Hip Replacement: From Limited to Liberated

Hip pain that seriously interferes with an active lifestyle drives almost a quarter of a million Americans each year to have hip replacement surgery.
 
 
Golfing with friends may be the first thing to go. Then the special vacations you used to love. Even chores around the house and working in thegarden may become uncomfortable. Pain from a damaged hip joint can take overyour life and, little by little, the quality of your days and the restfulness of your nights can fade away.

Hip pain that seriously interferes with an active lifestyle drives almost a quarter of a million Americans each year to have hip replacement surgery, or arthroplasty. A deteriorating quality of life caused by a painful hip joint, most often damaged by arthritis, is the main reason patients come into the office to discuss treatment options, says Charles Burrows, MD, a Doylestown Hospital orthopedic surgeon. And advanced age is often not a factor in these discussions. In Dr. Burrows' practice, the average age of patients electing to have hip replacement surgery is between 55 and 60.

As with many orthopedic conditions, doctors first recommend nonsurgical options to treat hip pain; weight loss, pain medication and physical therapy may help some patients maintain a level of activity that's acceptable to them without surgery. However, says Dr. Burrows, The range of treatment options for hip arthritis is significantly less than for arthritis of the knee, where we can give viscosupplementation injections  injections of a thick liquid into the joint that mimics normal joint fluid and helps cushion the knee joint. When we're talking about badly damaged or worn-out hip joints, on the other hand, the possibility of joint replacement surgery comes up fairly early in the discussion.

Patient involvement is key

Patient education and motivation are both important aspects of the decision to have surgery, since a great deal of patient involvement is critical for the best outcome. That involvement can even extend to pain management in the first few days following surgery, with appropriate patients having the option of using a patient-controlled analgesia (PCA) pump to self-administer pain medication through their IV lines to provide a level of comfort that's right for them. The entire care team at the hospital works to keep each patient well-informed, pain-free and totally involved in all care decisions, says Doylestown Hospital orthopedic surgeon J. Michael Whitaker,MD. With hip replacement surgery, patients play a very big role in their own recovery. The more they understand about the procedure and the rehab that follows, the better.

Rehab is an integral part of recovery

Rehab for hip replacement begins the morning after surgery. Physical therapists specially trained to work with joint replacement patients provide daily inpatient therapy that focuses on regaining mobility, strength, and range of motion. Occupational therapists help patients conquer activities of daily living, such as bathing and getting dressed. After four or five days the typical stay for hip replacement surgery  most patients continue their rehab as an outpatient or at home. For patients with limited help at home, further inpatient rehab at the Transitional Care Center at Pine Run Community or another skilled nursing facility can be very helpful, says Dr. Burrows. I encourage it for appropriate patients, because they have the benefit of additional inpatient physical therapy that enables them to be more self-sufficient when they return home and less dependent on friends and family members.

A long-lasting boost to quality of life

Most patients enjoy almost normal activity levels in approximately three months, and can expect their new hip to last for many years. In fact, according to Dr. Burrows, more than 75 percent of people who have had total hip replacement can expect their new joint to last 20 years or longer. As for quality of life? It's interesting, says Dr. Burrows. One of the first things patients usually ask me when we start discussing hip replacement surgery is how limited am I going to be if I have my hip replaced? But really, the typical patient is liberated following surgery and rehab, with an improved quality of life and a renewed freedom to do the things they enjoy doing. And that, after all, is what everybody really wants.

Dr. Charles Burrows is with Mackell/Cody/Burrows Orthopaedics.
Dr. J.Michael Whitaker is with Doylestown Orthopaedic Specialists