We offer both non-operative and operative treatment options for the hip.
There is a wide array of medications that are available to aid in pain management. After surgery, there are several medications prescribed to help in recovery. We will discuss oral medications during our visits in the office.
There are several different kinds of injections that help reduce pain in the hip. Their functions range from anti-inflammatory to providing a smoother surface for the joint to move along. Due to the variety of different injections available, your orthopedic specialist will evaluate your hip and your pain to determine which would be the best fit for you. Injections such as platelet rich plasma (PRP) and stem cells show great potential to help with hip pain, but studies are still not showing predictable results. We do currently offer PRP injections and this option can discuss further in the office.
Physical therapy offers different exercises that increase your range of motion and strengthen the muscles around your hip. This will help stabilize your hip and help improve your mobility which can reduce your pain. If you have a total hip replacement, physical therapy will be incorporated into your treatment plan after surgery. Physical therapy is essential for a good outcome after total hip replacement.
If medications, changes in your everyday activities, and the use of walking supports do not adequately help your symptoms, you may consider hip replacement surgery. Hip replacement surgery is a safe and effective procedure that can relieve your pain, increase motion, and help you get back to enjoying normal, everyday activities.
For this procedure, the surgeon will cut and dissect down to the hip joint and dislocate the femur from its place in the pelvis. Once the joint is exposed, the damaged cartilage in the socket is removed and a new metal socket is inserted followed by a plastic liner to allow the new joint to glide smoothly. Next, the damaged head of the femur is removed, and a stem is inserted into the femur. A ball is then placed on the top of the stem to recreate the former femoral head. The joint is then relocated, and the incision is closed. This operation can be done as an outpatient surgery where you are able to sleep in your own bed after getting your total hip that day.
There are two main approaches to hip replacement surgery: from the frontside (anterior) or the backside (posterior) of the hip joint. Traditionally, most hip replacement surgeries are done from the backside approach, but the anterior approach is gaining popularity in the field for a variety of reasons. In both techniques, the procedure is very similar. The posterior or backside approach requires important muscles and tissue to be cut through or disturbed. The anterior approach has provided a way to avoid this problem as the muscles and tissues in the front of the hip can be spread or moved to the side to expose the hip. This typically results in a faster recovery since there is less healing that needs to occur. The anterior approach may also reduce scarring due to a smaller incision, result in fewer restrictions during recovery, and allow stability of the implants to occur sooner.
As with any other mechanical device, a total hip replacement can be subject to various forms of mechanical or biological failure. Some of these conditions may require a re-operation of the hip replacement to address the cause of failure and its consequences. A re-operation of a total hip replacement is called a “revision.” Pre-operative investigations in patients who will undergo revision surgery are more extensive than for a primary surgery. Often, special radiographic (x-ray) projections, CT scan, bone scan or MRI of the hip may be necessary to determine position and fixation of the replacement parts (components), and to determine with precision the extent of bone loss around the failed implant. A preoperative aspiration (fluid sample) and/or special blood work may be needed if the surgeon suspects an infection in the failed hip. The most frequent reasons for revision are:
Depending on why you need a revision, the treatment will vary slightly. During the surgery, the old implants are removed, and the joint is cleaned. If necessary, at this point, the surgeon will perform a bone graft to replace any bone loss. The surgeon will then size and fit the new implants to the joint and secure them in place. Finally, he will close and stitch up the wound. This is a longer surgery that can take a few hours.