Hip replacement: cost, risks, purpose and surgery results

The number of patients being subjected to procedures requiring hip replacement is now on the rise, in Tanzania and globally. The procedure is termed as ‘total hip replacement’ (THR) or ‘total hip arthroplasty’ (THA).

In Tanzania many who are being operated for that are the ones who have been harried and ragged by a joint disease known as Osteoarthritis, a degenerative joint disease occasioned by cartilage loss in a joint.

It’s not that the  disease was not there before,  rather it’s just because the service is now available in the country. Before people were subjected to treatment options that could not absolutely assuage their woes.

It is an expensive procedure for a low or middle-income family that costs around Sh10 million here in Tanzania.

The procedure is done mainly  in Dar es salaam, whereby it’s reported that the service was first offered in the country in 2004 at a public orthopaedic institute located in the suburb of Dar es salaam. Now even some private hospitals in Dar es Salaam performs such operations.

Hip replacement surgery is a procedure in which the doctor replaces a hip joint with an artificial joint mostly made from metal and plastic components.

Osteoarthritis being the leading cause, such a bespoke replacement surgery should be done when other treatment options have failed to alleviate joint pain.

Joint pain makes life unbearable, thus doctors may be compelled to replace it with the artificial one. Medics may preferably term it as hip prosthesis.

Don’t fret, the procedure is safe but it takes long, about 3 to 6 hours depending on the surgeon and local issues.

How it’s done: In a nutshell

The surgeon will modestly cut along the side of the hip and aptly move the muscle connected to the top of thigh bone to keep the hip joint exposed.

Then the ball section of the joint is   now smoothly moved by cutting the thigh bone with a tailor-made saw for surgery, thereafter the prepared artificial joint is carefully  attached to the thigh bone using either a cement or a  material that suitably permits the remaining bone section to be attached to the new joint.

Not the cement you are using in mason work, this special cement makes the price for the procedure exorbitant. Researchers have found that the cemented one is better and more durable.

The surgeon then prepares the surface of the hip bone , removing any botched cartilage and attaches the the replacement socket section to the hip bone,  then once again the new ball part of the thigh bone is then inserted into the socket section of the hip.

A drainer is put in to assist with the drainage of any fluid, the surgeon will eventually re-attach the muscle and close the incision.

Post surgery

It may require the patient to stay in the hospital 5 to 6 days and you will be put on urethral catheter. A cushion is put between legs to hip your brand new joint in place , plus physiotherapy, and crutches.

Daunting complications

Some do come back for second surgeries for replacement,  simply for what doctors dub the procedure as Revision Total hip Replacement due to complications such as infections or mere loosening of the hip joint.

Thus after operation, follow your doctor’s advice to avoid complication. Whilst recovering, one should also ask the doctor for advise before resuming activities such as driving, physical exercises and sexual activity. Otherwise all the good work done will go down the drain.

Since the procedure is expensive, I have observed, patients who are sponsored by government of Tanzania through the Ministry of Health. For those who are under National Health  Insurance Fund (NHIF) are paid for this fund but after special approval following a medical report letter authored by an orthopaedic surgeon.

3 signs you may need a hip replacement

1. Hip or groin pain: Soreness during or after exercise or pain that interferes with your daily activities could be a sign of hip arthritis.

2. Stiffness: Difficulty putting your shoes or socks is a common sign of stiffness in your hip, especially if one foot is more difficult than the other.

3. The one leg test

If you can’t stand on your problem leg for longer than a minute – even with the support of a door frame or table-top for balance, then you might have a badly damaged hip.

The author is a medical doctor, public health activist and researcher based in Dar es Salaam.