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Minimally Invasive Hip Replacement |
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Traditional hip replacement surgery is done through an incision that is usually about 5 to 8 inches in length. Beneath the incision, the muscle is separated, and the hip joint is exposed. The surgeon then removes the arthritic hip joint, and replaces this with a metal and plastic implant. The surgeon performs this surgery by looking directly at the arthritic hip joint, and setting the artificial hip implant into place. After surgery, patients commonly stay in the hospital 4 to 6 days, and often require months of rehabilitation.
Latest Developments
New techniques have been developed that allow the surgeon to perform the same surgery (hip replacement) through two small incisions and with minimal muscle dissection. The surgeon does not look directly at the arthritic hip, rather, he or she uses x-ray guidance in the operating room to position the artificial hip. The hope is that patients who undergo this minimally invasive hip replacement will have shorter hospital stays, quicker rehabilitation, and better results. However, being a new surgery, there are questions as to whether or not this is actually a "better" procedure.
Background
Hip replacement surgery is among the most successful (in terms of satisfied patients) procedures available today. However, surgeons are constantly trying to improve hip replacement. The goal of the two-incision hip replacement is to provide a procedure that has less surgical morbidity (meaning less pain, less blood loss, less rehabilitation), but as good, or better, overall results. So far, some surgeons have been able to show results that this procedure may indeed have less pain and less blood loss, but there is great debate as to whether or not the overall results are better, or even as good, as traditional hip replacement surgery.
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Understanding Hip Replacement Surgery
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Total hip replacement surgery is one of the most common orthopedic procedures. Hip replacement surgery is performed about 300,000 times in the United States every year. Because of the long history of hip replacement surgery, this procedure has become a safer and more reliable method to treat severe hip arthritis pain.
What are common symptoms of hip arthritis?
Patients who have severe hip arthritis typically have some or all of the following symptoms:
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Difficulty walking |
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Stiffness of the hip joint |
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Pain in the groin and thigh |
The most common location to experience pain from hip arthritis is the groin area. Patients may also complain of thigh, back and knee pain. If pain is experienced in the low back, buttock, or outside of the thigh, a careful examination must be performed to determine the source of the problem.
Over time, patients who have hip arthritis often develop a limp--the body's attempt to minimize the forces acting on the joint. This may require the patient to limit their walking or use a cane or walker to help relieve the pain from the hip joint. |
What causes severe degeneration of the hip joint? |
The most common cause of hip arthritis is known as osteoarthritis, or degenerative joint disease. A narrow hip joint without cartilage and bone spurs are common findings on an x-ray. Other possible causes of joint problems include rheumatoid arthritis, and osteonecrosis (also called avascular necrosis). However, the most common reason for needing total hip replacement surgery is osteoarthritis. |
When is a total hip replacement necessary?
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The first step in treating hip arthritis is conservative treatments. Options include:
Anti-Inflammatory Medication
The medications are effective at treating the inflammation of hip arthritis and also help with pain relief. There are many medications available, and some may be better for you than others. Knowing which one is best is difficult to determine, and is often best discovered by trying different medications.\
Physical Therapy
Physical therapy can help maintain motion and strength of the soft-tissues and muscles around the joint. Even if total hip replacement surgery is definitely necessary, physical therapy can help keep your joint in the best shape possible prior to total hip replacement surgery.
Cane or Walker
Use of a cane or walker is helpful at taking some of the burden off your joint. These devices often help you walk more comfortably and without a limp.
If these treatments are not adequate in treating your symptoms, then total hip replacement surgery may be recommended. Before surgery is considered, a thorough medical evaluation should be completed to ensure you are in good health and your body is prepared as best possible for the procedure.
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Signs You're Ready For Hip Replacement
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You have hip/groin pain that keeps you awake, or awakens you, at night. |
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You have hip pain that limits activities necessary to go about your daily activities (getting up from a chair, climbing stairs, etc.). |
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You have hip pain that limits activities that give you pleasure (walking for exercise, traveling, shopping, etc.). |
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You have tried other treatments for a reasonable period of time, and you still have persistent hip pain. |
There are many other factors you and your doctor must consider prior to surgery, including age, overall health, and bone density, but the list above will give you an idea when you should begin to consider hip replacement surgery. |
Signs You Are Not Ready For Hip Replacement
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Your hip pain does not limit normal activities. |
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Your symptoms are improving with more conservative treatments (medications, activity modification, etc...). |
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You have not tried more conservative treatments. |
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You are only limited from performing activities such as running or skiing. |
Patients who fit these criteria usually need more effort at treating their hip pain with more conservative measures.
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