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The most common complaint of patients
with hip problems is growing pain, often associated with stiffness.
Sometimes patients describe the pain as radiating down the anterior
thigh to the knee.
Some other patients will complain of posterior buttock or
lateral hip pain.
But a vast majority of patients with hip problems report
growing pain on the affected side.
Overtime, a limp may also develop.
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Some actions that bother patients with hip problems include, prolonged
walking or standing, trying to get up after prolonged sitting.
Often patients with hip problems will report problems with certain
activities like bending, squatting, navigating stairs,
tying shoes, or putting on socks.
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The hip joint is a ball and socket joint.
Arthritis is defined by wearing away of cartilage,
which is the cushion of the joint.
Total hip replacement involves making an incision
on either the front or side of the hip and
getting down to the hip joint to remove the damaged ball and socket.
Once the damaged parts are removed or shaved,
they are then replaced with the combination of metal, plastic and
ceramic implants to restore the function of the joint.
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A good candidate for hip replacement surgery should have documented
debilitating hip arthritis that is significantly affecting his or
her daily activities.
Often times the patients symptoms have stopped responding to non
operative treatment.
Once the patient is deemed the candidate for surgery, he or
she should be in good enough health to withstand surgery and
the required post operative rehabilitation.
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The Johns Hopkins team is multi-disciplinary.
It includes nurses, operative room technicians, medical doctors,
rehabilitation doctors, anesthesia doctors and nurses, physician
assistants, nursing practitioners and obviously the surgeons.
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The procedure takes approximately one to two hours and the patient
stays in the hospital for one to two nights before going home.
More recently we now offer outpatient total joint replacement,
where selected patients are able to come in for these surgeries and
go home on the same day.
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The time to full recovery is different from patient to patient.
However, on average most patients with sedentary jobs can return to
work with three to six weeks.
Patient with labor intensive jobs usually we'll need
about six to twelve weeks before returning to work.
Complete recovery can sometimes take up to 6 to 12 months depending on
the patient's over all health.
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In the past, doctors reserved hip replacement surgery primarily for
people over 60 years of age.
The thinking was that older people are less active and therefore
expected to put less stress on an artificial hip than younger people.
However in more recent years,
doctors have found that hip replacement surgery can be
very successful even in the younger population.
New technology is improved to prosthetic parts,
allowing them to withstand more stress and last longer.
Today, a person's overall health and activity levels a more important
than age, and predicting the success of hip replacement surgery.
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All surgeries are associated with some risks.
Complications after total hip replacements may include infection,
excessive bleeding, blood clots, hip dislocation, fractures,
limb length inequality, and damage to blood vessels or nerves.
It is important to note that these complications are relatively rare
because advances in technology and
surgical techniques have greatly reduced these risks.
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Patients can expect dramatic pain relief and
overall improvements in function, range of motion and quality of life.
Recent advances and pain management has allowed us to control our
patient's pain significantly even starting from the day after surgery.
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Yes, most patients will need at least three to six weeks of formal
outpatient physical therapy.
But most are still encouraged to continue home exercises,
even after completing formal physical therapy.
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Before considering surgery, the doctor may offer physical
therapy to strengthen the hip or the use of assistive devices,
like a cane or crutches to off load the joint.
Or even the use of medications like anti-inflammatory medications to
help with pain and inflammation control.
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