Hip Replacement Can Help You Enjoy Life Again
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After nonsurgical treatment methods fail to relieve your symptoms of osteoarthritis in the hip joint (or lose their effectiveness), your doctor will talk with you about considering hip replacement surgery.
Hip replacement surgery can relieve your pain, improve your mobility, and help you return to normal activities.
“Typically I tell patients that hip surgery is something you want to consider once your hip arthritis is significantly affecting your quality of life, such that you are unable or unwilling to do the things that you enjoy anymore,” says orthopedic surgeon Ryan Bauman, MD.
He adds, “The greatest advantage of hip replacement surgery is to be able to have a pain-free joint and to be able to get back to those activities that they enjoy.”
In total hip replacement surgery the surgeon removes the damaged arthritic cartilage from the joint and removes the ball portion of the hip’s ball and socket joint.
Then the surgeon implants an artificial socket made of titanium or stainless steel. A plastic liner replaces the cartilage in the socket. Next, says Dr. Bauman, the surgeon implants a spike into the end of the femur – or thigh bone. A ceramic or metal ball, replacing the joint’s natural ball (the femoral head), is placed on the spike to complete the new joint.
The surgery can free you from pain as the replacement joint caps off the nerve endings that your worn, arthritic joint irritated.
The surgery takes about an hour. A typical hospital stay following joint replacement surgery can vary depending upon your individual needs. Patients who qualify may be eligible for discharge on the same day as surgery. This is followed by about a month and a half of recovery, Dr. Bauman says.
Dr. Ryan Bauman explains total hip replacement surgery.
Click play to watch the video or read video transcript.
Innovations In Hip Surgery
A newer approach to hip replacement surgery – anterior hip replacement – approaches the hip joint from the front, rather than from the rear, as in traditional, or posterior, hip surgery. Entering from the front to replace the joint requires a smaller incision, can be performed without cutting through muscle, and reduces your recovery time, Dr. Bauman says.
Traditional hip replacement surgery requires a 6- to 10-inch incision, and the surgeon cuts through muscle to reach the joint. “The new approach is to enter the joint from the front, going between muscle to avoid cutting through it. This results in less pain and faster recovery for patients,” Dr. Bauman explains.
Because anterior hip replacement avoids cutting through muscle, the patient’s normal muscle strength is retained. And patients can resume normal activities six weeks after surgery.
In contrast, traditional hip replacement patients are typically off work for three months after surgery, Dr. Bauman says.
Also, traditional surgery patients must follow restrictions after surgery, such as no bending over or crossing legs. But these restrictions are not required following an anterior hip replacement, Dr. Bauman says, “because the muscles are never cut and the stability of the hip joint is immediately present, whereas the traditional approach you have to rely on muscles healing prior to allowing some of those activities to resume.”
Dr. Ryan Bauman talks about the advantages of anterior hip replacement surgery.
Click play to watch the video or read video transcript.
“Unlike some minimally invasive approaches, greater than 95 percent of patients are a good candidate for anterior hip replacement surgery,” Dr. Bauman says. “Since most of us carry our weight on the back of our hips, the incision for the anterior approach (at the front of the hip) actually allows us to perform the surgery on patients of almost any size.”
Activity After Hip Surgery
After hip replacement surgery, you can return to activities such as horseback riding, gardening golfing, biking, “any activity that you enjoy,” Dr. Bauman says.
One of his patients even completed an iron man event 18 months after hip replacement surgery.
“Typically the patients that have an anterior approach return to their normal activities faster,” Dr. Bauman explains.
When advising patients after surgery, Dr. Bauman says, “our typical mantra is, ‘go low, go slow.’” For instance, he advises golfers to start with putting and chipping three to four weeks after surgery. “By six weeks, if they’re feeling good, they can golf nine holes.”
He adds that physical therapy is not required after hip surgery unless you are having difficulty resuming a normal walk.
How Long Hip Replacements Last
Dr. Bauman says that 80 to 90 percent of hip replacements are still performing well 10 years after surgery, compared to 60 to 80 percent 20 years after surgery.
When replacements fail common reasons include:
- The plastic lining in the socket wears out
- The implant comes loose from the bone
- The implant fractures
Hip replacements that fail can be redone – which is called a revision. But Dr. Bauman says that hip revision is “usually a harder surgery with a longer recovery time.”
He adds, “In cases where the replacements fail, oftentimes they have increased scarring and bone loss in the pelvis and thigh bone that makes the surgery more difficult to perform.” Because of their increased difficulty, these procedures tend to be performed only by surgeons with specialized training and experience in revision surgery, says Dr. Bauman.
Hip revisions are becoming more common as more people are having hip replacements at a younger age. Hip joint prosthetics are replaced after about 20 years.
Dr. Ryan Bauman talks about hip revision surgery.
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Source: Ryan Bauman, MD, Orthopedic Institute of Dayton; American Academy of Orthopaedic Surgeons
