Total hip replacement helps individuals address hip pain due to arthritis, injuries, pinched nerves or other problems. It involves the removal and replacement of damaged bone and cartilage in the hip with prosthetic components.
Millions of people have undergone total hip replacement surgery. There are several instances where this type of hip surgery is recommended, and these are:
· Hip pain makes it difficult to bend, walk or perform everyday activities
· Hip pain is ongoing and makes it tough to rest
· Hip stiffness limits an individual’s ability to lift or move the leg
· Anti-inflammatory drugs, physical therapy or walking supports are used to treat hip pain yet fail to deliver the optimal results
Many hip replacement surgery options are available, such as:
1. Traditional Hip Replacement Surgery
Traditional hip replacement surgery is intended for patients who are dealing with severe hip arthritis or joint damage that cannot be remedied with medication or other less-invasive procedures. It is most commonly used to address osteoarthritis, a chronic joint condition that causes cartilage or cushioning between joints to break down, resulting in pain, stiffness and swelling. Additionally, hip replacement surgery may be used to treat rheumatoid arthritis, hip fractures and hip pain.
With hip replacement surgery, a patient can replace damaged portions of the hip joint. During a hip replacement procedure, an orthopedic surgeon makes an incision over the hip joint; the incision may be several inches long. Next, the surgeon replaces a portion of the hip joint or the entire hip joint with a cemented or uncemented prosthesis. A cemented prosthesis is attached to the bone with surgical cement. Comparatively, an uncemented prosthesis connects to the bone with a porous surface, and the bone gradually attaches to the prosthesis over time. In some instances, a surgeon may use a combination of cemented and uncemented prostheses.
The benefits of total hip replacement can be significant. In a recent NIH study of 49 osteoarthritis patients, 40 patients reported being pain-free after hip replacement surgery. Also, most study participants were better able to perform certain activities of daily life, and their range of hip movement and mobility improved moderately following surgery.
2. Minimally Invasive Hip Replacement
Minimally invasive hip replacement is a variation of traditional hip replacement surgery. Like a standard hip replacement procedure, minimally invasive hip replacement involves the use of a prosthesis to replace a hip joint or a portion of the hip joint. However, during a minimally invasive hip replacement, a surgeon makes an incision of 3 to 6 inches. This generally results in less muscle damage and scarring and faster healing in comparison to traditional hip replacement surgery.
With minimally invasive hip replacement, a surgeon makes a small incision over the outside of the hip. Then, the surgeon detaches or splits the muscles and tendons from the hip; this is done to a lesser extent than in a traditional hip replacement procedure. The surgeon also repairs the tendons before inserting the prosthesis. This often helps reduce the risk of hip dislocation.
3. Hip Resurfacing
Hip resurfacing is ideal for younger patients who have strong, healthy bones. Or, patients with advanced arthritis may be candidates for this type of hip surgery.
A hip resurfacing patient can reshape the damaged ball of the hip joint and cap it with a metal prosthesis. During hip resurfacing, a surgeon makes an incision in the thigh and dislocates the femoral head out of the socket. He or she then trims the femoral head and cements a metal cap over the prepared femoral head. The surgeon next removes the cartilage that lines the socket, and a metal cup is then pushed into the socket; this socket is held in place by friction between the bone and metal. After the cup is in place, the femoral head is relocated back into the socket, and the surgeon closes the incision.
Hip resurfacing requires only about 1.5 to 3 hours to complete. It has been shown to reduce the risk of hip dislocation. Plus, various studies have revealed patients’ walking patterns are more natural after hip resurfacing versus traditional hip replacement.
Other Hip Surgery Options
Patients who experience hip pain may be candidates for hip replacement surgery, as well as other hip surgical procedures. In addition to total hip replacement, common hip surgical procedures that may be used to address hip pain include:
1. Hip Arthroscopy
Hip arthroscopy is a minimally invasive procedure that has a low risk of complications. It addresses joint conditions or injuries of the hip, including hip arthritis, hip joint infections and cartilage tears.
