​What kinds of symptoms do patients experience before receiving treatment?

Patients typically experience severe hip pain and difficulty walking or standing. By the time Children's Surgical Centre provides treatment, patients have often lived with these symptoms for months or more. A total hip replacement (THR) treats hips that are severely damaged and therefore not amenable to other forms of treatment.

​What is the impact on patients’ lives of living with these conditions?

Patients may not be able to walk or walk with great difficulty. Physical activity is extremely restricted, making any movement painful. This prevents patients from carrying out daily life, going to work, attending school, or taking care of themselves and their families.

What cultural or regional factors affect the treatment of these conditions?

Many Cambodians use motorbikes as their main form of transportation. Because of weak traffic laws, motorbike accidents are common. Injured individuals who cannot afford treatment often self-medicate or rely on Khmer traditional healers. Their fractures never heal, and patients live with the pain. Steroids are a common pain treatment in Cambodia. No prescription is required. Individuals who do intense physical labor take steroids regularly, which restricts blood flow to the joints. This causes bone tissue death and tiny bone breaks, making bones more susceptible to breaks and fractures.

What does the treatment process look like?

During a hip replacement, doctors replace both the acetabulum (hipbone socket) and femoral head (head of the femur) with prosthetic implants. Doctors remove the dead or broken bone. A cup is inserted into the acetabulum, and a metal hip prosthesis is inserted into the femur. Surgeons use a different technique to embed the prosthesis in the bones without using cement. The implant is more costly and preferred in patients that are younger.

What is the impact of this treatment on the patient’s life?

The patient will be able to walk independently without pain, improving their ability to work physical labor and quality of life.

What potential side effects or risks come with this treatment?

Severe disability, arthritis, and avascular necrosis of the hip can be successfully treated by a THR. This treatment is highly effective, with few risks.

How accessible is treatment in the area? What is the typical journey like for a patient to receive care?

Most Cambodians visit Khmer traditional healers before seeking modern medical care. As recently as ten years ago, a total hip replacement was entirely unavailable in Cambodia. Children's Surgical Centre is one of the few centers that provide this procedure. This procedure is more costly than the more common cemented version, as any potential revision surgery in the future is easier and the hip replacement may last longer.

What are the alternatives to this treatment?

There are other surgical alternatives, and much depends on the type of fracture, the health, and the age of the patient. Patients can elect to undergo hip fusion surgery and postpone the total hip replacement until later in life. In young Cambodian patients, surgeons may opt to use uncemented hip replacements albeit a more expensive procedure.