Hip-replacement surgery is commonly performed in patients with chronic pain, immobility, and deformity. These symptoms are caused primarily by joint osteo-arthritic changes, and affect all daily living activities. The procedure is normally performed under general anaesthetic (being ‘put to sleep’) or spinal anesthetic (epidural). It is achieved by removing the old hip joint entirely and replacing it with prosthetic parts. Osteoarthritis is a condition that affects the body’s joints, and is characterized by damage to the joint surface. When osteoarthritis occurs in a joint, the articular cartilage located at the ends of the bones slowly roughs and becomes thin. The underlying bone thickens and is rugged.
The bone develops outward at the bottom of the joint, producing osteophytes or bony spurs. The new bony tissue may be an effort by the body to reverse the cartilage damage. Friction towards the osteophytes produces articular cartilage fragments that are expelled through the joint. Then, these particles are brought into the synovium and trigger an inflammatory response.
In extreme osteoarthritis the cartilage can become so thin that the thickened bone ends are no longer covered. The bone ends touching, rubbing against each other and start wearing away. The loss of cartilage, bone wearing and the bony overgrowth at the edges can alter the joint shape, forcing the bones out of normal alignment, causing deformity and pain.
Post-operational care is described as the care provided after surgery between 24 hours and 30 days. Post-operational care is essential to ensure that the patient recovers fully from the surgery and is able to return to normal capacity without complications as soon as possible. Kontoyannis suggests that the post operative period is very important for monitoring the patient to prevent immediate and long term complications.
The first post operative assessment should take place immediately when the patient comes back from operating theatre. As soon as the patient returns to the ward, the nurse makes a very quick assessment of the patient’s condition. Criteria for assessment include respiratory, circulatory, neurological, dressing, patient comfort and safety.
During the first post operative assessment, after the nurse has received a hand over from the theatre nurse, the patient will arrive back at the ward with an intravenous infusion. They might also have a PCA (patient controlled analgesia) and drain. The nurse will monitor the patient’s vital signs, drain site and assess for pain.
Monitoring allows the gathering of information so that trends may be determined. This means that any worsening or progression in the patient’s condition can be recognised. Monitoring is essential to determine if the patient is responding to the treatment. The normal monitoring regime for any post operative patient includes: temperature, pulse rate, blood pressure, respiratory rate and oxygen saturation levels. These observations should be recorded and documented at 30 minute intervals, progressing to 4 hourly for the duration of the patients stay in hospital, unless the patient’s condition dictates otherwise.
Respiratory assessment is paramount to the post operative care of a patient. The nurse must observe the rate of and depth of the respirations. Pain increases the rate and depth; therefore if the patient is short of breath, a pain assessment should be carried out.
Other monitoring requirements that post operative hip replacement patients receive would be pain assessment and observations on the operated leg, for example, colour, movement and sensation. This is to check for circulatory and nerve damage. This neurovascular assessment should be carried out and documented at 30 minute intervals, progressing to 4 hourly for at least 24 hours after surgery.
The nurse should quickly assess the site of the operation, without causing pain, and observe the dressing. The nurse is responsible for monitoring the wound site at regular intervals during the immediate postoperative period. If fluid is supposed to pool in the hip region, then a drain is inserted to allow the fluid to escape.
Pain assessment should be carried out whenever the vital signs are being monitored. It is essential that the nurse assesses the site, nature and severity of the patient’s pain in order to choose the most suitable treatment.
To assess pain, there are several tools that can be used. The most common being a numerical rating scale. The patient can score their pain on a scale of 1 to 10, 10 being the worse pain they can imagine. When assessing pain, it is important to listen to what the patient is saying. A study by Seers (1987) showed that nurses persistently record the patients pain score to be significantly lower than the patient’s own assessment.
In India, hip replacement is an procedure conducted by a very professional orthopedic surgeon. The orthopedic surgeon removes the painful hip joint of the patient in this surgery, and replaces it with a new one. The cost of hip replacement surgery is very manageable in India when you equate the cost with some of the world’s western countries. The surgery is typically performed by the top orthopedic surgeons in India for hip replacement when there is no alternative medicine that can be consumed by the patient for relief from the pain of a faulty or diseased hip joint.
The disease called arthritis is among the most common causes where a hip replacement becomes necessary in India. There are over one hundred different forms of arthritis that physicians and researchers have described up until now. It is recommended that you visit one of the best hospitals for hip replacement surgery in India to get yourself diagnosed if you feel that you have some form of pain or the other which has been prolonged for a long time.
You will find the most skilled pathologists, laboratory technicians, and doctors in these hospitals who will be able to identify exactly what type of disease you have and will be able to guide how to get rid of it. If the India’s top orthopedic surgeons find you have some form of degenerative arthritis, also known as osteoarthritis, then they may recommend you to undergo the hip replacement surgery in India.
About one in five adults suffers from one type of arthritis or the other. This number only increases slowly as you age. The patient with a very sore hip generally can not walk easily because of the discomfort. Because of this, the patient’s walking posture will change, leading to more pain.
Normally this can be managed with pain killers, but when the condition is too serious, it is clear that the cost of hip replacement surgery in India would be much more manageable than following a lifetime course of costly drugs that not only have a lot of side effects but are often exhausting due to very frequent doctor follow-ups. Only pain killers just function for a brief amount of time.