HEALTH MATTERS 3/18: New Hip Replacement Procedure Offers Faster Recovery

By Brian Vannozzi, MD

Imagine having your hip replaced in the morning and then being able to walk the length of a football field that same afternoon.

A new muscle-sparing procedure offered at Penn Medicine Princeton Health is enabling many hip replacement patients to do just that.

In fact, most patients can go home in less than 24 hours, and many go home the same day.

If your doctor has recommended hip replacement surgery to help relieve pain and stiffness in your hip, talk to them about your options, including minimally invasive direct superior hip replacement.

Osteoarthritis Common Cause of Hip Pain

Hip pain and stiffness is often brought on by osteoarthritis, a degenerative joint condition that affects more than 32.5 million people in the United States, according to the Centers for Disease Control and Prevention.

While osteoarthritis can develop in smaller joints, it most often develops in weight bearing joints such as the hip.

Osteoarthritis of the hip occurs when the cartilage that protects the bone surfaces of the ball and socket joint and enables them to move easily wears away. This causes the bones to rub against each other, resulting in pain and stiffness that can limit your ability to perform even the most basic activities such as getting in and out of a car or up from a chair.

Common symptoms of osteoarthritis in the hip include:

• Pain in the groin or thigh that radiates to your buttocks or your knee.
• Pain that flares up with vigorous activity.
• Stiffness that makes it difficult to walk or bend.
• Grinding noise during movement or locking or sticking of the joint.
• Decreased range of motion.
• Increased joint pain with rainy weather.

The risk of developing osteoarthritis increases with age and occurs most often in people 50 years old and older.

In addition to aging, other risk factors for osteoarthritis of the hip include:

• Being overweight.
• Family history of osteoarthritis.
• Past injury to the joint.
• Improper formation of the hip joint at birth.

Other causes of hip pain include rheumatoid arthritis, post-traumatic arthritis (caused by a serious injury or fracture), fracture, and childhood hip disease.

When Hip Replacement is Recommended

Treatment for osteoarthritis of the hip typically begins with non-surgical approaches, such as lifestyle changes, physical therapy, assistive devices, and medications.

However, as the American Academy of Orthopaedic Surgeons (AAOS) notes, there are several reasons why your doctor may recommend hip replacement surgery to treat hip osteoarthritis.

People who benefit from hip replacement surgery often have:

• Hip pain that limits everyday activities, such as walking or bending.
• Hip pain that continues while resting, either day or night.
• Stiffness in the hip that limits the ability to move or lift the leg.
• Inadequate pain relief from anti-inflammatory drugs, physical therapy, or walking supports.

According to the AAOS, hip replacement surgery is one of the most successful operations in all of medicine, with more than 450,000 total hip replacements performed in the United States each year.

Minimally Invasive Surgery

At Penn Medicine Princeton Health, surgeons are performing hip replacement surgeries using minimally invasive techniques, such as a new procedure called direct superior hip replacement.

During direct superior hip replacement, which typically takes less than an hour to complete, surgeons do not have to cut the two muscles that are traditionally cut during hip replacement. This minimizes the trauma to the hip during surgery and, together with the use of new materials called dual mobility components, makes the joint significantly more stable after surgery.

As a result, the procedure generally eliminates the restrictions traditionally placed on patients after the surgery. In fact, most patients can walk over 300 feet (the length of a football field) within a few hours after the procedure.

Many patients go home the same day as their surgery and are usually not restricted when it comes to sleeping on either side, crossing their legs, or bending, unlike after traditional hip replacement when patients are advised not to perform certain movements for up to eight weeks.

Anyone in need of a hip replacement is a candidate for direct superior hip replacement. However, it is important to note that waiting too long to undergo the procedure can compromise the outcome. If the ligaments, soft tissues, and muscles around the hip have stiffened, it can take a little longer and require more effort to get back to 100 percent.

Taking a Step in the Right Direction

If you suffer from debilitating pain and stiffness in your hip, talk with your doctor about the benefits of hip replacement surgery. When performed with newest techniques and technologies, hip replacement surgery can give you your life back.

To find a physician affiliated with Penn Medicine Princeton Health, call 888-742-7496, or visit www.princetonhcs.org.

Brian Vannozzi, MD, is a board certified orthopaedic surgeon on the Medical Staff of Penn Medicine Princeton Health.