Hip Surgery: Total Hip Replacement
Total hip replacement is becoming more and more common. It’s one of the most common hip surgery procedures that we do. It’s more and more common in the U.S. with our aging population. It’s one of the most successful surgeries of all body parts of all time that we’ve ever done. The advantages of it are multiple, and the risks associated with it are becoming less and less.
The patient is severely limited in their daily activities by mostly groin pain, but also hip pain with advanced degenerative changes on their X-ray.
The ideal hip replacement patient is not overweight, does not have heart problems, does not have diabetes – but none of those things in of themselves prevent you from being a good hip surgery candidate.
Patient expectations are extremely important for the discussion of hip replacement surgery. We have to know ahead of time what their activity level is, and the goal activity level is. Because if a patient spends most of their time sitting on the couch and that’s all they want to get back to doing, then that’s a lot simpler than a patient who is an active runner and wants to return to running.
I’m trained on anterior, posterior and lateral approaches to the hip. Within that, I’ve also trained on the mini-posterior approach to hip replacement. That’s my preferred approach to the hip after exposure to multiple types of techniques.
The mini-posterior approach to the hip is in line with the standard posterior approach to the hip. However, it’s a much less invasive hip replacement surgery. This is both from a skin-incision standpoint as well as a muscle standpoint around the hip. In general, the mini-posterior approach is applicable to all patients. How “mini” is variable: larger patients often end up with larger incisions that correlate with their size, but beyond that, it is still much less invasive than hip replacement surgery used to be.
Recovery from total hip replacement, at the end of the day, is get up and walk on it. I want you using the hip, and I want you using it as much as possible. Immediately after surgery, we’ll have you work with physical therapy and begin mobilization within the hospital. You’ll often use a walker or crutches for about a week or two, primarily because I want you to learn to walk without a limp. The main limitation of any surgery and having had hip issues before the surgery is that the muscles are weak, so we have to strengthen them after we’ve now eliminated the source of the hip pain.
My primary advice to anyone, as far as should I have the surgery?, is this: [the hip pain] is interfering with what you want to do. If hip pain is interfering with activities of life, you can’t do the things you want to do, I think hip surgery is worthwhile regardless of age.