The options you need to know before deciding to have hip replacement surgery
Author: Dr. James Loging, MD, MBA, FAAOS
You have always enjoyed an active lifestyle until that one day when you start to notice an unusual pain in your hip. You tried to manage the pain hoping it would get better, only to find that over time it has progressively gotten worse. As the pain worsens you find yourself avoiding activities you once enjoyed. After realizing that the pain will not get better on its own, you decide to see your doctor to see what may be going on. It’s then that you find out that the pain your experiencing is related to severe arthritis in your hip and that you need a hip replacement to resolve your pain. This can be a scary and very stressful situation. But it doesn’t have to be if you know that there are options available to help you recover faster and experience less pain after surgery.
Most people don’t realize that there are multiple ways that the hip can be replaced by an orthopedic surgeon. Unfortunately, not all orthopedic surgeons are trained on all the different options available and tend to only offer one approach to patients. They also usually don’t even discuss the approach they will perform with the patient. The reason for this is because of the type of training the doctor received typically only involves one approach, which is why the orthopedic surgeon only performs that one option for patients. However, not all the different approaches are created equal and certain ones have significant benefits over others. The approach that has the most benefits is called the Anterior Approach.
Anterior Hip Replacement surgery means that the surgeon replaces a patient’s hip by coming from the front (anterior) of the hip. The benefit of coming from the front is that the doctor doesn’t have to cut muscles to replace the hip which makes for a significantly faster recovery compared to all the other methods of replacing a hip. All other approaches, which include posterior, lateral, and anterolateral all must cut muscles and disrupt vital tissues to replace the hip. Other benefits of anterior approach and not cutting muscles include less pain, less blood loss, less risk for dislocation, and more equal restoration of leg lengths. But the biggest thing most patients care about is the faster recovery which allows you to get back to living life without the pain and not having a prolonged recovery process. Anterior hip replacement is also so less invasive that lots of patients are candidates to have their surgery done outpatient and able to recover in the comfort of their own home with out the need for a costly hospital stay.
Some physicians may recommend a hip resurfacing surgery instead of a hip replacement. A hip resurfacing is essentially a hip replacement but instead of replacing the ball, a cap is placed over the patients existing ball and the hip socket is still replaced as in a hip replacement. Be cautious when considering this as hip resurfacings has lots of potential downfalls. First, for most surgeons to resurface a hip, a posterior approach is performed which cuts most all muscles away from the hip and leads to permanent damage to the muscle that can have detrimental consequences in the future. Second, hip resurfacings are all metal on metal components which have significant well known complications including implant failure, local hip tissue and muscle damage, and absorption of metal fragments that are generated from the metal components rubbing together into the blood stream and traveling throughout the body. This absorption of metal ions has been suggested to lead to numerus health problems including cancer. Hip resurfacings all have a very short and limited lifespan and will all eventually have to be revised to a full hip replacement. For these serious concerns mentioned, hip replacement performed by anterior approach is much preferred to hip resurfacing. Patients also experience a faster and easier recovery compared to hip resurfacing.
When it comes to anterior hip replacement, experience also matters. If your surgeon hasn’t been performing anterior hip replacement for very long or doesn’t perform it regularly, then you should consider looking for a surgeon who has more experience in the surgery. Surgeons with limited experience have a much higher complication rate and can lead to decreased success of the surgery. Thus, experience matters. Palmetto Bone and Joint has the most experienced surgeon in anterior hip replacement and has been performing this procedure longer and performed more anterior hip replacements than any surgeon in South Carolina.
So, if your contemplating hip replacement surgery, know that you have options and don’t settle for an approach that will affect your recovery and outcome. Call Palmetto Bone and Joint to discuss these options and what’s best for you.