hip symptomatic OA when conservative or non-invasive medical therapies fail to reduce pain and improve the pain and function.

This orthopedic procedure has been known to not only relieve the pain and quality of life. In addition to this, increasing life expectancy with hip replacement and improvement in the quality of implants has led to a rise in the need of surgical hip replacement.

Osteoporosis is a condition that is characterized by a reduction in bone mass and disruption of normal bone architecture. This results in a heightened risk of fragility fractures which represent the worst clinical consequence related to OA.

This has been contributing to a consistent rise in the increased morbidity and mortality. Although osteoporosis can affect people of any age, it is mostly found in adults and old people. OA can be primarily divided into the category of primary and secondary, and sometimes iatrogenic too, depending on many cases.

Primary osteoporosis is categorized into two types: Type 1 which is seen postmenopause and type 2 which is senile osteoporosis. Secondary osteoporosis occurs as a consequence of other pathological conditions, such as hypogonadism and other endocrine or metabolic disorders, including Cushing’s syndrome, hyperparathyroidism, thyrotoxicosis, and diabetes.

Some other conditions such as neoplastic diseases and related therapies, connective tissue diseases including rheumatoid arthritis and ankylosing spondylitis, and certain chronic diseases, gastroenteric diseases, nutritional problems as well as prolonged inactivity may also lead to joint problems such as osteoporosis.

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In patients with a diagnosed severe osteoporosis, it is crucial to postpone the surgery till the time the bone mass has recovered. In the meantime, it is also necessary to start a suitable integrative therapy and be careful during the surgery with intraoperative maneuver, and the use of cemented implants.

The patients with secondary osteoporosis will need to have therapy for the treatment or management of the primary cause as it can lead to a great improvement of the osteoporosis state.

What part of the hip can break in a fracture?
The hip is a ball-and-socket joint that includes an upper part comprising the thighbone (also called femur) and a curved hip socket, called the acetabulum, of the hipbone in the pelvic region. The ball or round top of the femur, also referred to as the femoral head, fits into the hip socket to form the complete joint.

The joint is supported by various muscles, tendons, ligaments, and soft tissues. Hip fractures can occur in several parts of the upper part – femur, but the most common types of hip fractures involve:

Femoral neck fracture – The femoral neck is the area of bone that lies just below the head or ball of the joint.

Intertrochanteric fracture: This occurs in the intertrochanteric area which makes the part of the femur that lies between the femoral neck and the long, straight femur bone.

Total hip replacement, also known as hip arthroplasty, is an orthopedic procedure that has been widely used in recent years. It is frequently used to improve the hip joints that have been damaged by an injury or arthritis. Joint replacement surgery is now considered a commonly practiced orthopedic technique.

It has also shown the best results for long-term improvement for the hip joint when other non-surgical treatments have failed to provide adequate results. The total hip replacement aims to reduce joint pain and restore the pain-free range of movement.

In a standard hip replacement surgery, the patient is given general anesthesia which makes them unconscious for the duration of the surgery so that they do not feel any pain.

Sometimes, a spinal anesthetic might be used as an alternative to general anesthesia to help prevent pain. Then the surgeon makes a cut along the side of the hip to access the damaged joint, after moving the muscles connected to the top of the thighbone.

The thighbone is cut using a saw and the ball part of the joint is removed. An artificial joint replacement is attached to the thighbone with a cement or other kind of special material to fix the prosthetic and allow the remaining bone to attach to the new joint.

Then the surface of the hipbone is prepared by removing any damaged cartilage and attaching the replacement socket part to the hipbone.

The new prosthetic part of the thighbone is inserted into the socket part of the joint. The muscles are reattached and the incision is closed using sutures. A drain might also be put in to help drain the fluid.

While the standard technique is a highly used hip replacement surgery, a minimally-invasive technique is now being frequently used. In the minimally-invasive hip replacement, smaller incisions are made to access the joint, in contrast to standard surgery. The surgeon uses special instruments to remove the damaged parts and insert the new replacement parts.

Hip replacement surgery in India is performed with the latest medical techniques and instruments such as computer navigation systems and robot arms for minimally invasive surgery. The small cuts in a keyhole procedure are expected to shorten the duration of hospital stay, lessen blood loss, and faster healing, along with less pain post-surgery and reduced scarring.

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