The ins and outs of hip replacement
Hip replacement is a surgical procedure performed when an individual has pain coming from the hip joint that is severely changing his or her life style. Joint replacement is considered when the pain is no longer controlled by more conservative things such as anti-inflammatory medications (like ibuprofen), weight loss, changes in your activity, or external aids such as canes or walkers. The procedure is designed to replace the surfaces of the affected joint including the upper end of the femur bone (your thigh bone) and the socket where the ball of the femur connects to the pelvis.
The hip joint is actually located in the groin area so most patients will feel pain in the groin area with motion or activity. Pain in the buttock, or running down the back of the thigh without groin pain, is most likely not coming from the hip joint. Your doctor can help you decide where your pain is coming from and whether or not you need further evaluation.
There are two types of surgical hip replacement surgeries: anterior or posterior. In general, the parts put in are unrelated to which type of surgical approach the surgeon is using; most all parts can be put in either way.
The anterior approach to hip replacement makes the incision on the front of the thigh while the posterior approach is more in the buttock or ‘posterior’ part of the hip.
Traditionally, most surgeons have been trained to do the operation through the posterior incision (the buttock area). Over the last five to 10 years however, the anterior approach (the front of the thigh area) has become more popular.
In the long run, meaning six to 12 months, it does not seem to make much difference which approach is used. But, in the short run, there are some pretty big advantages to the anterior approach (the front of the thigh area).
The advantages to anterior hip replacement include less pain right after surgery, and less of a chance of dislocation. Also, when using the anterior approach, the surgeon goes between the muscles rather than having to cut and then reattach them. Because of this there are fewer precautions and limitations placed on the patient after surgery, allowing for more aggressive early rehabilitation beginning on day one.
This all leads to shorter hospital stays with anterior hip replacement, which are typically one to two days for those going home, and a quicker return to an active lifestyle.
Anterior hip replacement for the right patient has made a difficult recovery from surgery significantly easier.
For those interested in learning more about this topic, Dr. King is giving a free seminar at 1 p.m. Wednesday, April 23, in the classrooms at MedWest Haywood Health & Fitness Center. He will talk about both hip and knee replacement. To register for this seminar or for more questions about joint replacement, call 452-8755 or email Rachel.Trantham@haymed.org.
Dr. Gerald King specializes in general orthopedics and joint replacement. He is Board-Certified by the American Board of Orthopaedic Surgery and is the medical director of the joint replacement program at MedWest Haywood.