Hip Arthritis and Hip Replacement Surgery
What is hip arthritis?
Hip arthritis is when the cartilage covering the bones of the joint is damaged and absent. It can vary from minimal damage to complete loss of the cartilage.
How does hip replacement work?
Hip replacement removes and replaces the ball and socket of the native joint. The artificial parts work the same as the native joint components. The capsule, ligaments, and surrounding muscles move the artificial parts the same as the native ones.
What is the difference between the anterior approach to the hip and the traditional approach?
The anterior approach to the hip enters the joint from the front. The move traditional approach in North America enters the hip through the back. Different muscles are altered for each approach, and the hip capsule and ligaments are weakened in the front versus the back.
How long will I need to stay in the hospital?
The typical stay is 1-2 days. Leaving the hospital is based on your pain and mobility. Once your pain is well controlled with oral pain pills, and you can climb stairs and use the bathroom, you are usually safe to go home.
Will I need physical therapy after my surgery?
The need for therapy varies from case to case, but it is not necessary for everyone. If a therapist can help you get moving faster and speed the recovery, one is prescribed.
When do I need to follow up with the doctor?
Typically the patient is seen 1 and ½ weeks, 1 and ½ months, and 3 months after surgery. Visits continue until pain and function have returned to normal.
How long will I be on pain medicines?
This can vary from days to weeks depending on disability before surgery and other medical issues.
When can I return to work?
Desk work is okay days after surgery. Manual labor is usually not safe for at least 1 and ½ months after surgery.
When can I drive a car?
Once you are off narcotic pain pills, you can drive.
What activities does a hip replacement prevent me from doing?
One can perform any activity after hip replacement. The issue is the activity’s impact on the longevity of the replacement. Higher impact activities will decrease the lifespan of the implants and therefore should be minimized.
About Hip Dysplasia and PAO
What is hip dysplasia?
Hip dysplasia is when the hip socket is too shallow providing inadequate support to the femoral head. This inadequate support leads to premature damage to the hip cartilage and arthritis.
What are the alternatives to surgery?
Activity modification, pain pills, gentle exercise.
What exactly is done in surgery?
The socket of the hip is repositioned to better cover the femoral head and support weight. This repositioning is done after freeing the socket from the rest of the pelvis. Once the position has been changed, the socket is held with screws to allow bone healing similar to fracture healing.
Will surgery fix my problem?
Surgery will improve the position of the hip and its biomechanics. The hip will not be perfect, but will be better able to support your weight for activities of daily living.
How long will I be in the hospital?
Typically 3-4 days. When you can do stairs and go to the bathroom, you can go home.
What special equipment will I need?
You should only need crutches. Occasionally a raised toilet seat helps, but not always necessary.
Will I need physical therapy?
Physical therapy is not always necessary, but can help certain patients get back to there active lifestyle faster. Each case is evaluated separately for this need.
How long will I need to be off work after PAO?
Desk work can begin days after surgery. Manual labor is not possible for about 2 and ½ months.
When can I return to recreational activities?
Biking and swimming are good usually after about 2 weeks. Impact sports are not advisable until after 3 months.
When can I drive a car?
Once you are off narcotic pain pills, you can drive a car.
About Hip Arthroscopy
What is a labral tear?
The labrum is a soft cartilage around the rim of the hip socket. This labrum can tear as a result of impingement conditions, described above, or with trauma.
What is hip arthroscopy?
Hip arthroscopy is a procedure where the hip joint is visualized using small instruments that require a very small incision to insert. The instruments enable visualization of the joint and certain interventions such as removal of pieces of tissue, repair of cartilage, and bone removal.
How does hip arthroscopy surgery fix my problem?
Hip arthroscopy addresses the different issues you may have. A torn labrum can be trimmed or repaired. Excessive bone can be shaped to avoid rubbing. Inflamed tissue lining the joint capsule (synovium) can be removed. Also rarely, tissue floating in the joint can be removed.
Will I need crutches?
If bone is removed from the femoral neck, the hip is protected with crutches for 4 weeks to reduce the risk of injury to the femoral neck. The bone takes longer to fully recover, but the risk of falling is fairly low at this time after surgery.
What is the recovery?
Recovery can vary, but typically if bone work is performed, the recovery is 2-3 months. One should remain active during this time, mainly taking part in low impact activities such as swimming and biking.
When can I return to recreational activities?
A gradual return can begin immediately after surgery beginning with swimming and biking. After 2-3 months, one can resume higher impact sports unless advised by the surgeon.
When can I drive?
You can drive once off narcotic pain pills.