If you are considering hip replacement, it is essential that you understand all the important aspects of this potentially life-changing surgery. Let's explore everything from what it entails to the advantages of having this procedure performed in Costa Rica.
What is hip replacement?
Hip replacement, also known as arthroplasty, is a complex but highly effective procedure. In this surgery, the damaged hip joint is replaced with an advanced prosthesis, composed mainly of metal, ceramic and a special, highly resistant plastic. This surgery is crucial to significantly improve the quality of life and restore functionality in cases where other therapies have not yielded satisfactory results or are not feasible.
Common causes of hip replacement
The reasons vary, but some prominent causes include:
• Hip fractures, which often occur as a result of falls in older adults, especially in women with osteoporosis, due to their bone fragility.
• Osteoarthritis, known as the progressive and irreversible wear and tear of the cartilage in the hip joint.
• Rheumatoid arthritis, an autoimmune disease that causes chronic inflammation and erosion of cartilage and bone in the joints.
• Osteonecrosis, characterized by a lack of blood flow to the moving part of the joint bone, which can lead to deformities, dislocations, or fractures.
• Hip dysplasia, a congenital malformation, which can cause progressive and irreversible damage over time, limiting mobility and requiring consideration of a hip replacement.
When is hip replacement recommended?
The decision to recommend a hip replacement is based on a thorough evaluation that considers several aspects, including:
• Persistent pain despite treatments such as painkillers and physical therapies.
• Progressive deterioration of the patient's mobility and quality of life, especially if he or she experiences stiffness when sleeping, difficulties going up or down stairs, getting up from a sitting position, and a clear worsening of his or her daily activities.
These signs indicate the need for a more effective solution, such as hip replacement, to improve the patient's health and well-being.
Technological advances and types of hip replacement surgery
Hip replacement has seen remarkable advances thanks to technology. During surgery, both parts of the affected joint are removed. The femoral segment is replaced with a femoral stem that is inserted into the bone and has a ball at its end. This ball is attached by screws to a cup anchored to the hip bone, ensuring smooth movement and preventing displacement. These parts can be made of various materials such as metal, ceramic or high-strength plastic, and their fixation may require the use of a special bone cement.
The choice of replacement type and fixation method is determined individually for each patient, discussed in detail during pre-surgical consultations.
Technological advances have strengthened hip prostheses, prolonging their lifespan and allowing a wider range of people, including younger people, to benefit from this solution. In addition, there are two main surgical techniques: the traditional and effective posterolateral technique, and the frontal technique, recognized for its faster recovery and similar long-term results.
Step by step hip replacement
How to prepare for surgery
Prior to surgery, I perform a thorough preoperative assessment to evaluate your overall health. This includes a complete medical history, assessment of range of motion, pain, and muscle strength in the hip. Additional tests such as X-rays or MRIs may be performed in specific cases. Medications that you should continue or stop taking prior to the procedure are also reviewed.
On the day of surgery, you should arrive at the hospital at least one hour early, having fasted for at least 8 hours. Upon arrival, you will be provided with special clothing for the operating room and introduced to the anesthesiologist, who will administer medications to relax you, induce amnesia, and eliminate pain during surgery. Depending on your medical history and the type of replacement being performed, a nerve block using a spinal block and sedation may be performed to keep you relaxed during the procedure.
The surgical procedure includes several steps:
1. Additional anesthetics are applied to the skin and tissues to reduce postoperative pain.
2. The surgeon makes an incision over the hip, the size of which varies depending on different factors.
3. Diseased bone tissue and cartilage are removed from the hip joint.
4. The ball (head of the femur) and the surface of the socket (acetabulum) are replaced with new artificial parts.
5. The angles and mobility of the new joint are checked.
6. The tissue layers are closed with special sutures and a dressing and bandage are applied.
7. After surgery, you will be moved to the recovery room where your vital signs and pain level are monitored to adjust medications and ensure your comfort.
The postoperative period is a crucial stage in the recovery process
• In-room recovery: Once you have recovered from surgery, you will be taken to your room. The length of your hospital stay will depend on your previous health status and the type of surgery performed.
• Preventing complications: During your recovery, you will be given a machine to perform breathing exercises. This will help keep your lungs free of fluid and reduce the risk of infection.
• Early mobilization: It is crucial that you move around early after surgery. You will be encouraged to sit and walk with crutches or a walker soon after the procedure. This early mobilization improves blood circulation and reduces the risk of deep vein thrombosis.
• Wearing compression stockings: During and after surgery, you will wear elastic compression stockings. This helps prevent blood clots from forming by improving blood flow in the veins of your legs.
• Anticoagulant medications: Your surgeon may prescribe anticoagulant medications, either injected or oral, depending on your mobility and risk of blood clots.
• Exercise and mobilization recommendations: After surgery, you will be given specific recommendations of exercises and movements to perform, as well as those to avoid initially.
• Follow-up with a physical therapist: Your follow-up will be coordinated with a physical therapist. The therapist will help you regain mobility and strengthen the muscles in the operated area. This will allow you to gradually reduce your dependence on supports and progressively improve your quality of life.
Benefits and risks of hip replacement
The benefits of hip replacement are significant and include:
• Pain reduction and improved mobility after recovery.
• Recovery of daily activities and better quality of life.
However, as with any medical procedure, there are potential risks such as blood clots, infections or complications with the prosthesis, which are managed with postoperative care and appropriate medical follow-up.
Full recovery from a hip replacement varies from person to person, but in most cases, people feel fine three months after surgery.
How hip replacement works when living abroad
If you are considering hip replacement and live abroad, it is crucial to understand how this process works outside of your home country. Below we detail the specific benefits of having this procedure done with us in Costa Rica.
Benefits of having a hip replacement in Costa Rica
• International Insurance Coverage: At our practice, we understand the importance of providing comprehensive care that includes strong international insurance coverage. This ensures that our patients are financially supported throughout the entire medical process.
• Personalized and bilingual care: We pride ourselves on offering highly specialized and personal medical care. Each patient has direct contact with our medical team, which ensures consultations and humane and personalized follow-up in a bilingual environment.
• Hospitals certified with international standards: The Costa Rican hospitals where we work have international certifications, ensuring quality standards that meet or exceed globally recognized regulations, such as the Joint Commission (US quality certification).
• Affordable Prices: At our office, we offer total hip replacement at a cost of $11,000-14,000, compared to $40,000-60,000 in the United States and €22,000 in Europe. This significant difference allows our patients to access quality care at a more reasonable cost.
Logistics and telemedicine
In addition to these advantages, logistics and telemedicine play a crucial role in the patient experience:
• Telemedicine for remote evaluations: Advances in telemedicine allow for detailed evaluations to be performed remotely, simplifying the process for international patients. The local medical team evaluates each case in depth, coordinating all aspects necessary for a successful surgery.
• Comprehensive coordination: from the necessary documentation to the organization of flights, accommodation and even tourist activities during your stay in Costa Rica, a specialized agency takes care of comprehensive coordination so that your experience is as smooth and satisfactory as possible.
• Postoperative recommendations: It is essential to follow the postoperative recommendations for optimal recovery. We recommend that you be in Costa Rica three days before surgery and seven days after surgery before traveling to your home country. During the return trip, we will recommend that you continue using vasopressive bandages and follow other recommendations to ensure a successful recovery.
Referencias:
1. Hip replacement - Mayo Clinic https://www.mayoclinic.org/tests-procedures/hipreplacement/about/pac-0385042
2. Hip Replacements - What to Expect & How to Prepare | NIAMS (nih.gov) https://www.niams.nih.gov/health-topics/hip-replacement-surgery