Absolute contraindications to total hip replacement include sepsis, a remote source of ongoing infection, muscular dysfunction and severe vascular disease. Relative contraindications include medical conditions that preclude safe anesthesia and the demands of surgery and rehabilitation.

Work-up for this operation requires routine blood tests as in any major surgery, specific checkups for chronic diseases, urinalysis, radiographs and treatment of any septic focus. Most patients who undergo THR are elderly with comorbid diseases. Patients must have good cardiopulmonary function to withstand anesthesia and to withstand a blood loss of upto 1000 mL over the perioperative period. Patients with ischemic heart disease, congestive heart failure, and chronic obstructive airway disease should be seen by a medical specialist or anesthetist.

The aim of total hip replacement is to resurface the deficient and damaged joint surfaces with a low-friction articulation.

Selection of regional or general anesthesia is made following preoperative discussion between the anesthetist, the patient and input from the surgical team. The operation should be performed in a laminar flow operating theatre with meticulous attention to detail to prevent contamination of the operation site.

The hip joint is usually exposed by anterolateral (Hardinge) or posterolateral approach. Osteophytes and intra-articular soft tissues are then cleared. Acetabular reaming, femoral neck resection and trial of components for mechanical alignment is important to allow optimum load sharing and prevent eccentric loading through the prosthesis.

Once the definitive components have been selected, they are cemented into place with polymethyl methacrylate cement. If an uncemented system is being used, press-fit and bony ingrowth provides the short-term and long-term fixation of the component. The hip joint may be drained and wedge placed post operatively.

The patient is recovered and usually observed for a 24-hour period in a high-dependency ward. Adequate hydration and analgesia are essential in this time of high physical stress.

Drains are usually removed within 24 hours, and the patient is encouraged to walk on the second postoperative day. At this early stage, the patient begins hip exercises. These are continued under the supervision of a physiotherapist until discharge. Continual improvement is generally observed, and discharge occurs in 5-7 days. Discharge is only recommended once wound healing is satisfactory patient able to walk with crutch support and no complications are present. Thromboembolism prophylaxis is often continued at home for a period of time. The first outpatient review generally is in 2 weeks then 6 weeks and after 3 months.

Follow-up care: Follow-up depends on the surgeon, the patient, and the health care system. A typical example would be a surgical follow-up appointment at 6 weeks, 3 months, 6 months and then every year. This is modified for each patient according to age, degree of activity, and presence of complications.

We, at Medwin – Joint Replacement Center strive to provide exceptional & cost-effective medical care that improves the quality of life for patients who suffer from joint diseases and disorders. Here's what you can expect from us.

• Personalized services
• Comprehensive diagnosis
• Effective treatment and surgery
• Diligent Post-operative attention
• Pain Management
• Physiotherapy and Rehabilitation program
• All these at very affordable prices