To perform a hip arthroscopy procedure, a surgeon first puts a patient’s leg into traction. The surgeon pulls the hip away from the socket to ensure he or she can view the entire joint, insert instruments and administer treatment. After traction is applied, two or three small incisions are made in the hip. At this point, the surgeon uses an arthroscope and other surgical instruments to repair any labral tears, deformities or misalignment of the femoral head or inflamed tissue.
Upon successful completion of hip arthroscopy, the surgeon inserts pins into the re-shaped bone. These pins ensure the bone stays in place to accommodate the correct fit of the femoral head and hip socket.
2. Hip Fracture Surgery
Hip fracture surgery is used to treat stress fractures and breaks caused by degenerative conditions. It may involve stabilizing broken bones with surgical screws, nails, rods or plates. Or, hip fracture surgery may require replacement of the entire hip joint or a portion of it with artificial parts.
Typically, a surgeon will use X-rays or an MRI to diagnose the root cause of a hip fracture. The surgeon then will determine the best hip fracture surgery option based on the diagnosis.
3. Hip Osteotomy
Hip osteotomy corrects a deformed or misaligned hip socket, as well as hip dysplasia, mild hip arthritis or a deformed or improperly formed femur. It involves cutting and realigning the hip bone into a new position and placing healthy cartilage in the weight-bearing area of the joint.
During hip osteotomy, a surgeon cuts the pelvis around the hip joint and moves it into a position that helps a patient alleviate pain. Once the hip is repositioned, it is held in place with screws. It takes about six to 12 months for a patient to recover after hip osteotomy. The screws in the hip can be removed, but this is not usually required.
4. Hip Bursitis Surgery
Bursitis refers to inflammation of the bursae, jelly-like sacs in the hips and other parts of the body. Bursae are located between bones and soft tissues and contain a small amount of fluid that enables the sacs to act as cushions that help limit friction. Two bursae are located in the hip: one that covers the bony point of the hip, and another that is found on the inside of the hip. If one or both of these bursae become inflamed, an individual may experience hip pain.
Hip bursitis surgery is a minimally invasive procedure that involves arthroscopic removal of a bursa. A surgeon uses an arthroscope to guide surgical instruments in the hip and remove the bursa. Removal of bursae does not cause permanent hip damage, and after surgery, a patient can use the hip normally without bursae.
5. Hip Dislocation Surgery
An individual who experiences a car accident, serious fall or sports injury may suffer hip dislocation. Thanks to hip dislocation surgery, a person can manipulate the thigh and leg to realign the femur into the hip socket.
Hip dislocation surgery simultaneously treats a broken hip bone and hip dislocation. In most cases, hip dislocation patients suffer posterior dislocation. When this happens, the thigh bone is pushed backward out of the socket, the lower leg moves into a fixed position and the knee and foot rotate toward the middle of the body. Anterior dislocation also may occur. In this instance, the thigh bone moves forward out of the socket, the hip becomes slightly bent and the leg rotates toward the middle of the body. Both posterior and anterior hip dislocation may cause damage to the ligaments, labrum, muscles and soft tissues that hold the femoral head in place. Nerves surrounding the hip may be damaged as well.
Choose La Peer Health Systems for Hip Surgery
Hip pain is a common problem that can affect both children and adults, and it may hinder a person’s ability to walk, play sports and perform everyday activities. Hip pain occurs for many reasons, and without proper diagnosis and treatment, it may worsen over time.
La Peer Health Systems helps patients in the Beverly Hills area address a wide range of hip conditions. We offer minimally invasive, state-of-the-art procedures to treat hip ailments, and our highly trained and specialized orthopedic surgeons can work with you to determine how to help you alleviate hip pain. To find out more about our hip surgery options, please contact us today at 855.360.9119 to schedule a consultation.