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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 right patients. Many factors will 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 Arthritis

Hip replacement surgery at Sauk Prairie Healthcare is a long-term solution for those with joint pain caused by end-stage hip arthritis. Overwhelmingly, the source of the problem tends to be osteoarthritis, in which the cartilage that protects the bones from friction during movement wears out. 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 the progression of the symptoms of the condition and relieve some of the pain and swelling, such as modified behavior 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 thighbone 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. Goals shift to resuming normal homemaking tasks and regularly walking a quarter of a mile with less use of aids — from a walker or crutches to a cane or a single crutch.

Within weeks, the goals begin to resemble full recovery: 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 and golf.  

Progress and recovery varies from person to person. Follow-through with prescribed exercise plans is extremely important. 

Hip Replacement Surgery — Direct Anterior Approach

In the direct anterior approach, an Orthopedic surgeon will access the hip joint by making a roughly 4-inch incision in the front of the leg, 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 are: 

  • Typically, a shorter incision and less muscle detachment (which can lead to faster recovery)
  • The ability to use real-time x-ray while in surgery to ensure all of the hip components are well-aligned and that the leg lengths are appropriate

Hip Resurfacing

In rare cases, often involving younger, male patients, an Orthopedic surgeon may recommend hip resurfacing as an alternative to total joint replacement surgery. 

Hip resurfacing leaves most of the thighbone intact. During surgery, the posterior approach to the hip is used. The hip is dislocated from the joint and the head of the femur is reshaped, removing the cartilage and a layer of bone. The socket is prepared to remove arthritis. A metal shell is impacted into the socket. A metal cap is then fit onto the top of the femur. The hip is then put back in place and the cut muscles are repaired. 

Some patients opt for the hip resurfacing procedure to preserve bone for future procedures if needed, though this is otherwise not any less invasive an approach than hip replacement. 

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 and group support, 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 your hip replacement surgery, we will set you up on our Guided Care Path, 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 start you walking, then it’s group therapy twice a day, as well as individual walking goals. All of our hip replacement and knee replacement patients have therapy together, which helps to 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 Surgeons: 
Matthew Hebert, MD
Diana Kruse, MD
Michael Lamson, MD
David Marcu, MD
Arnold Rosenthal, MD

References:

https://orthoinfo.aaos.org/en/diseases--conditions/arthritis-of-the-foot-and-ankle/
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CONTACT US FOR ORTHOPEDICS

Orthopedics Nurse Navigator: 608-643-7689

>>Request Information