By Meelan Patel, M.D.
Did you know, that according to federal health statistics, more than 300,000 total hip replacement surgeries are performed each year in the United States?
Moreover, hip replacements are becoming more common in middle-aged Americans in part due to advances that have extended the lifespan of artificial joints.
Whether you’re 45 or 85, if you suffer from pain due to an injury or a condition such as arthritis, total hip replacement surgery can provide a safe and effective remedy.
At Princeton Medical Center’s Jim Craigie Center for Joint Replacement, board-certified orthopaedic surgeons offer access to a full range of hip replacement options that help patients get back on their feet faster.
When Conservative Measures No Longer Bring Relief
Your hip is a joint made of two basic parts – the ball and the socket – that move and work together to ensure smooth motion and function.
When conditions such as arthritis affect the joint, the cartilage that cushions the hip wears away or is destroyed, leading to pain and stiffness that gets worse over time.
Typically, arthritis pain is first treated with medications and physical therapy, but when conservative measures no longer bring relief, a total hip replacement may be recommended.
During total hip replacement surgery, the surgeon replaces the upper part of your femur (the long bone in your thigh) with a metallic ball that will glide normally in your hip socket. As part of the surgery, the hip socket is typically lined with metal and plastic.
The surgeon may decide to attach your new joint with or without bone cement. If the surgeon decides not to use bone cement, a special implant will be used that allows your bone to grow into the joint Posterior or Anterior Approach Surgeons can access your hip joint during total hip replacement surgery using a posterior approach or an anterior approach. With modern techniques, both approaches can be performed in a minimally invasive fashion.
The posterior approach involves a single incision through the back of the hip while you’re on your side. The muscles are split or detached from the hip, allowing the hip to be dislocated and fully viewed by the surgical team. The muscles are carefully repaired as part of the closure.
The anterior approach is a technique that can be performed with either one or two small incisions through the front of the groin while you’re on your back. With this approach the muscles are moved out of the way, and fewer – if any – of the muscles around the hip are cut or detached.
Both approaches have advantages and disadvantages that should be discussed with your surgeon.
As the American Academy of Orthopaedic Surgeons (AAOS) notes, the goal of using the anterior approach is to reduce pain and speed recovery.
However, the AAOS also notes that the anterior approach is not suitable for all patients. In general, according to the AAOS, candidates for the anterior approach are thinner, younger, healthier, and more motivated to participate in the rehabilitation process, compared to patients who undergo surgery via the posterior approach.
The anterior approach is less suitable for patients who are overweight or who have already undergone other hip surgeries. Patients who have a significant deformity of the hip joint, are very muscular, or have health problems that may slow wound healing, may be at higher risk for total hip replacement using the anterior approach.
Additionally, current research suggests that while the anterior approach may be slightly less traumatic than the posterior approach, there is little statistical difference in long-term outcomes. Overall, patients who have undergone total hip replacement using either approach recover extremely well and are typically able to return to their normal activities.
Regardless of the approach, procedures should be performed by well-trained, highly experienced orthopaedic surgeons, according to the AAOS.
The Results
The AAOS also reports that advances in techniques and technology, as well as improvements in implants have made hip replacement surgery one of the most successful operations in medicine today.
Long-term studies show that 85 to 90 percent of artificial joints are intact and functional for between 20 and 25 years, and newer materials will likely extend the lifespan of the artificial joint even longer.
In addition, the joint will last longer if you maintain your ideal weight and avoid high-impact activities.
Comprehensive Joint Program
The Jim Craigie Center for Joint Replacement offers the latest minimally invasive procedures, research-based protocols and a thorough program of pre- and post-operative care for patients receiving total hip replacements.
Patients receive care from experienced, board certified orthopaedic surgeons and anesthesiologists, along with specially trained staff, including nurse anesthetists, hospitalists, orthopaedic-certified nurses, physical and occupational therapists, and specialized technicians.
Patients benefit from a comprehensive joint program that offers:
- A multimodal pain management approach that reduces the use of narcotics and improves outcomes.
- Pre-operative education to prepare patients for surgery and recovery.
- A dedicated nurse navigator who coordinates care.
- A wellness model that emphasizes an early return to activity. Patients are encouraged to sit up and walk on the day of their surgery.
- An on-site gym where patients participate in group physical therapy the day after their procedure.
- A hotel-like environment with private patient rooms.
Also, for appropriate candidates, the Jim Craigie Center offers outpatient hip replacement surgery and computer-navigated or robot-assisted hip replacement surgery.
Penn Medicine Princeton Health is one of only four New Jersey healthcare organizations to earn advanced certification in total hip and total knee replacement from the Joint Commission, the nation’s oldest healthcare accrediting body.
In addition, Princeton Medical Center is rated high performing in hip and knee replacement procedures by U.S. News & World Report.
To find a physician with Penn Medicine Princeton Health, call 888-742-7496 or visit princetonhcs.org.
Meelan Patel, M.D. is board certified in orthopaedic surgery. He is the Director of
Orthopaedic Trauma and Director of the Hip Fracture Program at Penn Medicine
Princeton Medical Center.
