Do I need Total Hip replacement?

Total Hip Replacement Considerations

A total hip replacement is a elective surgery to get you back to the life that you want. It would be very rare for you to be told that you need a hip replacement; a hip replacement is a choice outside of reconstruction from a hip fracture. The choice becomes more attractive over time as conservative treatments fail to offer relief and quality of life is becoming an issue. If you are having chronic hip pain, a hip that is unstable, and conservative treatment has been failing, and imaging shows destruction of the hip joint from osteoarthritis, or the joint has been destroyed by avascular necrosis then a total hip replacement is a answer that we offer to reduce or eliminate your hip pain, and get you mobile again.

What To Expect from Total Hip Replacement

There are many approaches to total hip replacement, each with their own upsides and downsides. While orthopedic surgeons have their own strong opinions on which way is best, the most important factor in choosing a surgeon is the results of how they do the approach that they are most comfortable with. A skilled surgeon is more important that what angle they approach from since after recovery all three approaches solve the issue if the surgery itself is successful.

Posterior Hip Replacement

Posterior hip replacement is the most common hip replacement done in the US. The incision is close to the hip and the buttock, just behind the greater trochanter. Recovery time for this approach is slightly longer since three muscles are cut into to reach the joint. Sleeping my be difficult for some since the wound is where many people lay down.

Anterior Hip Replacement

Anterior Hip Replacement is the most minimally invasive, but most technically difficult, of the hip replacements with muscles only pushed to the side instead of being cut through. Recovery time is the shortest of all the replacement surgeries, and this approach has the least post-surgical pain. However, nationwide there are slightly more incidences of poor wound healing and infection rates. Obesity is also a more limiting factor for the anterior approach. Due to the downsides of this procedure there are stricter requirements put on the patient for pre-surgical clearance to ensure a highest rate of positive outcomes. You may want this procedure but may not a candidate if you are unable to meet the strict, hard stop, guidelines. There is a steeper learning curve for this newer procedure than other approaches, so this approach is usually not considered by surgeons that have already mastered other approaches in their schooling and careers.

Additional Considerations for Total Hip Replacement

All approaches of hip replacement carry the risks of dislocation after the surgery, post-surgical nerve damage, and eventual wearing out of the replacement hardware leading to a hip revision surgery with the possibility of needing allograft. Rates of nerve damage are around 1% nationally, and initial data seems to point to the anterior approach having slightly less chance of nerve damage. The hip joint is a poorly oxygenated joint with very little blood flow. Due to this lack of blood flow extra precaution must be taken in preparing for the surgery. Diabetes must be well controled and smoking must be stopped. Smoking causes carbon monoxide to permanently bond with the hemoglobin in your red blood cells preventing them from carrying as much oxygen to the recovering tissue. It is required to quit smoking 30 days before the surgery, so that your red blood cells can be replaced, to prevent catastrophic failure of the replacement. We will test your blood the day of the surgery and will not proceed if carbon monoxide levels are present.