Hips For You - Guide to Total Hip Replacement

Dr. A. K. Venkatachalam

Updated 12/17/2011

Dr. A. K. Venkatachalam is a consultant Orthopaedic surgeon in Chennai. He offers Joint replacements.  Hip resurfacing, Proxima hip replacements, Primary & revision total hip replacements are commonly performed procedures. Getting a hip resurfacing or replacement in India is easy. Visit http://www.hipsurgery.in

The Proxima Hip Replacement

The Proxima hip is an uncemented hip. It has metal on metal bearings. It is implanted through a minimally invasive approach. The disadvantages of a total hip like thigh pain, risk of dislocation, wear are eliminated with this hip. It is suited for young and active patients with hip arthritis in India.

Indications for the Proxima hip

Young patients with hip arthritis with moderate to severe bone involvement.

Advantages of the Proxima hip

1. Bone preserving surgery

2.  Minimally invasive surgery

3. Restoration of normal function

4. No incidence of thigh pain, a common complaint with traditional hip replacements

5. No incidence of dislocation

6. Long lasting prosthesis as it is made of metal on metal

Proxima hip versus Hip resurfacing

Both have their place. When the bony involvement is minimal to moderate and the anatomy of the head of the femur is intact, then a Hip resurfacing can be done. When the anatomy is altered, resurfacing of hip is not ideal. Limb length cannot be restored with a hip resurfacing procedure, but can be restored with short stem implants like the Proxima and METHA hip.

Cost of Proxima hip replacement

A Proxima hip replacement with a week's stay in a private room will cost about 7500- 8000 US dollars
 

New hip prosthesis offers lease of hope to Young patients

Hip replacements in Chennai got a boost with the introduction of the " Proxima hip" by Dr. A. K. Venkatachalam consultant Orthopedic surgeon of www.hipsurgery.in and www.kneeindia.com

Nov 30 2006 -  A 33 year old South Indian house wife suffering from a condition called "Osteonecrosis" or avascular necrosis of both hips underwent a novel form of bone preserving hip replacements at Bharathi Rajaa Specialty Hospitals this week. Dr.A.K.Venkatachalam, Consultant Orthopaedic Surgeon, performed the surgery. The prosthesis implanted was the Proxima Hip Replacement, which is a very small prosthesis.

The technology has been introduced recently in India and Dr. Venkatachalam is the First Indian Surgeon to perform the operation in South India, as other surgeries had been performed by visiting foreign surgeons. "The size of the implant is smaller and provides maximum direct contact with bone, besides increasing the longevity of the surgical procedure and eliminating thigh pain," says the Doctor.

"It preserves more bone than traditional hip implant surgeries, but lesser than what hip resurfacing does."

Dr. Francesco Saverio Santori an Italian Orthopaedic surgeon in association with a British Surgeon has designed this prosthesis and it has a ten year follow up.

Talking about the operation Dr.Venkatachalam says that it is novel as the bone in the neck of the femur (Upper end of the thigh bone) is preserved. This type of hip replacement is a solution to selected group of patients who are not suitable for Surface hip replacement and in whom a total hip replacement is an option. This replacement surgery preserves bone stock, as the prosthesis is not implanted deep within the thighbone. It is a "stemless" stem. The bearing surfaces are made up of metal and this confirms enormous longevity to the prosthesis. It is also very stable as the diameter of the prosthesis is large and replicates the normal size of bone.

At present, minimally invasive surgery is the main trend of orthopaedic surgery and involves almost all its fields, joint replacement included. A total hip arthroplasty should be considered minimally invasive not just because it can be done through a small incision but it should preserve bone and only if bone resection is limited to pathologic tissues (conservative replacement) and the procedure is performed without major sacrifice of soft tissues. This last statement suggests that the term "mini-incisions" be substituted with "mini-approaches", meaning surgical approaches that respect the skin, but also fascia, tendons and muscles. Bone preservation may be obtained through proximal load, neck-retaining and resurfacing implants. Evaluating bone sacrifice both on the femoral side and on the acetabular side, neck-retaining arthroplasties seem to warrant the most balanced maintenance of bone tissue. Neck-preserving implants through a lateral or posterior mini-approach seem to be the most consolidated solution in minimally invasive total hip replacement.

It could be used in selective cases of hip arthritis, such as for people with good bone stock for whom resurfacing would not be suitable and a total hip replacement would be too radical.

Recently the same surgeon at this Hospital has performed a number of minimally invasive Knee Replacements with the high flex knee for patients including UK and Middle East.

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