New Delhi: Like any regular patient, the 44-year-old Sikkim engineer Deep Pradhan was also wary of undergoing a rare hip replacement procedure. Even though Deep – who had suffered from the effects of a rare disorder called hip dysplasia or misalignment of the hip joint associated with dwarfism – had done enough research to know the impact of the surgery, what it entails, and its life; he wasn’t sure if it will bring him the benefit that he wished.
At 4'3" of height, Deep Pradhan suffers from dwarfism, the medical condition that made him vulnerable to the disorder. The young man suffered early onset arthritis and dysplasia of the hip joint, and increasingly faced difficulties in walking, and performing other daily activities of life.
But as the pain and restriction got intolerable about two months back, he decided to travel to Delhi to undergo the treatment. And such has been the impact of the surgery by Dr Rajeev K Sharma, Senior Consultant, Orthopedic and Joint Replacement Surgeon at Indraprastha, that Deep is able to walk without limping and the pain has also subsided. “Patients who have dwarfism and resultantly small statures are prone to bone disorders such as dysplasia or degenerative hip disease; they are also susceptible to arthritis that develops because of wear and tear of the hip joint. This happens because of development disorders and abnormal load distributions through the hip joint. The patient was in extreme pain and found it difficult to walk and even sit. A total hip replacement was the only solution in this case. However, this presented another challenge as the patient’s acetabulum or hip cup was very small,” said Dr Rajeev K Sharma.
While he discussed Deep's case with us, Dr Sharma also spoke about several other key aspects. Read on.
Impact: Patients who have dwarfism and resultantly small statures are prone to bone disorders such as dysplasia or degenerative hip disease; they are also susceptible to arthritis that develops because of wear and tear of the hip joint. This happens because of development disorders and abnormal load distributions through the hip joint. The patient was in extreme pain and found it difficult to walk and even sit. A total hip replacement was the only solution in this case. However, this presented another challenge as the patient’s acetabulum or hip cup was very small
The most important thing for any patient is what will happen if he opts and doesn’t opt for the surgery. Will I be able to walk or become permanently disabled? What will the life of implant be? Will I have to undergo a surgery again after 5 or 10 years (a decade is considered a short time)? Will it lead to absolute normal recovery?
To get appropriate answers to each of the aforementioned queries we need to spread the word about this procedure. If the media reports about Delta motion ceramic-on-ceramic Total Hip Replacement implant, and the fact that it has a life of 30-40 years, it will help several patients like Deep. After the surgery, Deep can do all normal activities such as running, squatting, sitting and pushups.
Precautions: It is important for patients especially who have sensitive joints to avoid sitting on the floor. They should also avoid stairs, keep weight on lower side and strengthen muscles. The kind of lifestyle we follow, we end up putting on weight and finding no interest in gaining weight.
What to eat/avoid: Whether it is food (which has spurious elements), milk (which we don’t even know if it is healthy or not), we have to be extra cautious. But yes, to ensure you don’t face any medical problem, you should have foods that are high in proteins. Make sure you don’t consume carbohydrates and fats. Black chana (cooked/sprouted) is a safe option. Ghee qunatity should always be less. No matter how much we like Indian street food (samosa, etc), we never know what oil (which is highly saturated) is used. And what if it hasn’t been changed for days? These are easy but key steps to avoid trouble.
Delta motion ceramic-on-ceramic Total Hip Replacement: Hip replacements are most commonly done in elderly patients who suffer fracture or displacement of bone. In older patients, implants lasting even 15 years often suffice for a lifetime. However, performing a joint replacement -- hip or knee – in a much younger patient like Deep is a challenge in itself because a young patient can easily outlive the normal life of an artificial prosthesis. This is why we had to carefully choose the implant we used in the procedure. We used Delta motion ceramic-on-ceramic Total Hip Replacement implant by DePuy. This implant is specially used in young patient as it has low wear rate and lives up to 40 years. The team also used a rarely used variant of prosthesis to make this surgery a success. The surgeon used the smallest available hip prosthesis – 42 mm – to achieve the best assimilation with the hip joint. We also used a special ceramic monoblock implant that has long durability and can last almost 4 decades.
Cost involved: Going by the cost charged by the hospital, this surgery (whether it is knee or hip) will come up to Rs 2.50 lac. And the cost of the implant would be come up to Rs 7 lac (Rs 3.5 lac per joint).
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