Hip Replacement Surgery -

 

 

Dear Mr Rahman

 

The attached Xrays are of poor quality and do not give me any useful information apart from the fact that there is a cemented bipolar hemiarthroplasty (half hip replacement) on the right side. I cannot make out if there is any arthritis of the left hip or if the implant on the right side has loosened.

 

I presume that patient's symptoms from left hip are due to arthritic changes. It is possible that the right hip dicsomfort could be due to either loosening of the implant or due to erosions of the acetabular cavity on right side.

 

Treatment will depend on the severity of symptoms and Xray findings. Since patient is 75 year old it do not think that it will be wise to adress both hip surgeryies together. In such a situation we should treat more symptomatic side first. Onleft side it will involve a cemented TOTAL hip replacement surgery and on right side it will involve Revision Total hip replacement(or conversion of hemiarthroplasty to a Total hip replacement). If pain on the right side is mild at present then we should only do left side first and wait till symptoms on right side worsen.

I would like to know which is the more symptomatic side and it would be also helpful if patient could send us another good quality photograph of the Xrays of both hips.

 

Thanks.

Dr Jayant Arora
MS(Ortho), DNB(Ortho), MRCS(Edinburgh)
Fellowship in Joint Replacement and Arthroscopic Surgery, Newcastle, UK

Senior Consultant Orthopedics and Joint Replacement Surgeon
Columbia Asia Hospital
Gurgaon

 

 

 Tel-00-91-9873830947 

Web: http//www.arthrocure.com

 

Hip Replacement Surgery

 

 

 

"My father Md Foyzur Rahman ( 75) needs to hip replacement on his left leg. He did hip replacement on his right leg in July, 2006. But still he is getting pain his right leg. I want to send my father for his hip replacement (could be one or both). But depending on his condition of right leg. Bangladeshi Doctor said he needs to hip replacement only left leg."

 

I am also attaching the patient's x-rays and the medical questionnaire herewith for your consideration.

 

Fw: Treatment Assistance Patient Ms Chidinma from Nigeria

 Dear Ms Chidinma

 

Patients with sickle cell disease(SS) usually develop avascular necrosis of the ball of hip causing arthritis, pain and shortening of the leg. This complication usually occur in the younger age group as in your case.

Treatment options include using painkillers and physiotherapy till the pain and functional limitation is mild to moderate. Once pain appears even on rest and on minimal movements then Hip replacement surgery can be considered.

 

Hip replacement surgery works wonderfully well in relieving pain and restoring function in patients with arthritis and has excellent results. However in patients with sickle cell disease hip replacement has an increased risk of complications as compared to normal population. The complications will include increased possibility of infection and early loosening of the hip implants. These complications can also happen in normal population after total hip replacement but its chances are increased in patients with Sickle cell disease. Having said that we have sucessfully carried out Total hip replacement in patients with sickle cell disease from Nigeria at out hospital previously. Chances of complications after total hip replacement in normal population is 5% and in patients with sickle cell disease it is 15%.

 

Looking at your xrays it appears that you have badly damaged the hip joint.You should delay the surgery as long as possible but if you have significant pain and discomfort in the hip that is not responding to nonoperative treatment then hip replacement surgery will relieve your symptoms and can be carried at out hospital, provided you are aware of and accept the increased risks of complications associated with such a procedure.

 

Hospital stay after such a procedure is 1 week approximately and would involve an expenditure of(-----Dr Kousar/Rashmi  please mention the figure). 

Feel free to contact us if  you have any further queries

 

 

Dr Jayant Arora
MS(Ortho), DNB(Ortho), MRCS(Edinburgh)
Fellowship in Joint Replacement and Arthroscopic Surgery, Newcastle, UK

Senior Consultant Orthopedics and Joint Replacement Surgeon
Columbia Asia Hospital
Gurgaon

 

 

 

Web: http//www.arthrocure.com

---

From: Kousar Ali Shah <kousarali.shah@columbiaasia.com>
To: 'Jayant Arora' <arorajayant@yahoo.com>
Sent: Tue, February 15, 2011 10:26:00 AM
Subject: FW: Treatment Assistance Patient Ms Chidinma from Nigeria

Dear Dr Jayant

Please suggest.

 

Thanks & Regards

Dr Kousar A Shah

Chief of Medical Services                            

Columbia Asia Hospital – Palam Vihar

Block-F, Near Gol Chakkar,

Palam Vihar, Gurgaon – 122017,

Haryana.

Telephone:  +91 - 124 - 39898969

Facsimile:     +91 – 124 - 3022022

Website:   www.columbiaasia.com

 

 

Please find below the query from the patient.

 

My name is chidinma and am 25 years old.my genotype is ss,i've sickle cell anemia.since 2008 a developed a hip problem here is a copy of my X-ray.The doctors said that i've Avascular Neurosis(AVN)of Formal Head,limp shortening of 3cm i want to know if i can get  hip replacement. Though the doctors in Nigeria said that there are so many implications based on my genotype that Replacement is not the best option.Please doctor i want to know the best option, implication of the surgery based on my genotype, and also the cost of the surgery.Please will be expecting a response from you .

 

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Fw: Treatment Assistance Patient Ms Chidinma from Nigeria

 

Dr Jayant Arora
MS(Ortho), DNB(Ortho), MRCS(Edinburgh)
Fellowship in Joint Replacement and Arthroscopic Surgery, Newcastle, UK

Senior Consultant Orthopedics and Joint Replacement Surgeon
Columbia Asia Hospital
Gurgaon

 

 

 

Web: http//www.arthrocure.com

----- Forwarded Message ----
From: Kousar Ali Shah <kousarali.shah@columbiaasia.com>
To: 'Jayant Arora' <arorajayant@yahoo.com>
Sent: Tue, February 15, 2011 10:26:00 AM
Subject: FW: Treatment Assistance Patient Ms Chidinma from Nigeria

Dear Dr Jayant

Please suggest.

 

Thanks & Regards

Dr Kousar A Shah

Chief of Medical Services                            

Columbia Asia Hospital – Palam Vihar

Block-F, Near Gol Chakkar,

Palam Vihar, Gurgaon – 122017,

Haryana.

Telephone:  +91 - 124 - 39898969

Facsimile:     +91 – 124 - 3022022

Website:   www.columbiaasia.com

 

 

Please find below the query from the patient.

 

My name is chidinma and am 25 years old.my genotype is ss,i've sickle cell anemia.since 2008 a developed a hip problem here is a copy of my X-ray.The doctors said that i've Avascular Neurosis(AVN)of Formal Head,limp shortening of 3cm i want to know if i can get  hip replacement. Though the doctors in Nigeria said that there are so many implications based on my genotype that Replacement is not the best option.Please doctor i want to know the best option, implication of the surgery based on my genotype, and also the cost of the surgery.Please will be expecting a response from you .

 

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