When hip pain and stiffness makes it difficult for you to get out of bed or take a short walk, arthritis may be to blame. The degenerative condition is the leading reason why more than 350,000 hip replacement surgeries are performed each year. Find out why hip replacement surgery may be necessary to get you back to a normal, pain-free life.
Hip Arthritis Doesn’t Discriminate
Hip arthritis is an equal opportunity disease. “It can affect anybody from active people to sedentary people,” said Dr. Rhett Hallows, MD, an orthopaedic surgeon at Duke Regional Hospital who specializes in joint replacement surgery. “It does not discriminate.”
Typically hip arthritis occurs around middle age, when cartilage, the firm, rubber-like material that protects the hip joint, starts to erode. With no cartilage cushion in place, bone starts to painfully rub against bone. A previous hip injury or a family history of arthritis can increase your risk for developing hip arthritis too.
The resulting pain can radiate from your hip, buttock, leg or lower back. When the pain impacts your ability to perform your daily routine, it’s time to seek medical care.
Treating Hip Arthritis
Nonsurgical treatments may be your first step if your hip arthritis doesn’t appear on an X-ray, or if you’ve only been experiencing painful symptoms for a short time, meaning anywhere from four weeks to three months. A steroid injection may be recommended to some patients for temporary relief.
Physical therapy may also be prescribed because it can help improve your hip’s range of motion and work out some of your joint stiffness.
However, neither therapy will stop arthritis from causing further hip joint degeneration. “When your normal activities are limited by pain, it’s time to have a discussion about hip replacement surgery,” Hallows said.
Two Approaches to Hip Replacement Surgery
Surgeons have two options when replacing your deteriorating hip joint with an artificial one made from plastic and metal.
Nearly 80 percent of hip replacement surgeries use the traditional (also called the posterior) approach. The surgeon creates an eight to 10 inch cut in the side of the hip, then moves or cuts aside the buttocks muscles to reach the back of the hip. Following the surgery, people are cautioned to limit movements and certain positions. The precautions prevent the possibility of the hip dislocating.
Hallows uses a newer "anterior-based muscle sparing approach," to reach the front (known as the anterior) of the hip. It can require a similar length incision, but leaves the muscles around the diseased hip intact. Because it is less likely for hip dislocation to occur following this procedure, hip precautions are unnecessary. “The anterior approach helps them get up and get moving a little sooner,” Hallows said. “There is less pain.”
Recovery May Take Time
No matter which procedure you undergo, the recovery period is about the same. “We have people walking with therapy the day of surgery,” Hallows said. “Most people spend a day or two in the hospital.” Physical therapy helps people return to normal work and recreational activities anywhere from 6-12 weeks after surgery. Sometimes, however, a full recovery can take up to one year.
“The goal of surgery is to get you back to a pain-free normal life,” Hallows said. “That doesn’t mean you’ll be a college athlete again. I tell people they can do most everything except run long distances for exercises.”
Choosing the Right Surgeon for Your Hip Replacement
There is no significant difference in overall outcomes between the anterior and posterior approach. Typically, joint replacement surgeons tend to prefer one approach to the other. That's why it’s important that you choose a surgeon with whom you feel comfortable, and who has experience with the procedure.
“Look for somebody who has done a high volume of surgeries because you will get better results than somebody who does low volume surgeries,” Hallows said. That’s what sets Duke apart. “I do between 350 and 400 joint replacements a year,” he said. That’s what I specialize in. I do it every day.”