People
with hip joint damage that causes pain and interferes with daily activities
despite treatment may be candidates for hip replacement surgery, according to the
National Institutes for Health. Osteoarthritis is the most common cause of this
type of damage. However, other conditions, such as rheumatoid arthritis (a
chronic inflammatory disease that causes joint pain, stiffness, and swelling),
osteonecrosis (or avascular necrosis, which is the death of bone caused by
insufficient blood supply), injury, fracture, and bone tumors also may lead to
breakdown of the hip joint and the need for hip replacement surgery. According to the Centers for Disease Control and Prevention
(CDC), 332,000 total hip replacements are performed in the United States each
year.
In the
past, doctors reserved hip replacement surgery primarily for people over 60
years of age. The thinking was that older people typically are less active and put
less stress on the artificial hip than do younger people. In more recent years,
however, doctors have found that hip replacement surgery can be very successful
in younger people as well. New technology has improved the artificial parts,
allowing them to withstand more stress and strain and last longer.
Today, a
person’s overall health and activity level are more important than age in
predicting a hip replacement’s success. Hip replacement may be problematic for
people with some health problems, regardless of their age. For example, people
who have chronic disorders such as Parkinson’s disease, or conditions that
result in severe muscle weakness, are more likely than people without chronic
diseases to damage or dislocate an artificial hip.
People who
are at high risk for infections or in poor health are less likely to recover
successfully. Therefore they may not be good candidates for this surgery.
Recent studies also suggest that people who elect to have surgery before
advanced joint deterioration occurs tend to recover more easily and have better
outcomes. More info can be found at this website: http://www.niams.nih.gov/Health_Info/Hip_Replacement/
.
According
to John Hopkins Medicine, as with any surgical procedure, complications can
occur. Some possible complications may include, but are not limited to, the
following:
·
Bleeding
·
Infection
·
Blood
clots in the legs or lungs
·
Dislocation
·
Need
for revision or additional hip surgery
·
Nerve
injury resulting in weakness or numbness
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure. A significant amount of information, including how to prepare for surgery, what happens during the surgery in the hospital, and recovery, can be found at this website: http://www.hopkinsmedicine.org/healthlibrary/test_procedures/orthopaedic/hip_replacement_surgery_procedure_92,P07674/ .
Some
surgeons, however, are performing another type of hip surgery, according to the
New York Times, called anterior hip replacement. The
surgeon makes the incision at the front of the hip instead of through the
buttocks or the side of the hip. This approach permits the doctor to reach the
hip socket without cutting through major muscle groups.
Surgeons who perform the procedure also say the anterior
position makes it easier for them to use fluoroscopy, a real-time X-ray technique
that allows doctors to precisely position the implanted artificial hip. That,
in turn, may allow artificial hips to last longer. And since the major muscle
groups of the hip are left untouched, there appears to be a lower risk that the
artificial joint might pop out, or dislocate. Conventional hip
replacement techniques have a dislocation rate of about 1 percent. Preliminary
studies suggest that the rate following anterior surgery may be less than
one-third of that, according to the NY Times.
Yet
reports of the benefits are mostly anecdotal, based on surgeons’ experience. No
large randomized studies have been done comparing the outcome of anterior
surgery with other approaches. And there are downsides. Anterior hip
replacement often takes longer to perform and can result in more blood loss. Some patients experience
temporary numbness in the thigh afterward.
Because
the operation is tricky to perform, there is a steep learning curve for
physicians, which partly explains why it hasn’t been taught as widely as other
approaches in medical schools. Special operating tables have been designed that
make the surgery easier to perform, but many medical centers don’t have them.
Even surgeons who perform the new procedure are quick to say that it isn’t
“minimally invasive,” the term often used in marketing materials. More info on
this procedure can be found at this site: http://well.blogs.nytimes.com/2013/03/18/faster-recovery-from-hip-surgery/?_php=true&_type=blogs&_r=0
.
According
to NPR, what
patients really need is knowledge. The Internet is great for providing
information, but it lacks a context in which to interpret that. How does a
patient sift through all the information and make an informed decision? And, patients should investigate hip
replacement information on a reputable website.
One key question to ask an orthopedic surgeon is about the number of times he or she performs this procedure in a year. Like most things in medicine, practice makes perfect. And being expert means performing a surgery at least 100 times a year. Once patients have found a doctor, they should talk the physician which technique is best, given the patient's history and preferences.
All
techniques have improved over the years, with fewer complications and faster
recovery times. Plus, all approaches to hip replacement have gotten less
invasive over time because of medical practitioners’ understanding of anatomy,
more sophisticated surgical tools and instruments that allow better access with
a smaller incision. All the surgical approaches are less invasive than they
were seven to 10 years ago. More info can be found at this site: http://www.npr.org/blogs/health/2013/07/15/200862227/new-anterior-approach-to-hip-replacement
.
Hip
replacement surgery should not be taken lightly. Consult your doctor and any
specialist recommended about your particular situation. You may or may not be a
good candidate. Only a medical professional can guide you to make that
decision. Do your research well. Once chosen, then remember to follow all the
advice given for both pre-op and post-op recovery.
Until
next time.
156 comments:
Hip pain is a common problem, and it can be confusing for you because there are many causes. It is important to make an accurate diagnosis of the cause of your symptoms so that appropriate treatment can be directed at the underlying problem. Prior to looking at hip pain in detail, I would like to point out that your hip pain may be coming from the hip itself, or from your lower back and pelvis. 50% of the cases I see of hip pain have a lower back component and 50% do not.hip replacement mexico
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Hip replacement surgery has been in practice for a considerable period of time. For sixty years hip joint surgery has been utilized to help people to walk again when injury or degradation of the body has occurred. Hundreds of thousands of individuals are mobile and taking care of themselves because of this ground breaking procedure. Now there is anterior approach hip joint replacement surgery that is a better way than the conventional hip joint surgeries that have been being conducted for so long.
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