Small is beautiful; silent is also beautiful - especially if it has to be sitting inside your body. The ‘Silent Hip’ is the philosophy of the future, when it comes to joint replacements, because it is going to help you feel that the implant is your own.

Bringing state-of-the-art technique and implants to India, at a special master’s course on Joint Replacements, MIOT Hospitals also performed the first ‘silent hip’ procedure on an Indian patient. Prithvi Mohandas, consultant hip surgeon, who informed the media of this, is also one among the 12 surgeons who were trained in implanting ‘Silent Hips’ in Kiel, Germany. He came back home to try the implants on cadavers and proceeded to the next logical step on Saturday, with a 42-year-old male whose hip joint needed replacement.

Along with Nicola Pace, Divisione di Ortopedia, Jesi, Italy, he performed the new technique in total hip replacement on the young patient, in about an hour. “The accent today is not merely on pain relief and some restoration of function. The aim of modern day joint replacement surgery is to return the patient to completely normal activity,” Dr. Prithvi added.

This is true especially in the more active young patients, who will require the implant to last longer and offer greater mobility, unlike in older patients. The idea then is to implant an artificial joint with maximum longevity and minimum damage to the human bone and tissue, he explained. The ‘Silent Hip,’ a refinement on the pre-existing thrust plate, currently costs Rs.1 lakh and is made of titanium coupled with a delta ceramic bearing that seems to have worked well on the patients on whom it was used so far, internationally.

“Usually in joint replacements, the implant produces a reaction in the natural bone and this is called stress shielding. It likely occurs in the first 18 months,” Dr. Prithvi said. It causes discomfort to the patient, stiffness and affects the elasticity of the natural structure.

In the ‘Silent Hip’ procedure, effort is taken to conserve as much bone as possible. Also scientific studies, which measure this reaction, have shown that no stress shielding occurs in the first 18 months when it is most likely. The patient can begin to walk an hour after surgery; climb stairs in 48 hours and in three to five days, go home. Complete normal activity will be restored in four weeks, he added.

The workshop, sponsored by the Indo-German Orthopaedic Foundation, saw participants from the United Kingdom, Italy and Germany, discussing various aspects of joint replacements. Live – interactive surgeries were also performed during the two day-course for orthopaedic surgeons that began on Saturday.