Hip Surgery

Hip Surgery/replacement overview, Pro's vs Con's:

Hip Surgery is becoming more and more common these days.  In fact, now days.. we are seeing hip surgery performed on younger people than in the past.  This could be due to a few different factors such as a higher BMI amongst the general population now days than in the past. (People now days are generally 5-10 pounds heavier than generations before us thus adding weight and therefore stress to the hip joints).  And people now days tend to be more active than in generations before and therefore expect to do things like run marathons, hike, bike and or at least hit the gym daily without hip pain. This being said, it makes perfect sense as to why we are seeing hip surgeries amongst younger people than in previous years.

However, as with anything, there are always pro's and con's to everything and hip surgery certainly has both.  One pro to having hip surgery and the main reason anyone has this surgery, is obviously to move better with reduced pain for many years to come following surgery recovery and most patience do in deed achieve this outcome and can expect to move pain free for a good 10 years or more after surgery before needing a revision to their older surgery to keep them pain free. The main Con to early hip surgery is that sense the life of the hip surgery/replacement is about 10 years, the younger a person is when they get it, the more active they typically are and for longer... therefore, they will most likely need revisions to their surgery sooner and perhaps even more often than a person who has the surgery later in life.

I guess the real message here is that hip surgery/replacement has a relatively short life span of about 10 years.. and revisions to the original surgery will become necessary sooner with more use.  Therefore, It is highly recommended to really weigh out all of your options carefully prior to having the surgery AND... be sure to look deeply into holistic and more natural remedies first.  There are many things you can do all by yourself to help alleviate the pain and help your hips to move better and with less pain before resorting to surgery.  

Some conservative treatment strategies to try before resorting to surgery:

Try things such as...

1. changing your diet to include more anti-inflammatory foods and beverages... less inflammatory foods such as sugars, loosing even just a few pounds  and simply walking and stretching daily can help a lot.  You can seek the advice from a nutritionist for more information about your diet and how changing it can help you lose weight and lighten the load your joints have to carry thus, reducing pain in your joints.

2. Try exercises designed specifically to strengthen and or stretch and loosen tight joints.  You can seek out a personal trainer to teach you both strengthening and stretching exercises and a yoga instructor to really help to deeply stretch and strengthen your muscles and joints helping to alleviate the pain even more.

3. You can take it even further and seek out a physical or physiotherapist who will help you with everything you need to know regarding the natural and most conservative methods of managing your hip pain from anti- inflammatory drugs to diet and exercise therapy to physiotherapy. It is important to exhaust all natural or conservative treatment strategies of weight loss, non-steroidal anti-inflammatories and physiotherapy first. Research shows that physiotherapist working as first points of contact in primary care have actually reduced referrals for hip and knee replacements by 20%. As long as the physiotherapist has the support and experience to make the judgement, they should know which person is a good candidate for physiotherapy and which ones are best surgical candidates.

If surgery is your last resort:

If you find yourself still facing surgery after exhausting the natural and conservative approach, do not despair, Hip Replacement Surgery, also called Total Hip Arthroplasty, is helping many people to live active, pain free lives. With this surgery, The hip joint is replaced with an artificial one, this surgery is performed for reasons such as a hip fracture, break or even due to certain types and degrees of arthritis.

There are a number of types of arthritis that affect the hip joint such as Osteoarthritis,

Rheumatoid arthritis or Traumatic arthritis.

The hip replacement surgery is done in order to replace the damaged parts of the hip joint and thus, the patient is relieved of the hip pain.

Two types of surgeries:

Accounting for about 95% of all cases and dating all the way back to several decades ago, the most common and traditional method of surgery is called the posterior hip replacement

where the incision is usually done on the back and is several inches long. This method is a little more painful, not as exact and a little longer recovery time taking up to eight weeks. However, the newer approach, called Anterior hip replacement involves smaller incisions through the front side of the body, is the minimally invasive hip replacement method resulting in less pain, faster recovery time (about 4 weeks vs 8 weeks), reduced risk of complications and a more accurate positioning of the new hip components.

Although the (posterior or back) method is currently still used for about 95% of all surgery cases, the new (anterior or front) method is quickly becoming the most commonly used method as this newer technique is now considered more desirable for it proves to have more benefits and is a far superior method for its faster recovery time and more accurate position ability.

Goal of Hip Replacement Surgery:

The reason for hip replacement surgery is to relieve the patient from pain and disability of the hip area, to give them back their strength, flexibility, range of motion and ultimately to increase their mobility allowing them to enjoy a fuller, healthier, more active life. Thus prolonging their life by allowing them to stay active longer and pain free.

Most common reason for hip surgery:

As mentioned earlier, the most common reason for hip replacement surgery is arthritis.  

In particularly...Osteoarthritis. This type of arthritis causes wear and tear of the joint cartilage of the hip to such a degree which actually then results in the total loss of it. Without our joint cartilage, there is nothing between our bones to cushion the joints and bones as they move past one another this causes a great deal of friction and bone on bone movement and as you can imagine, this would definitely make the movement of the bones and joints extremely difficult and cause mush pain.

