Should You Consider Hip Replacement Surgery?
Listen to Jacob Smith on our podcast Memorial Health Radio in the new episode titled Hip Replacement Surgery.
Transcription
Melanie Cole (Host): When your hip pain affects the quality of your life and you are unable to complete daily tasks without undue pain; then it might be time to consider a hip replacement. Whether you have just begun exploring treatment options or have already decided to undergo hip replacement surgery; there are some important questions you should ask your doctor. My guest today is Dr. Jacob Smith. He is an orthopedic surgeon with Memorial Health System. Welcome to the show Dr. Smith. So, tell us about the most common causes of hip pain that you see.
Dr. Jacob Smith, MD (Guest): The common causes of hip pain are usually related to degenerative osteoarthritis processes that begin in middle to advanced stages of life. Usually the patient will present with complaint of groin pain, mostly when attempting to stand or ambulate. The patient also may present with complaint of buttock pain or pain over the posterior hip region.
Melanie: So, once you have tried all those conservative, nonsurgical methods; then what do you tell your patients about considering hip replacement surgery and what should they be thinking about when you are giving this discussion with them?
Dr. Smith: So, after the patient has failed all conservative treatments for hip osteoarthritis pain, we usually will have a discussion regarding total hip replacement. The patient should consider the overall process of going through the hip replacement, what the physical therapy will entail, in terms of rehab after the hip replacement and usually expect anywhere from a two to three-day hospital stay after the procedure. There are some occasions where we in the properly selected patient doing joint replacement as an outpatient procedure.
Melanie: So, then let’s talk about the procedure. When you do a hip replacement and you do an anterolateral approach; please explain the procedure just a little bit and even the material that you use for the hip.
Dr. Smith: The approach that I use when performing a total hip replacement is an anterolateral approach. This is more of a muscle sparing approach than the traditional posterolateral approach to the hip joint and will allow the patients to perhaps recover quicker and speed along the process in the physical therapy rehab following the procedure. The materials used during the hip replacement are a combination of titanium prosthetic replacement components and a portion of the prosthesis is made of cobalt chromium.
Melanie: What are some advantages to the anterolateral approach for the patient?
Dr. Smith: Quicker recovery time perhaps, less pain medication used during the postoperative period because there is not as much soft tissue dissection as performed in some of the other approaches.
Melanie: Are there some people for whom this is not an option, some candidates that could not have this approach?
Dr. Smith: Certainly there are patients that would not be a candidate for the anterolateral approach just as they may not be a candidate for a direct anterior approach or the traditional posterolateral approach. The patient would have to have an office visit and discussion with their surgeon regarding which approach would be best suited for their particular case. There are some instances where the patient has already had previous hip surgery or we are revising a hip replacement and a different approach may be chosen. Most surgeons are trained across the country in all three approaches to some degree and we all perform the one or two approaches that we feel yield the best outcomes for our patients.
Melanie: So, then what is it like post-surgery for them? How soon can they start physical therapy after they have a hip replacement and then after physical therapy; how soon can they resume things like driving and some of their daily activities?
Dr. Smith: So, after the hip replacement procedure, physical therapy is actually begun that afternoon or evening following the surgery while the patient is in the hospital. This will consist of the physical therapy team helping the patient transfer and ambulate in their hospital room into the bathroom and down the hallways. This physical therapy will either be continued at an inpatient rehab facility that the patient may need to be transferred to following their two to three-day stay in the acute hospital setting; or sometimes the patient will be a candidate for going home with either home physical therapy or doing outpatient physical therapy. The patients usually will return to driving around the six-week timeframe because we think that is usually when the reaction time to push the accelerator or the brake in your car returns following a hip replacement and usually by that time; the patient is off any narcotic pain medication or significantly taking a reduced amount of pain medication, which would make driving safe.
Melanie: And are there sometimes when the hip that you have replaced might have to be replaced again? How long do they usually last?
Dr. Smith: There are instances where the hip replacement may have to be revised down the road. This is usually around the fifteen-year timeframe, assuming the patient had not had any previous complications with the hip replacement.
Melanie: Should surgeons have a special expertise or training to do this anterior approach, Dr. Smith?
Dr. Smith: Surgeons usually will get trained on one approach to the hip or various approaches to the hip joint while in residency training. And some surgeons do an additional year of training called fellowship training which they may get trained in other approaches to the hip joint. Your surgeon should have adequate training in performing either the anterior, anterolateral or posterolateral hip approach.
Melanie: So, wrap it up for us with your best advice for people that are suffering from hip pain. Maybe they have had it for quite a while, they have tried some of the other conservative measures to deal with it and now they are considering hip replacement surgery and what would you like them to know?
Dr. Smith: For the patient that has suffered hip pain for quite some time and has failed some of the conservative nonsurgical treatment options; I would recommend that you go see an orthopedic surgeon and have a discussion regarding your best treatment options going forward. There could very well be some additional conservative nonsurgical treatment options at your disposal or it may be time to consider having a hip replacement and your surgeon could help you make that decision.
Melanie: You are listening to Memorial Health Radio with Memorial Health System. And for more information you can go to www.mhsystem.org. That’s www.mhsystem.org. This is Melanie Cole, thanks so much for listening.
