Mumbai: A 50-year-old patient grappling with avascular necrosis, which causes death of bone tissues due to lack of blood supply, in both hips achieved recovery with Simultaneous Bilateral Hip Replacement surgery, a less option common in India as it poses higher risks and demands more from the patient during recovery. The surgery was carried out using a direct anterior approach which is minimally invasive and helps preserve the surrounding muscles and tissues by minimizing trauma to the soft tissues.
What Is Avascular Necrosis?
Avascular Necrosis (AVN) is a condition where the blood supply to the bones is reduced, leading to bone death and joint collapse. A 50-year-old man had been struggling with AVN in both hips for several years and this resulted in severe pain and significantly reduced his mobility. Over time, he found it increasingly difficult to perform daily activities like walking, climbing stairs, or even standing for long periods.
Despite trying a variety of non-surgical treatments, including medications and physical therapy, his condition continued to worsen. He started researching surgical options for long-term relief. Based on his research and consultations, he decided that hip replacement surgery using the direct anterior approach would offer him the best chance for a swift recovery.
The patient’s diagnosis of advanced AVN in both hips meant that the bone structure of his hips had deteriorated, causing pain, stiffness, and a limited range of motion. While traditional treatments like medications, injections, and lifestyle changes may help manage symptoms in the early stages, his condition had progressed to the point where hip replacement surgery became necessary.
Patient Opts For Simultaneous Bilateral Hip Replacement Surgery
Given the severity of his condition in both hips, the patient opted for simultaneous bilateral hip replacement surgery, a procedure in which both hips are replaced at the same time. This option is less common in India, as it poses higher risks and demands more from the patient during recovery. However, the potential for a faster return to normal activities and avoiding two separate surgeries made it an appealing choice for him.
The key aspect of this surgery was using the direct anterior approach. This technique is minimally invasive and helps preserve the surrounding muscles and tissues. By minimizing trauma to the soft tissues, this method typically results in a quicker recovery, less post- operative pain, and a lower risk of dislocation compared to traditional hip replacement methods.
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About The Surgery
Dr. Supreet Bajwa, an orthopaedic surgeon at Wockhardt Hospitals, Mumbai Central, performed Mahesh’s simultaneous bilateral hip replacement surgery. The procedure was done while Mahesh was in a supine position, where the patient lies on his back, which allowed the doctors to operate on both hips without having to reposition the patient. This approach is beneficial because it reduces the risk of dislocating the newly replaced hip during surgery and simplifies the procedure.
Dr. Bajwa commented, “Mahesh’s case highlights the significant benefits of the direct anterior approach, particularly for simultaneous bilateral procedures. This method reduces trauma to the muscles and other tissues around the hip joint, leading to quicker recovery times and fewer complications compared to traditional methods.”
Remarkably, within 12 hours of the surgery, the patient was able to walk and climb stairs with assistance. This rapid recovery is a testament to the effectiveness of the direct anterior approach, unlike traditional approaches, which may require several days before a patient can bear weight on the new hips, the minimally invasive nature of this technique allowed Mahesh to start moving almost immediately.
"On this World Arthritis Day, it's crucial to recognize that Avascular Necrosis (AVN) can lead to debilitating arthritis if left untreated. By understanding the importance of early diagnosis and intervention, we can prevent the progression of joint damage. Total hip replacement is a vital option for restoring function and alleviating pain in advanced cases. Together, we can raise awareness and promote proactive measures to combat arthritis,” added Dr. Bajwa.
