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Hip Replacement Surgery: Purpose, Procedure, Cost in India

Hip Replacement Surgery cost in India

  • 2021-04-24

The average Hip Replacement Surgery cost ranges from 2000 $ to 4000 $ in the best hospitals from top orthopedic surgeons in India.

What is Hip Replacement Surgery? 

Arthritis means inflammation of joints. This results in swelling and pain in the joints of the body. A few common body areas for such a condition to occur are the knees and hips.

The hip in our body consists of two main parts, the femoral head (thigh bone) and the acetabulum (part of the pelvis), which can be surgically operated on. This medical condition is known as hip arthritis.

The hip joint is a ball (femoral head) and socket (acetabulum) joint in our body. The cartilage in between these two points provides a cushioning effect on the movements of the bones. Due to unforeseen situations like an injury, this cartilage gets affected, resulting in severe pain and restriction in movements.

In a hip replacement surgery, this femoral head and acetabulum are replaced by an artificial prosthesis. The prosthesis consists of an acetabulum component and a femoral component.

Intravenous fluids, antibiotics, and medication are administered to the patient’s body in order to prevent any emergence of pain during the surgery. There will be the following provisions before the surgery:

Spinal anesthesia

A catheter placed in the bladder (if needed)

Banked blood

During the procedure (Fig. 1), an incision is made near your groin for accessibility. It is achieved by pushing aside the muscles to expose the ball and socket joint. It is assured that no muscles are split or detached during this procedure.

The next step is the dislocation of the femoral head from the acetabulum. The damaged cartilage that was restricting movement and causing pain is removed. The acetabulum socket is reshaped for the next step.

The process begins with the installation of screws (prosthesis) which will support the femoral component. The femoral head from the femur is removed. A prosthetic installation of a femoral component is followed in the femur.

The acetabulum is fitted with a prosthesis (screw) to support the femoral component (i.e.an an artificial femoral head) installed by removing the femoral head. This prosthetic head is slide into the acetabulum component by the surgeon.

The artificial hip joint is then tested and verified through an x-ray.

The next step is to join the muscle gap and repositioning the muscles. The incision is closed and excess fluid is removed. The procedure is completed within a day. The patient is then shifted under surveillance only to be discharged within 2-4 days, post-surgery.

Hip Replacement Surgery Symptoms

There is persistent pain around your hip.

There is a recurrence of pain around your hip region.

Your mobility is frequently obstructed for actions like bending, walking, or while taking the stairs.

There is a feeling of stiffness after prolonged hours of sitting inside a theatre or a car.

You feel a swollen hip.

If stiffness is felt in the morning and that persists for around 45 minutes. (if it is less than 30 minutes then the medical diagnosis can term it as rheumatoid arthritis).

Medication is not providing any relief to the pain, any longer.

If there is the presence of severe persistent hip pain, not getting cured by medication, interferes with your daily activities.

If there is a restriction of movements, such as walking, due to stiffness in your hip.

Hip Replacement Surgery Causes

Old age. The risk of hip arthritis increases with age. 

Obesity contributes to inflammation in your joints. An increase in body weight has been a major cause for hip replacement surgeries as a result of persistent pain.

Joint injuries, incurred during playing an outdoor sport or due to an accident increase the chances for persistent pain and loss of flexibility in your hip joint. Repeated stress on such areas can further increase the need for hip replacement surgery.

Natural causes like genetics (tendency to develop osteoarthritis) and bone deformities.

Certain metabolic diseases such as diabetes or hemochromatosis (too much iron in your body) can sometimes lead to arthritis.

Types of hip replacement surgery

There are three types of it:

Total hip replacement surgery 

Total hip replacement surgery (or total hip arthroplasty) is the most common type of surgery. The procedure includes surgical removal of worn-out or damaged sections of the hip. Then it is followed by the replacement of artificial implants. The femoral head is constructed using ceramic or metal allow. The femoral component will be made up of a metal stem which is inserted into the femur, as explained earlier. This form of surgery is further classified into:

The posterior approach

The anterior approach

For the operation, the surgeon will perform an incision in the back (posterior) or the front (anterior) of the hip. These approaches are directed towards offering pain relief and improvement in movement within a few weeks of the surgery.

Partial hip replacement surgery is also known as hemiarthroplasty. ‘Hemi’ means half. This kind of surgery involves the replacement of only one side of the hip joint. This form of surgery is common in older patients who are suffering from a hip injury.

Hip resurfacing

This kind of surgery is common among younger and active patients. The procedure is not directed towards the removal of the femoral head. Instead, the head is trimmed and capped with a smooth metal covering. The damaged structures (bones and cartilage) are removed from within the socket. A metal shell is provided as a replacement for the damaged structures that are operated and removed. Hip Replacement Treatment

Anti-inflammatory medication such as ibuprofen.

Injection of corticosteroids in order to block the inflammation of the joint.

Physical therapy programs in order to improve rigidity and flexibility of the muscles.

