Painful, exhausting and limiting...that’s how Ankit (name changed to conceal the patient’s identity) felt living with osteoarthritis of the hip for five years. The joint condition and a body weight of 108kg had made routine activities like climbing stairs, entering or exiting a vehicle, walking and even standing an agonizing ordeal for him. Getting his hips replaced was his last and only resort for an improved quality of life. But it wasn’t so easy…his weight posed challenges to the surgery.

Total Hip Replacement (THR) is a routinely performed orthopaedic surgery, with proven success rate across the global. However, in obese patients the risk of dislocation, leg length discrepancy and soft tissue imbalance are higher than others. Hence, the surgery requires an advanced level of care and management.

After meeting several doctors, Ankit consulted Dr. Hemant Sharma, Director and Head of Orthopaedics at W Pratiksha Hospital, Gurugram, who specializes in advanced computer-assisted navigation therapy. Explaining the link between Obesity and arthritis, Dr. Sharma says, “Obesity is the largest contributing factor for osteoarthritis today. Our hips carry the weight of our body. Every 1kg of extra body weight an individual gain, the hip joint and muscles experiences 6 times the pressure. Gradually, this results in degeneration of the joint.”

Ideally, obese patients are required to shed a few kilos before the procedure for improved surgical results. However due to painful joints and excess weight such patients find it difficult to lose weight. The advent of new age technology has enabled joint replacement surgeons to deliver improved patient outcomes even in obese cases.

“Placing an implant accurately as per the patient’s anatomy is critical for the long-term success of a joint replacement surgery. In obese patients, due to the presence of multiple layers of fat, the joint visibility is often compromised. Navigation technology takes out the human error and helps the surgeon navigate better even in such complex cases. Through infrared sensing of the patient anatomy, the computer precisely advices the surgeon on the exact positioning and alignment of the artificial implant. Thereby, allowing us to significantly minimize the risks and improve the surgical outcomes in comparison to the conventional technique. This was a unique surgery as it was the first time in North India, Computer navigation system was used for Hip replacement. We have now done 5 successful hip replacement through this technique” Dr. Sharma shares.

The computer assisted navigation system combines precision and accuracy of computer technology with the surgeon’s skill, delivering the best possible patient outcomes. Like the navigation systems available in cars that readily provides directions using satellite navigation with accuracy and guides on the traffic, a computer-assisted joint replacement offers a visual mapping of the patient’s joint anatomy to the surgeon, thereby, helping them to make crucial decision prior and throughout the procedure.

“Navigation-based THR reduces the risk of blood loss, fat embolism, clotting in the legs or deep vein thrombosis, post-op infection rates and a smaller incision ensures faster post-op recovery. In fact, obese or not, patients with bony deformity are ideal candidates for utilizing the computer navigation guidance systems,” he adds.

Ankit, on his surgery experience, said, “I was in grave pain for quite some time but was delaying the surgery because of the pandemic situation and also I was scared that the surgery could go wrong considering my weight, but when Dr. Sharma explained the technology being used and assured me that I will be able to get back to my normal routine at the earliest, I decided to go for it. Today, I feel that it was my best decision as I feel much better after the surgery. It took me only 5 days to get back home from the hospital”.