There are multiple diagnoses that can lead you to require hip replacement.

The majority of folks that undergo hip replacements had degenerative or wear and tear arthritis. There are some other conditions that tend to affect younger patients which may force you to undergo hip replacement to achieve pain relief and actually an improvement in your functional ability.

And what we’ve moved to, very aggressively and very commonly, is to try to use a much less invasive approach.

Traditionally, we would make large incisions and have to do a whole lot of surgical exposure to get down and put the implants in place, and we’ve developed techniques that allow us to put the implants in through a smaller incision.

What we really hope, by doing that, is that the patient is going to have an easier recovery because they’ve sort of had less trauma, if you will, to the surrounding muscles and soft tissues around the joint itself.

Traditionally, we used to do hip replacements where there was a metal ball that touched against a plastic liner, so when the hip was pushed back together, there was metal rubbing against plastic. And what we’ve really gone to now, particularly in our younger patients, is a hip replacement that allows us to put a metal ball against a metal liner.

And we’re very excited about the likelihood that we won’t have to worry about the plastic liner wearing out because there isn’t really a plastic liner -- again, it’s a metal ball against a metal cup. It’s not just that that excites us about these hip replacements, it’s also the improved range of motion -- it really is a function of the ball size itself.

Again, this ball is about the size of your actual hip joint itself -- we’re recreating your anatomy by putting a ball that closely matches the size of the bone ball, if you will, that’s in your hip. That allows us a greater range of motion for activity, but also a greater range of motion before the neck of the prosthesis might hit the cup and try to dislocate.

When this actually goes into a patient’s hip, the patient’s hip joint itself will make natural joint fluid that all of our joints make, and that’s what lubricates the surface -- the two metal surfaces are lubricated by your own hip. And that’s really important to how the hip will function as you go forward with this in place.

These devices are placed into the patient without a cemented technique, and what that means is, we don’t use a bone cement. These are what we call press-fit, or bone-ingrowth prostheses, and they have specially-designed surfaces that are porous, meaning they have space in between the metal at the very microscopic level, if you will, and we actually place these into people’s bone after repairing the bone very meticulously, and then pack them into position, so that they’re pressed into position very solid, stable, and eventually your own body -- your own bone -- will grow into these devices.

One thing about metal-against-metal is, with that plastic liner not being in place, the theoretical idea is that there is nothing to wear out.

And one of the main things we want people to do is get back to being active, and that’s sort of the main reason of staying in shape and staying fit, and that’s important after having a procedure like this.

So we’ll let people do a wide range, a wide array, of things. Some of the things we’ll let people do include certainly playing golf, doubles tennis, doubles racquetball, downhill skiing, using an elliptical trainer, using a recumbent bike or a treadmill, and we certainly have had people return to high-impact activities.

It’s really after careful discussion about the risk and benefits of doing that after undergoing this procedure, and certainly those are people we want to follow closely and make sure they’re doing okay as they return to those activities.