Health Break | Published February 14, 2011

Are You A Candidate for Total Hip Replacement?

With winter in full force, many people may have spent the last few months experiencing joint pains and stiffness that limited their ability to perform normal activities. If pain in the hips reaches a point of impeding daily activities, it may be worth talking to your doctor about whether a total hip replacement is an appropriate treatment.Pain associated with a diseased hip is usually felt as groin or thigh pain, whereas buttock pain is usually due to referred pain from a diseased lower back. In some cases, if the joint is sufficiently damaged, the physician may recommend surgery to replace the hip with an artificial joint.Hip replacement is a fairly significant operation, however, so before surgery is considered, patients may try other remedies to control their pain. These could include medicines such as aspirin, ibuprofen, and acetaminophen. For some people, losing weight or doing low-impact exercise may be a way to decrease the pain associated with an arthritic hip joint.Hip replacement is considered an elective surgery, and most hip replacement patients choose to have the surgery because of pain. If the joint does not hurt, physicians should be cautious about recommending surgery. As a result of the operation, the patient may gain mobility and improved function, but the real reason for the surgery is to relieve pain.Most hip joint disease occurs naturally as a result of osteoarthritis, a degenerative condition that often accompanies aging. With this condition, the joint cartilage wears down, exposing the underlying bone ends, which begin to rub together. The symptoms are pain, soreness, and stiffness that make weight-bearing activities uncomfortable. Less commonly, hip degeneration may be a result of trauma, such as a car accident or athletic injury.The technology of hip replacement has improved greatly in the last 15 years, with new joint materials on the market and new procedures to implant them. The hip joint is a “ball and socket” joint with the ball portion on the upper end of the femur (the long bone of the leg), fitting into the cup or socket in the pelvis bone. During hip replacement surgery, the “cup” of the joint in the pelvis is replaced with an artificial socket. The “ball” of the femur is replaced with a metal or ceramic ball attached to the femur with a metal stem inserted into the shaft of the bone. Although surgical techniques and the manufacturing of joints have both improved, physicians are still hesitant to perform this surgery on patients under the age of 50. Even with the durability of current implants, there is a concern about how long the implants might last before wearing out in a younger person.Because hip replacement is a major surgery, physicians look at not only the age of the patient, but at general health as well. Some conditions, such as heart problems, severe lung disease, or a previous hip infection could be a concern and prevent the surgery.Hip replacement surgery is not done to save a life, but to improve one’s quality of life. After recovery from surgery, patients can expect to return to a very active life, although most doctors do recommend exercise be limited to low-impact activities.James S. Martin, M.D. is an orthopedic surgeon with Martin & Suhey Orthopedics, State College, Pa. He is a member of the medical staff at Mount Nittany Medical Center. For more info go to www.mountnittany.org.

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