Hip pain, arthritis and hip replacement
A hip replacement or hip arthroplasty is the gold standard for treatment of a damaged or worn out hip joint. Causes of hip joint degeneration include various types of arthritis, trauma or fracture, avascular necrosis or a sports injury. Symptoms which you may experience are hip or groin pain, loss of function and/or ability to perform normal daily activities or hobbies/sports and loss of range of motion of the hip.
There are various surgical approaches to the hip which you may have read about. Through his training both in South Africa and Canada, Dr Manjra has been trained in a number both traditional and minimally invasive approaches, such as the Direct Anterior Approach (DAA) to the hip. Prior to surgery Dr Manjra will discuss the benefits and risks of each, and formulate a surgical plan with a post operative rehabilitation programme depending on your condition and needs.
Hip conditions which may be amenable to Total Hip Replacement:
- Osteoarthritis
- Post traumatic arthritis
- Avascular necrosis of the hip (AVN)
- Rheumatoid arthritis
- Developmental dysplasia of the hip (DDH)
- Congenital/developmental deformities
- Fractures of the hip and/or pelvis
- Previous infection of the hip
- Septic Arthritis (Infection of the hip joint)
- Osteomyelitis (Infection of bone)
Anterior hip
The Direct Anterior Approach, or the DAA as it is commonly referred to, is a surgical approach to the hip joint in which the surgeon is able to access the hip joint without the need to cut any of the muscles that support the hip. The hip joint is accessed by working between the muscles.
Therefore it is regarded as a “minimally invasive” or “muscle sparing” approach. Multiple studies have shown that patients experience significantly less pain, use less pain medication after surgery and recover much quicker in the first 6 weeks after hip surgery with the DAA. Patients are also at less risk of certain complications such as a dislocation, where the ball of the prosthesis dislocates out of the cup.
Other approaches to the hip are: the posterior approach, where the small muscles at the back of the hip are cut to access the hip and repaired back to bone; and the lateral approach (or anterolateral approach), where the gluteus medius muscle on the side of the hip is cut to access the hip and then stitched together afterwards.
Through his training and mentoring both locally and internationally, Dr Manjra has had the opportunity to have rigorous training in the various surgical approaches to the hip.
Dr Manjra favors the DAA and uses the approach routinely, capitalizing on the superior outcomes early after surgery. However Dr Manjra, still does make use of the posterior approach especially in complex or revision cases.
Dr Manjra does not use the lateral or (anterolateral) approach as it involves cutting the gluteus medius muscle on the side of the hip. Dr Manjra aims to maintain the gluteus medius muscle for its critical role in maintaining hip function and stability.
Pelvis trauma
The above x-ray demonstrates complex pelvic and acetabular fracture’s due to a high energy motor vehicle accident. Dr Manjra fixed these injuries utilizing a variety of surgical approaches and devices to position the bone fragments in the optimal position for healing. This allows the patient the best chance of returning to pain free motion and activity.
Hip Replacement
The above x-ray demonstrates severe degenerative hip disease causing the patient significant pain, disability and loss of quality of life. A left total hip arthroplasty (replacement) was done by Dr Manjra via a minimally invasive, muscle sparing Direct Anterior Hip Approach, relieving the patient of the pain and improving mobility and independence. The left hip replacement is an example of what we call an “uncemented hip”. In this type of hip replacement, the implant bonds directly to bone without the need for a layer of bone cement between the implant and bone.
071 8000 336
info@drmmanjra.co.za
Ahmed Al-Kadi Private Hospital
Suite 9, Level 2, 490 King Cetshwayo Highway, Mayville, Durban, 4058
031 492 3455
Life The Crompton Hospital
Suite 4, 102 Crompton Street, New Germany, Pinetown, 3610
031 065 1893
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