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The Hip Side of Joint Replacement

By Alan Williams, PT, OTR/L, ATC, CSCS

Remember the show from the seventies, The Six Million Dollar Man? Lee Majors starred as the astronaut victim of a horrendous crash who was rebuilt with bionic parts to become a superhuman agent against evil. A line from the show’s opening credits (“We can rebuild him – we have the technology!”) became a pop culture catchphrase that has far outlived the show and its subsequent TV movies, spin-off series, and remakes. Thirty years later, that phrase has taken on a whole new meaning for a generation of baby boomers and retirees suffering from painful hip joints that impede their everyday life.

There are many reasons why our hips wear out. Osteoarthritis (also known as “wear and tear” arthritis) is perhaps the most common. This occurs when the joints degenerate, leading to a breakdown of cartilage (the collagen-rich material that covers the ends of bones to create a smoothly-moving joint). Although this “wear and tear” is often seen in the elderly, many people – such as super-athletes, the obese, or those with jobs that require excessive repetitive motion – may begin to see the affects of osteoarthritis at an earlier age. Some other reasons hip joints may wear out are injury (such as a fracture or other trauma), disease (such as rheumatoid arthritis), or bone death (called aseptic necrosis, this can be caused by trauma, disease, or drug use).

The hip is classified as a ball-and-socket joint. It consists of the rounded top of the upper leg bone (called the femoral head) and the cup-shaped portion of the pelvic bone (called the acetabulum). During a total hip replacement surgery (called arthroplasty), these two parts are replaced with metal, ceramic, or plastic prosthetic components, depending on your specific needs. With proper follow-up care, rehabilitation, and lifestyle adjustments, most hip replacements last for around 15 years. However, a total hip replacement cannot turn you into a bionic superhuman. If you weren’t a marathon runner before, an arthroplasty will not make you one. In fact, running and other strenuous or high-impact activities are discouraged because they will wear out or perhaps even break the prosthetic components, requiring further surgeries.

As with any surgery, a total hip replacement has inherent risks (blood clots, infection, pneumonia, stroke, etc.). Therefore it’s recommended that you try other methods for controlling your hip pain before considering arthroplasty. Physical therapy, assistive walking devices (such as canes or walkers), glucosamine supplements, and over-the-counter pain medications (if approved by your doctor) can all be effective at alleviating hip pain and discomfort. But if these methods are no longer enough, and your hip pain is worsening to the point where you can no longer participate in your daily activities, an arthroplasty may be the way to go.

The ideal candidate for arthroplasty is a person of healthy weight who is free from heart problems, lung problems, infections, or other conditions which may increase the risks of surgery. Even if you don’t exactly fit this profile, a total hip replacement may not be out of reach. Special precautions will have to be made during your surgery and recovery to insure optimal results. Your doctor will discuss any concerns with you beforehand and will be able to answer all your questions.

Perhaps more than with other types of surgery, physical therapy is absolutely vital to the health and well-being of your new hips. Muscle tone must be rebuilt to aid in stabilization of your new joint, and strengthening and stretching will help to avoid certain possible side-effects of arthroplasty, such as joint stiffening, dislocation, and uneven leg length.

A total hip replacement is not something to be entered into lightly, but if uncontrolled hip pain is keeping you from your daily activities, an arthroplasty may be the right choice for you. You won’t be the Six Million Dollar Man, but with the right care and rehabilitation, you will be able to return to the activities you love.

For your FREE Hip Assessment, call 463-0022 today!