Hyderabad, March 2021: The team of Orthopedic surgeons at Apollo Hospitals led by Dr Paripati Sharat Kumar, Consultant Orthopedic Surgeon, Apollo Health City; performed south India’s first minimally invasive Daycare Total Hip Replacement Surgery on a 22-year-old international patient Mr Liban, a student from Somalia, Africa; at Apollo Health City, Hyderabad.
The patient was able to sit, stand and walk within 6 hours and was discharged in 7 hours post-surgery.
The trauma he was enduring began a couple of years ago and gradually aggravated inspite of taking medicines and physiotherapy. The condition was impacting his daily routine, walking and climbing stairs was an excruciatingly painful experience. As it didn’t seem to subside and started crippling his mobility further, he approached Dr Sharat Kumar complaining of severe pain in left hip. Investigations including ‘X’ Ray, revealed severe arthritis in his hip due to Ankylosing Spondylitis, warranting left total hip replacement.
Ankylosing Spondylitis is an inflammatory condition affecting spine and hip joints. No specific cause is known for it, but the presence of a genetic factor called Human Leucocyte Antigen [HLA-b27] increases the incidence of the disease, which is 0.4 to 14 per 100,000 persons-year.
Ankylosing Spondylitis leads to a gradual loss of articular tissue and is replaced with bone, resulting in fusion causing stiffness and immobility, leading to bamboo spine and hip joint fusion.
Mr Liban, being young and healthy except for Ankylosing Spondylitis, was considered an ideal patient for day care direct anterior total hip replacement. A minimally invasive uncemented total hip replacement surgery using jumbo cup with 36mm ceramic head implants, was done through a minute incision of about 4 to 5 inches. He has since recovered and is undergoing physiotherapy.
The minimally invasive Daycare Total Hip Replacement surgery has multiple advantages over the conventional open surgery, including relatively smaller incision, minimal bleeding, quicker recovery and also lesser chance of complications, particularly dislocation and infection.
However, a robust multidisciplinary support system is vital for it to be effective. Also, patient selection is critical, as all patients are not suitable for it and every case has to be considered on an individual basis in order to avoid complications later, particularly in the elderly and those with multiple medical conditions.
The minimally invasive Daycare Total Hip Replacement surgery is the latest and will be the preferred choice for most hip replacements in the years to come.
In fact, reports predict that 50% of all joint replacement will be performed through Daycare by 2027, considering the enormous benefits they bring along, like being back the home the same day, faster recovery, less infection, economic advantage, minimal disturbance to regular routine to the patient and family, etc., says Dr. Sharat Kumar. The precision in joint replacement technique and advances in technology brought in many changes in implant designs, giving joint more stability as well as longevity, he adds.
Mr Liban has been advised to be in India for a fortnight, as the perioperative period is crucial and no compromise in care is prudent during this phase of the treatment. His stay will be utilized to remove sutures and for him to acclimatized to the physiotherapy routine, which is an integral and important part of the treatment to restore strength and flexibility.