Swimming is an excellent solution for sufferers.

Lifestyle modifications such as:

Maintaining a healthy weight through a balanced diet.

Exercise daily for around 30 minutes.

The final solution if the above methods prove to be ineffective

Total hip replacement surgery.

Osteotomy surgery in less severe cases (under expert advice).

Before Hip Replacement Surgery 

Pre-surgery visits.

This is done within 30 days before the surgery.

Each visit can get extended to 2 to even 6 hours. There will be a physical examination (and blood work, x rays, if needed) by your primary doctor.

During the visit.

Medications that can be stopped and continued will be discussed.

Risk factors associated with the surgery and the associated solutions will be notified to the patient by the doctor.

Instructions are being briefed that are to be followed before the day of the surgery. 

NOTE: There are certain instructions and protocols which if obstructed can result in the cancelation of the surgery.

After Hip Replacement Surgery

The patient is shifted to the surgical monitoring area for recovery. The patient is provided with:

Intravenous fluids (IV) and antibiotics

Pain medication

A catheter is removed if it was placed before the surgery.

Medications (i.e. blood thinner) are given to prevent blood clotting in the legs.

Compression stockings are provided that the patient is required to wear. 

A gap of a few days is then provided for adequate rest to the patient. It is then followed by:

The patient is advised to walk with the help of support such as a stretcher.

The physician in charge may provide a sequential compression device (SCD) on the legs/feet to prevent the possibility of a blood clot, known as deep vein thrombosis (DVT).

(DVT is a condition formed as a result of the formation of a clot in the vein located deep inside the body of an individual. A clot is a solidified clump of blood. DVT typically forms in the thighs or lower leg with possibilities of formation in other areas of the body.) The patient may sit and bend his legs after a few days and can probably go home within 2-4 days, post-surgery.

There will be scheduled check-ups by the physician in charge.

Recovery

Hip replacement recovery on average takes around two to four weeks but it differs among individuals.

Factors such as the mindset of the patient after the surgery, how active the patient is after the surgery. Age, nutrition, preexisting conditions, and lifestyle factors, shall decide the recovery period.

These implants can last 20 to 30 years post-surgery. 

Frequently asked questions about Hip Replacement Surgery 

1. Is hip replacement surgery safe?

For 2020, hip replacement surgery is safe judging by the advancements in medical science. This kind of surgery has been performed for years. There are always associated risks with every surgery in this world and this kind of surgery being no different. There are a few aspects that can come into the picture which are to be discussed with your surgeon. The aspects are:

Your legs might not be of equal length after the surgery.

Breathing problems can occur after a few months of the surgery.

Numbness can occur in the hip area due to swelling or pressure as a result of injury in the nerves.

At the least, the replacement may become loose, break or get infected.

2. What is the life of my new artificial joint after my surgery?

According to the results of the recent surgeries performed in India and abroad, about 85% of the hip joint implant will last approximately 20 years as compared to the surgeries performed in 1970. In situations of repairing the damaged repairs, the surgeries can get complicated.

3. Can I have both hips replaced at the same time?

Yes. A healthy patient, less than 75 years, with no history of cardiopulmonary disease, can have both hips replaced at once. It is always safe to rely on the advice of your physician in charge and operating surgeon.

4. What are the names of the prosthesis of hip replacement surgeries are made of?

The prosthesis is implanted that are: the stem, the ball, and the socket, replicating the hip joint. 

The stem, made out of metal (titanium or cobalt-chrome) is inserted in the thighbone by removing the femur head.

The ball, made up of polished metal or ceramic, replaces the natural femur head,

The socket (in the acetabulum area) is made up of a combination of cobalt chrome or titanium.

5. Will there be any issues with the metal detector area at the airport?

The screening mechanism will detect the implant but will identify it. Your physician can also provide a card that authorizes hip replacement surgery. It is also advisable to inform the airport authorities about your surgery.

6. How soon can I resume my normal activities?

The patients basically can resume his/her daily activities by six weeks, post-surgery.

7. What are the criteria for an ideal hip replacement surgeon?

An orthopedic surgeon should be researched in terms of his/her qualification, experience, and current work area. 

It is equally important to research the hospital facility where you are planning to get operated on. The supporting staff and anesthesiologist should also be looked upon. 

8. What activities should be avoided after hip replacement surgery?

For a period between 6-12 months after the surgery, pivoting or twisting of the involved legs should be avoided. The most common habit of sitting cross-legged past the midline of your body or turning the involved leg inward (in case of a partial hip replacement surgery). You should avoid bending forward or refrain from physical exercises such as squatting. 

9. What activities can I involve myself in after the surgery?

Your physician will briefly instruct you about the activities that you can indulge yourself in.

You can climb stairs at a minimum, at least once or twice a day.

Recliners should not be used but a straight-back chair.

Avoid an environment that is messy and that can result in falling.

An elevated toilet seat must be used that shall avoid bending too far at the hips. 

Advantages of hip replacement surgery in India.

