When non-operative treatments such as medication, changes in your everyday
activities, and the use of walking supports no longer provide relief from
your hip pain, and your limited level of activity is keeping you from
things you enjoy, it may be time to consider hip replacement surgery.
Sauk Prairie Healthcare’s Joint Health Center offers total hip replacement for the appropriate candidates. Many factors
determine which treatment option is best for you, including your age,
bone quality, and other medical conditions. Your orthopedic surgeon will
perform a complete evaluation and discuss your hip replacement options with you.
In total hip replacement surgery, the arthritic ball of the upper femur
(thighbone) is removed, as well as damaged bone and cartilage from the
hip socket. The ball is replaced with a ceramic or metal ball that is
fixed solidly inside the femur. The socket is replaced and a durable bearing,
or liner, is placed within that socket to create a smoothly functioning joint.
Hip replacement surgery at Sauk Prairie Healthcare is a long-term solution
for those with joint pain caused by end-stage hip arthritis. The vast
majority of those with this problem have osteoarthritis, a condition caused
by cartilage wearing out that used to protect the bones from friction
during movement. The cause can also be rheumatoid arthritis, AVN or avascular
necrosis, hip dysplasia, or even post-traumatic arthritis.
Although the effects of osteoarthritis cannot be reversed, there are steps
that your orthopedic surgeon can recommend to slow symptom progression
and relieve some of the pain and swelling, such behavior modifications
and exercise. Following examination, doctors typically first recommend
conservative, non-operative treatment. If those options don’t provide
relief, your Orthopedic surgeon may suggest hip replacement surgery.
Hip Replacement Surgery — Posterior Approach
The posterior approach to hip replacement surgery begins with an incision
on the side of the hip. Muscles are then split or detached from the hip,
allowing the surgical team to view and access the hip joint.
The ball and socket of the hip is separated and the damaged head of the
joint at the top of the thigh bone is removed with the femoral neck. A
metal socket is implanted in the pelvis, and a liner is placed within
it. A ceramic or metal ball is attached to a titanium stem. That stem
sits securely within the femur, or thigh bone. The new ball in the new
socket makes up the new hip joint.
At Sauk Prairie Healthcare, recovery begins with hip recipients getting
out of bed the same day as the surgery and going home the next day or
within a couple days. At home arrangements will need to be made to limit
undue stress such as going up and down stairs and being able to follow
through with prescribed exercises for the recovering hip. Physical therapy
will be a part of healing and recovering strength and flexibility in the joint.
Over the first two weeks, recovery goals include moving with a walker or
crutches, walking several hundred feet several times a day, and going
up and down a flight of stairs once a day. In the beginning, pain management
will be part of recovery as well as taking care of the incision area as
it heals and recovering from bruising and swelling.
In the following weeks, the incision will heal and stitches will come out
as swelling and stiffness becomes less severe and less frequent. Your
goals will shift so you can resume everyday housekeeping tasks and regularly
walk a quarter of a mile with less use of mobility aids such as a walker
or crutches and you will transition to a cane or a single crutch.
Within a few weeks, your goals begin to resemble full recovery, including
walking without assistance for a half mile or a mile at a time, using
stairs with normal movement, and resuming low-impact activities like dancing,
bowling, or golf.
Progress and recovery vary from person to person. Adherence to your doctor’s
orders and exercise plans is extremely important.
Hip Replacement Surgery — Direct Anterior Approach
In the direct anterior approach, an orthopedic surgeon accesses the hip
joint by making a roughly 4-inch incision in the front of the leg and
then separating the two muscles in front of the hip. This differs from
a posterior approach from the side of the leg, in which muscles are cut
and then reattached. Both methods are acceptable and provide reliable
outcomes, but there are some advantages to the anterior approach.
The
anterior approach to hip replacement has been in practice since the 1980s but has become more common and reliable
with the availability of new specialized surgical tools. The technique
has been described as a “tissue-preserving” method of joint
replacement.
The hip is exposed by going in between the muscles. Other benefits to the
anterior approach to total hip replacement surgery include the fact that
the incision is shorter, which means less muscle detachment, which can
lead to faster recovery. During the operation, the surgeon uses a real-time
x-ray to ensure all of the hip components are well-aligned and that the
leg lengths are appropriate.
Expectations of Hip Replacement at Sauk Prairie Healthcare
When you have hip replacement surgery at Sauk Prairie Healthcare’s
Joint Health Center, you can expect to be actively involved in your treatment
through each step of the program. Preparation, education, continuity of
care and a pre-planned discharge are essential for your optimal results.
Every detail, from pre-operative teaching to post-operative exercising,
is considered and reviewed with you. Our Joint Care Coordinator will be
a resource for you, assisting by coordinating all pre-operative care and
discharge planning.
Our team approach to care makes Sauk Prairie Healthcare’s Joint Health
Center unique. By incorporating family involvement, patients are encouraged
and motivated in their recovery. We encourage you to have a family member
or friend be your “coach” to help you stay on track as you
recover from surgery.
Before hip replacement surgery, we will set you up on our Guided Care Path.
This is an online tool for you and your coach to follow from six weeks
pre-op until three months post-op and beyond. The Guided Care Path is
designed to help you know what to expect from each step along the way,
what you need to do to prepare for surgery and make the most of recovery,
and how to care for your new hip as you begin using it.
Physical therapy is very important when you have hip replacement surgery.
We get you out of bed the same day as surgery to take small steps. The
next morning we’ll help you start walking, then you’ll have
group therapy twice a day as well as individual walking goals. All our
hip replacement and knee replacement patients have therapy together to
helps motivate everyone to do their exercises and reach their goals. Depending
on their situation, a hip replacement patient might not need physical
therapy after they leave the hospital.
Our team of joint replacement experts will help you find out if hip replacement
surgery is right for you and help you learn about the process and preparation.
Then after surgery, will guide you through recovery and rehabilitation.
Orthopedic Surgery, OrthopedicsView Profile
