If you suffer from debilitating hip pain, you know how much it can limit your movement and ability to perform every day activities such as walking, getting in and out of a chair, or even putting on your shoes. Your hip may be stiff and you may even feel uncomfortable while resting.
In general, severe hip damage that results from arthritis or injury is initially treated with rest, non-weight-bearing exercises such as cycling or water aerobics, anti-inflammatory medications for pain, and lifestyle changes such as losing excess weight. Self-help devices, like canes, may also be helpful. When these measures no longer offer pain relief, you may begin to consider having a hip replacement.
To help determine if you are a candidate for hip replacement surgery, your physician may ask you questions about your hip pain and how it affects everyday activities. Diagnostic tests, to determine the location and severity of damage in your hip joint, may include a physical examination, x-rays, blood tests and MRIs.
With the joint replacement program at Baptist, patient education and support begins at the time the surgery is scheduled, and continues through the hospital stay and the recovery process at home. The patient's family members and primary care physician-or hospitalist on staff at Baptist-are involved in the patient's care from preadmission through discharge. This constant communication contributes to quality care and good patient experiences, which are our priority at Baptist.
The first step in having hip replacement surgery at Baptist is being seen by one of our physicians. All orthopedic surgeons on staff at Baptist are board certified, and many have subspecialty training within the field of orthopedic surgery. Each year, our physicians perform more than 1,100 joint replacement surgeries.
At Baptist, orthopedic surgeons may use a computer navigated system to help pinpoint alignment for knee and hip replacements, and more recently, hip resurfacing procedures. Like global position systems (GPS) help drivers arrive at exact destinations in the world, the computer-assisted surgical system helps surgeons align the patient's bones and replacement implants with a degree of accuracy not possible with the naked eye or traditional instrumentation. Research has proven that with the assistance of computer navigation, the procedure is less invasive and the overall alignment of the joint is better than when traditional instruments are used alone.
The hip consists of two main parts: a ball (femoral head) at the top of your thighbone (femur) that fits into a rounded socket (acetabulum) in your pelvis. Ligaments connect the ball to the socket and stabilize the joint.
The bone surfaces of the ball and socket are covered with smooth cartilage that provides cushioning, allowing them to move easily. A thin, smooth tissue called synovial membrane covers all remaining surfaces of the hip joint. The synovial membrane makes a small amount of fluid that lubricates the joint to almost eliminate friction.
During a total hip replacement, an orthopedic surgeon removes all the damaged cartilage and bone of the hip joint, and then positions the new prosthetic hip implant to restore the alignment and function of your hip. The procedure takes a few hours.
While many different types of designs and materials are used in artificial hip joints, all of them consist of two basic components: the ball component, and the socket component. Surgical cement may be used to secure the artificial joint to the natural bone.
A prosthesis which does not require the use of surgical cement has also been developed. This type is usually covered with textured metal or a substance which allows bone to grow into the prosthesis. Noncemented prostheses are used most often in younger, more active patients with strong bone.
A combination of a cemented ball and a noncemented socket may also be used.
Your orthopedic surgeon will choose the type of prosthesis that best meets your needs.
The hip resurfacing procedure preserves more of the patient's natural bone. In a traditional total hip replacement, the head of the thighbone (femoral head) and the damaged socket (acetabulum) are both removed and replaced with a prosthetic hip implant. In hip resurfacing, the femoral head is not removed, but is instead trimmed and capped with a smooth metal covering. The damaged bone and cartilage within the socket is removed and replaced with a metal shell, just as in a traditional total hip replacement.
The total hip replacement and the hip resurfacing procedure both have advantages and disadvantages that you should discuss with your orthopedic surgeon.
Baptist uses the hana® table, a unique surgical table designed specifically to aide orthopedic surgeons in the direct anterior approach to hip replacement surgery. While utilizing the table, surgeons are able to reach the hip socket and place the implant without detaching muscles or tendons from the hip or thigh bones. With the anterior approach, a small 3- to 4-inch incision is made on the upper part of the thigh over the hip. Two muscles are then gently pushed aside, giving the surgeon access to the hip socket. No muscles are split or detached at any time during the procedure. Using this technique, patients who need to have both hip joints replaced may have both done during the same operation.
Dislocation risk is reduced, leg length is more accurately controlled, and postoperative pain is significantly decreased. The patient is typically discharged one or two days after hip replacement surgery. They can resume their normal activities as soon as they wish. For most patients, depending on their health, there are no precautions afterwards. They can move how they want after surgery.
Some patients may be candidates for hip replacement surgery using minimally invasive techniques. In this type procedure, the incisions are approximately half the size of those used in a standard approach. The smaller incisions and new techniques to expose the joint may result in short-term advantages such as a quicker rehabilitation, less pain, and a shorter hospitalization.
The minimally invasive approach to the total hip replacement is typically indicated for those who are thinner, younger, healthier, and more motivated to have a quick recovery compared with patients who undergo traditional surgery. Hospitalization may be reduced to 1 to 3 days among these patients, compared to a 4- to 5-day stay for those treated with traditional surgery.
Baptist's Joint Replacement program focuses on pain management, recovery and an early return to normal activities. To help control pain after surgery, an optional, but recommended, anesthesia-administered nerve block is available prior to surgery. For the first 24 hours following surgery, most patients are on pain medication delivered via IV. After that point, if possible, most patients are transitioned to oral pain medications. In all cases, pain medication is individualized for each patient to minimize discomfort.
The complication rate post hip replacement surgery is low. Blood clots in the leg veins or pelvis are the most common. Your orthopedic surgeon may prescribe one or more measures, such as blood thinners or inflatable leg coverings, to prevent blood clots from forming or, if they do form, to prevent them from causing symptoms. Serious complications, such as joint infection, occur in fewer than 2% of patients. Major medical complications, such as heart attack or stroke, occur even less frequently.
Most patients can resume normal light activities within 3 to 6 weeks following surgery. It's common to experience some discomfort with activity and at night for several weeks. At Baptist, recovery begins right away with group inpatient rehab, held on the Joint Replacement Unit. Therapists get patients up and moving as soon as possible to promote healing as blood flow to the hip is increased, and to restore movement. Source: American Academy of Orthopedic Surgeons