Phil used to suffer pains in his right hip due to osteoarthritis. For several months, he endured walking with a limp. While serving as managing director of a company, he found time and used to enjoy regular sports activities, including marathon running.
But due to stiffness and hip pains, he was unable to enjoy his favorite sports. The pain in his hip did not go away despite medical treatment.
After undergoing a thorough assessment, he was advised to have a complete replacement of his ailing hip. But Phil was worried about undergoing surgery because his grandfather had a total hip replacement in the 1980s. He was concerned about wound pains, prolonged rehabilitation after surgery and risks of a revision surgery.
A hip joint is a ball and a socket joint. Osteoarthritis results in the wear and tear of the cartilage. When the congruence of a joint is lost, it will result in pain and stiffness. Total hip replacement is an elective orthopedic surgery recommended for advanced arthritis. The diseased hip joint will be replaced by prosthesis made up of different components.
Advances in technology allow the use of a durable joint, with functions close to that of a natural hip joint. Patients can enjoy pain-free daily living and may return to non-contact sports activities. Data from national registries in Western countries reveal that more than 95 percent of replacement joints last more than 10 years without further surgery. Contemporary orthopedic surgery emphasizes enhanced recovery. This allows surgery to be done safely, minimizes potential complications, prepares patients psychologically and physically and addresses any potential social problem. Before surgery, proper medical assessment is mandatory to reduce the chance of medical complications. Patients are given proper orientation before undergoing surgery and they are taught rehabilitation exercises after surgery.
Early and severe wound pains were not uncommon in the past. They affected rehabilitation after surgery. Recent advances in perioperative pain control emphasize pre-emptive analgesia. This involves the use of painkillers before the onset and transmission of pain signals.
During surgery, analgesics can be applied along the wound and this further reduces wound pain.
As a result, wound pain is minimized and a patient can undergo rehabilitation as soon as medical condition allows after surgery.
On the third day after surgery, Phil managed to walk home with a stick. He was back to work two weeks after surgery. After six weeks, he managed to walk unaided and even resumed swimming.
Theoretically, marathons can reduce the longevity of an artificial joint. Phil was well aware of potential problems. But he has opted to press on with his hobby although he heeds advice to undergo periodic X-ray tests to monitor the condition of his replacement joint.
Source: The Standard,
Dr Ng Fu-yuen is a specialist in orthopedics and traumatology