Now it is possible to get a soft-tissue surgery of the hip using a minimally invasive procedure, which is usually performed for knee and shoulder joints. Doctors at the orthopaedic department of Safdarjung hospital operated a 27-year-old man with synovial condromatosis, a rare condition in which nodules of cartilage start forming within a joint causing pain and immobility.
Instead of an open surgery with two big cuts to reach the patients hip bone from the front and the back, the doctors could perform the procedure with just three small incisions.
“It is difficult to perform and open surgery for patients with this disease because we have to make multiple big cuts to be able to reach the entire hip bone and take out these floating cartilaginous bodies. But, using a scope we were able to navigate inside the body and take out more than 150 nodules with just the small cuts,” said Dr Davinder Singh, the doctor leading the surgery.
Two days after the surgery, the patient was able to get up and walk around, whereas in an open-surgery, he would have to be in bed for at least three to six weeks, the doctor said.
“For more than two years, the pain in my hip joint was so intense that moving around was a challenge. I could not sit down on the floor, my mother had to tie my shoe-laces. But, with only two weeks of physiotherapy I can do almost everything,” said Deepak, who goes by one name.
As the equipment required for the surgery is too expensive, the doctors modified equipment usually used for shoulder surgeries. “We need to inject saline into the joint to inflate it before the surgery, but the cannula or a thin tube required is very expensive. So, instead we used a sharpened covering that comes with the shoulder surgery equipment, which is usually discarded,” said Dr SK Pandey, who assisted with the surgery.
Currently, such minimally invasive surgeries are performed only at two private centres in the country in Mumbai and Chennai. This is the first time it has been performed in a government set-up in northern India, the doctors said.
“The reason is that surgeries of the hip for soft-tissues are not commonly needed in Indians, so no hospital wants to invest in the expensive equipment needed. In the Western countries, there is a higher prevalence of problems in the hip bone so it is common there,” said Dr Singh.