Treating Osteoarthritis of the Hip with Total Hip Replacement Surgery

By Dr. John C. Kagan, M.D.

Total Hip Replacement SurgeryOsteoarthritis, also known as “wear-and-tear” arthritis, is a common condition. More than 28 million people in the United States were estimated to have osteoarthritis in 2011. Osteoarthritis occurs most often in weight-bearing joints, including the hip. It causes stiffness and pain and can make everyday activities difficult to manage.

Before considering surgery, your doctor will consider lifestyle modifications, such as losing weight and avoiding high-impact activities; physical therapy, to increase flexibility and range of motion; assistive devices such as canes or walkers; and pain medications. However, if the osteoarthritis is debilitating and not relieved with nonsurgical treatments, total hip replacement is one surgical option to treat osteoarthritis.

Hip replacement surgery removes the damaged bone and soft tissue of the hip and replaces it with a metal stem and socket, along with a plastic liner to replace the damaged cartilage between them. Modern, minimally invasive hip replacements avoids cutting into the tissue around the hip, and can complete a total hip replacement with one or two small incisions. This leads to reduced pain and a quicker recovery from the surgery.

The single-incision surgery usually requires a 3- to 6-inch incision, depending on the size of the patient and the complexity of the surgery. The incision is made on the outside of the hip, and the muscles and tendons are detached from the hip and then repaired, which leads to faster healing and minimizes the risk of hip dislocation.

In a two-incision surgery, the surgeon makes a 2- to 3-inch incision of the groin to insert the socket, and a 1- to 2-inch incision over the buttock to insert the femoral stem. The complexity of this surgery often means the surgeon will take x-rays to ensure correct guidance. Two-incision surgery often is a longer procedure than one-incision surgery.

Minimally invasive surgery leads to less damage to the muscles and soft tissues surrounding the hip, which can make recovery quicker than in traditional surgery. Depending on your overall health and the complexity of the surgery, you can expect to stay in the hospital for one to four days following the surgery. But regardless of the type of surgery performed for total hip replacement, physical rehabilitation is critical to restore the full motion and function of the hip joint. Your doctor should discuss what to expect in terms of exercise, physical therapy, and the recovery process beforehand.

Am I a candidate for minimally invasive surgery?
While minimally invasive total hip replacements can lead to quicker recovery times than traditional total hip replacements, the surgery isn’t suitable for everyone. Your doctor will carefully evaluate you and consider several factors before deciding which surgery technique to use. Candidates for minimally invasive surgery are generally thinner, younger, and healthier. They also have to be more likely to participate in and complete the physical rehabilitation process.

If you are overweight, very muscular, or have health problems that cause wounds to heal slowly, minimally invasive surgery may not be right for you. If you experience symptoms of osteoarthritis that are so severe that they interfere with your daily activities, consult your doctor to see if hip replacement surgery is the right course of action for you.

Dr. John C. Kagan and his staff are happy to answer your questions about total hip replacement surgery. Dr. Kagan has more than 30 years of experience as an orthopedic surgeon treating patients in Southwest Florida. He specializes in treating patients with knee, shoulder and hip pain, as well as general orthopedics and hand surgery. For more information, visit www.kaganortho.com or call 239-936-6778.

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