If a patient is suffering from this type of degenerative joint disease then, as you can imagine, it is not possible for them to perform even the most basic and normal activities such as bending, sitting, walking or even just standing. Any movement, or anything in which the patient may have to bend the hip will cause tremendous pain.

Other kinds of arthritis like rheumatoid arthritis which is usually caused due to hip injury can also damage the hip joint and cause pain.

Hip replacement surgery can also be performed in order to treat hip fractures caused mostly due to a fall. A fracture can disable a person and can cause severe pain.

Patients are usually given strong pain medicines in order to control arthritis/fracture pain.  However, if their pain continues the physician may recommend hip replacement surgery. Some medicines that are used for degenerative joint disease and fractures include Anti-inflammatory medicines, Glucosamine, physical therapy and other pain medicines/remedies.

Risks of Hip Replacement Surgery:

As with any and all surgical procedures, there may be complications such as bleeding, infection, dislocation, nerve injury and sometimes the need for revision of the initial surgery. There can also be other risks factors depending of on the severity of your hip injury and your current health condition. It is a good idea to consult your primary care doctor or your surgeon to understand all of the risks associated with your particular situation.

Preparations for Hip Replacement Surgery:

Before the surgery, is a very good time to ask any questions that you may have regarding your hip replacement surgery. Most hospitals, will require your to complete a consent form allowing the doctor to perform the planned procedure. You should have had plenty of opportunity to discuss the surgery in full detail with your doctor or surgeon prior to being asked to sign the consent form.  It is very important that you read the form in it's entirety and understand it prior to signing it. Should you not understand something or have general questions about what is contained on the form, please be sure to ask all questions and understand it prior to signing.  Once the form is signed, you have now given your consent for the procedure to begin. Your doctor will schedule your appointment and notify you of the date.  It is important to let your doctor know about any 

allergies you may have, have all blood tests or other diagnostic tests done and let your healthcare provider know about any sort of medication that you may be taking.

You will be advised not to eat anything 8 hours prior to the surgery as food on your stomach is not a good mix with the Anesthesia and could cause nausea. Before the surgery starts, you will be given sedatives that will help to relax you. If you are a smoker, it is best to not smoke before the surgery since smoking can delay the healing process. Be sure that there is someone to drive you home and to look after you at home after you are discharged from the hospital.

The process of Hip Replacement Surgery:

Hip replacement will require you to stay in the hospital for at least a night. It is performed after you are asleep while under general anesthesia or spinal anesthesia.

When you arrive at the hospital, you will be called back and asked to remove your clothes and put on a hospital gown. you will then lay on the hospital bed, warm blankets placed over you, An IV will be started in your arm supplying you with pain medicines, fluids and anesthesia. Once you start getting sleepy and numb you will be positioned on the operating table and surgery will soon begin. Your heart rate, blood pressure, breathing and blood oxygen level will be monitored by the anesthesiologist during the entire process of surgery.

The skin of the area of the incision will be cleaned with an antiseptic solution and the healthcare provider will make he appropriate incision in the cleaned area. The healthcare provider will remove the damaged parts of the hip joint and replace them with prosthetic parts. The prosthetic parts have a stem part that goes into the femur, a ball part that fits into the stem and a cup is installed in the socket for the ball to fit in. The stem and the cup are made of metal while the ball may be made of either metal or ceramic. The incision is then closed by stiches or surgical staples. In order to remove any fluids from the incision, a drain may be placed. The last step is dressing the incision site with a dressing.

After Hip Replacement Surgery:

After the surgery is done, you will be taken to the recovery room and monitored. Your blood pressure, pulse and breathing is monitored, when they are all back to normal, stable and you have come out of the anesthetic, then you will be moved to the hospital room where you ill stay comfortable for a number of days.

It is advised that you move your new hip joints very soon after the surgery. You will be introduced to a physical therapist right after the surgery and a plan of exercises and stretches will be created for you. Medication will be given to you to sooth the pain so that you can exercise and move more. You exercise according to the plan during your stay at the hospital and at home after your discharge.

After you are discharged, you will be either sent home or to a rehabilitation center, depending on your condition. You will attend physical therapy sessions weekly if not daily at least in the beginning to strengthen your muscles.

When you reach home, make sure that you keep the surgical area clean and dry at all times. Take showers according to the bathing instruction given by your healthcare provider. There will be a number of visits to the healthcare center for follow up care and eventually for the removal of stitches.

In closing:

Be sure not to skip any doses of medication that your healthcare provider has recommended to you to relieve you from soreness and pain. Make sure that you only take the prescribed medicines. Get plenty of rest but move as much as possible to get your muscles working and strong again. Take care of yourself and remove any obstacles from your house such as electrical cords or carpets that may cause any trip and falls.