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Total Hip Replacement Information


Hip pain and hip replacement options

If you’re currently suffering from hip pain brought on by arthritis or other causes, treatment options are available to help you get back to living an active lifestyle. Below, you’ll find general information on hip pain and the options available to help you get back on your feet.

Hip arthritis & total hip replacement

The first step when making the decision about hip replacement is to meet with your surgeon to see if you are a candidate for total hip arthroplasty (THA). Your surgeon will take your medical history, perform a physical examination, and X-ray your hip. Even if the pain is significant, and the X-rays show advanced arthritis of the joint, the first line of treatment is nearly always non-operative. This includes weight loss if appropriate, an exercise regimen, medication, injections, or bracing. If the symptoms persist despite these measures, and with corroborating X-rays, then you may consider THA.

The decision to move forward with surgery is not always straightforward and usually involves a thoughtful conversation with yourself, your loved ones, and ultimately your surgeon. The final decision rests with you based on the pain and disability from arthritis influencing your quality of life and daily activities. Those who decide to proceed with surgery commonly report that their symptoms keep them from participating in activities that are important to them like walking, taking stairs, working, sleeping, putting on socks and shoes, sitting for long periods of time, etc., and that non-operative treatments have failed. For the right patient, THA is one of the most successful operations that orthopedic surgeons can perform for pain relief and improvements in quality of life.

Minimally invasive muscle sparing anterior hip replacement

The minimally invasive muscle sparing direct anterior approach (DAA) to the hip was initially described in the 19th century and has been used sporadically for total hip arthroplasty/ replacement (THA). In the past decade, enthusiasm for the approach has been reintroduced because of increased demand for minimally invasive techniques. New surgical instruments and tables designed specifically for use with the DAA for THA have made the approach more accessible to hip arthritis patients in need of total hip replacement. The goal of this approach is to hopefully perform surgery that results in less muscle damage and pain as well as rapid recovery.

Traditionally, elective total hip arthroplasty (THA) has been done with one of two approaches, direct lateral or posterior. Several years ago, in conjunction with increased demand from the public for minimally invasive surgery, other approaches began to receive more attention and be used more frequently for performing these common procedures. Some of these approaches have had very high complication rates and fortunately only limited use. The direct anterior approach (DAA) to the hip appears to have sustained its popularity. The approach is unique in that it takes advantage of a natural interval between two muscles. There are no muscles which are removed from the bones, and the operation is performed between these muscles in order to implant the total hip components. This is important because there may be less muscle damage and pain as well as rapid recovery after hip arthroplasty. Most US surgeons’ familiarity with the approach is limited, but these possible improved outcomes have generated powerful interest in the DAA.

Additional benefits to this approach include the opportunity to avoid what is known as hip precautions following the total hip replacement. Hip precautions are activity restrictions as well as positioning limitations which traditional total hip replacement patients must follow for the remainder of their life with the hip replacement to avoid dislocation of the hip. Anterior hip replacement patients are not required to follow such precautions and the risk of dislocation with this approach is one of the lowest reported in the medical literature.

If you have additional questions about hip pain or would like more information about treatment options please contact our office at 972-403-2843.