1. Cost-benefit analysis: India is a price-sensitive market that provides quality treatment at affordable costs which is much less as compared to countries like the United States and Singapore. The cost of living in India plays an important role in terms of the affordable costs of hip replacement surgery in India.

2. Premium healthcare facilities: India has seen exponential growth in the healthcare system in the last five years. Financial injections in private and public healthcare sectors and an increase in the percentage of the economy have resulted in a demand for better healthcare facilities in India. Various hospitals are not less behind premium foreign institutions. Hence, there will be less risk in terms of the results of the surgery.

3. Health tourism in the right sense: India is a land of many wonders that are on the bucket list of most foreigners. Surgery in India is the perfect economic gateway for an individual where he/she can fulfill her bucket list.

Disadvantages of hip-replacement surgery in India.

1. Proximity to patients: India can be really far for a lot of patients. The travel expenses if concluded can add up to be more than the entire cost of the surgery in their own domestic country. As a result, many patients decide to look for options according to preference to proximity.

2. Proximity to competitors: Health tourism has made the world closer than it used to be a few decades ago. It has opened opportunities for Indian surgeons to provide premium facilities at affordable prices. This strategy is applied by other countries such as China and Singapore (including others) that have resulted in an increase in competition.

3. Health-related issues: This is an important condition where pre-existing illness for a patient can obstruct his/her travel plans to India since certain geographical conditions such as weather, temperature, humidity, and rest might not suit an individual. 

Risks

The following are the list of associated risks with hip-replacement surgery: 

Blood clots: As mentioned earlier, clots can form in your veins after surgery.

Infection: The site of your incision is the breeding ground for an infection but in terms of a major infection near the prosthesis might require surgery to remove.

Fracture: There are chances of fracture of healthy portions of your hip although sometimes the fractures are small enough to heal on their own.

Dislocation: This is an important risk in which the new artificial ball of your new joint can come out of the socket. This can happen in the first few months of the surgery. In terms of hip dislocation, your doctor can treat it with the help of a brace by relocating your hip in the correct position.

Change in length of your leg: This is a common problem that is mostly avoided by surgeons these days but occasionally, a new hip tends to make the patient’s leg to be longer or shorter.

Loosening of implant: It is a rare complication where the new implants might not become fixed as expected or might loosen over time resulting in pain, post-surgery.

Nerve damage: Sometimes, the nerve can be damaged where the new implants are placed. The symptoms can be numbness, weakness, and pain. Fortunately, such symptoms can be treated with expert advice and techniques.

Why choose India for treatment/surgery?

Quantitatively, more than 332,000 total hip replacements are carried out in the United States on annual basis. In India, around 300 patients are being operated on through joint replacement surgery in hospitals. Due to the boost in the medical tourism industry, there is a tangible shift of hip replacement surgeries in India with a success rate of above 90 percent. India has a mixed tangent for a standard of living offering an affordable range of prices for surgeries. The entire cost of living (stay in India), surgery, and the post-surgery operational cost, combined, are comparatively less against the operational cost in certain developed nations like the United States. Health tourism has bridged the gap of ignorance regarding such aspects, opening doors for such operations being carried out successfully in India.

Surgery consists of the following areas which are added to conclude an entire bill for surgery. The total cost depends on:

The choice of hip implant used in the surgery.

The number of days spent in the hospital (that includes the fees of the surgeon and associated staff, nursing services, and associated costs of the operation room).

The type of room one decides to spend during his/her stay in a hospital. 

In terms of treatment of pre-existing conditions, an additional cost of treatment gets added.

On average, a single hip replacement surgery costs in India between 2.5 4 lakhs, and a bilateral (both sides of the hip) hip replacement surgery costs around 4.5 to 6 lakhs.

In 2020, the Indian healthcare system contains highly skilled surgeons, dedicated nurses, and coordinated house staff at an affordable price in India. The state of art facilities in the hospitals in India makes a comfortable choice for patients visiting India for hip replacement surgeries.

India boasts of rich heritage sites for tourism. For patients visiting India from their homelands, there are a plethora of spaces that they can visit.

India produces 50,000 doctors a year. Among them, around 30 percent are based abroad, posted as dentists and doctors in various fields. This is a clear indication of the potential of doctors and surgeons in India. Your next-door neighbor (for people outside India) can be a doctor of Indian origin. That is the reachability of doctors from India. 

The Indian healthcare system has shown exponential growth in the last decade. From surgeons to healthcare layouts, everything in 2020 has been worked upon, strategized before implementation. There has been a 90 percent success rate for surgeries conducted in India. As a result of health tourism in India, such opportunities have increased and Indian surgeons have put a brilliant track record of successful surgeries under expert administration. Hip- replacement surgeries have been conducted in India for more than two decades providing expert supervision of experienced surgeons at affordable prices. The prognosis (result) has been positive as feedback from most patients. The number of successful surgeries every year has been on the rise while winning the credibility of domestic as well as foreign patients. 


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