The most common reason to have a hip joint replacement surgery is to provide relief for severe arthritis pain. The surgery is usually done in people age 60 and older. Other reasons for replacing the hip joint are fractures in the thigh bone or hip joint tumors.
Even when a hip replacement is needed, some medical problems may lead your doctor to recommend alternatives. Some of these problems include morbid obesity, very weak quadriceps, severe mental illness and unhealthy skin around the hip.
Hip replacement surgery results are usually excellent (97 percent success). Most or all of your pain and stiffness should go away after surgery. However, some people may have problems with infection or loosening or even dislocation of the new hip joint. Over time the artificial hip joint will loosen and a second replacement may be needed.
Not having surgery is always an alternative and there are effective treatments for hip replacement surgery that may help patients avoid the need for a total hip replacement. Non-surgical alternatives are physical therapy, walking aids, anti-inflammatory medications, cortisone injections, joint supplements and viscosupplementation. Viscosupplementation is the injection of an artificial lubricant into the joint.
Other surgical alternatives to hip replacement surgery include hip resurfacing, arthrodesis, osteotomy and arthroplasty.
Hip resurfacing surgery is an alternative to standard hip replacements for patients with severe arthritis. During the hip resurfacing procedure, only a small amount of bone is removed from the ball-and-socket hip joint and a metal cap is placed on top of the ball. A metal socket is placed in the pelvis, similar to the hip replacement procedure. This hip resurfacing preserves much more normal bone than a standard hip replacement. Hip resurfacing is gaining interest especially in younger patients.
Arthrodesis, also known as hip fusion, is a seldom performed procedure now that hip replacement has become so successful. Hip fusion surgery eliminates all motion at the hip joint by having the bones of the femur and pelvis heal together. They are held in this position by a large metal plate and screws. Hip fusions are usually done in young patients who are heavy laborers. The hip fusion does not wear out like hip replacements would in these patients. The hip fusion allows the patient to perform physically demanding tasks that could lead to early wear on a total hip replacement. The problem with hip fusion is that patients will have no motion of the hip; they will walk with a limp, and may eventually need further surgery to convert to a hip replacement.
A hip osteotomy is a procedure that is done to realign the bones of the hip joint. The osteotomy can be performed on the thigh bone, the pelvis or both. Osteotomies are usually performed on patients with an underlying problem that has led to early arthritis of the hip joint. For example, developmental conditions such as hip dysplasia can lead to early hip arthritis. Hip dysplasia occurs in infants and leads to misaligned bones around the hip. The osteotomy helps to realign the bones and relieve the symptoms of early arthritis.
Arthroplasty is a procedure where the bone around the hip joint is removed and the joint space is allowed to fill with scar tissue. This procedure is usually done in patients with severe infection that cannot be controlled or in patients whose physical condition is such that they have little chance of normal walking. Patients who undergo arthroplasty will likely need some assistive device for walking.
Sources:
http://www.niams.nih.gov
http://www.ehealthmd.com
http://en.wikipedia.org
http://orthopedics.about.com
MC Ortega is the former publicist for the late Walter Payton, Coca-Cola and Dunkin’ Donuts. Ortega is a senior communications and messaging executive specializing in media relations, social media, program development and crisis communications. Also, Ortega is an avid traveler and international shopper. Ortega resides with her partner, Craig, dog, Fionne and extensive shoe collection. Ortega also enjoys jewelry design/production and flamenco dancing.