Hip replacement and treatment options

The hip is one of the largest joints in the body. It is a ball-and-socket joint that allows the leg to move in a variety of positions. It consists of several components:

• The femur is the thigh bone, or upper leg bone.
• The acetabulum is a socket or cup-like structure that holds the femoral head.
• The femoral head (ball) rides in the acetabulum (socket) and the joint is lined with cartilage.
• Cartilage acts as a cushion and a lubricant, reducing friction when the joint moves and bears weight.
• The synovial membrane lines the joint, lubricates it and seals it into a joint capsule.
• Ligaments and tendons are tough, connective tissues that surround the joint and provide stability, support and movement control.
• The bursa is a fluid-filled sac located between bones, ligaments and other structures. It helps cushion the joint.

The most common cause of hip pain and disability is arthritis. Osteoarthritis, rheumatoid arthritis and traumatic arthritis are the most common forms of the disease. Other common causes of hip pain include:

• Avascular necrosis. An injury to the hip, such as a dislocation or fracture, may limit the blood supply to the femoral head. This is called avascular necrosis. The lack of blood may cause the surface of the bone to collapse, and arthritis will result. Some diseases can also cause avascular necrosis.
• Childhood hip disease. Some infants and children have hip problems. Even though the problem are successfully treated during childhood, they may still cause arthritis later on in life. This happens because the hip may not grow normally, and the joint surfaces are affected.

Treatment options for hip pain include physical therapy, medication, nerve block injections or surgical repair. The decision to undergo hip surgery is a collaborative one between you, your family, your primary care physician and your orthopedic surgeon. At Parkview Ortho Hospital, subspecialized Ortho NorthEast (ONE) surgeons provide you the highest level of hip surgery expertise and skill.

Arthroscopic hip surgery

When you need surgery to treat ligament tears, tendon damage or other joint injuries in your hip, your orthopedic surgeon may recommend a minimally invasive arthroscopic procedure. During this procedure, your surgeon will make a few tiny incisions in the skin around your hip. He will then slip a pencil-thin surgical instrument through the incisions to perform your surgery.

An arthroscope (miniature video camera) transmits high-quality images of your joint onto a television screen that your surgical team monitors throughout your surgery. This helps ensure you get timely, appropriate care.

Because your surgical incisions are very small, you’ll likely notice less pain and scarring after your arthroscopic hip surgery. You’ll also likely return home the day of surgery, and recovery takes anywhere from a few weeks to several months, depending on your overall health.

Total hip replacement surgery

Total hip replacement can be an extremely successful surgical procedure. Total hip replacement, also called arthroplasty, involves removing the damaged bone and cartilage and resurfacing it with orthopedic implants. The goal of this surgery is to relieve pain that cannot be controlled by other treatments.

During total hip replacement surgery, your orthopedic surgeon will make a small incision – about 1.5 to 2 inches – in the skin over your hip joint. He will then remove the damaged parts of your hip, and replace them with the synthetic implants. The implants are made of a stem that goes into the femur, the ball that fits into the stem, and a cup that is inserted into the socket of the hip joint. Finally, your surgeon will close your incision and apply a sterile bandage or dressing.

Anterior hip replacement surgery

This technique allows your orthopedic surgeon to approach from the anterior (front) of the hip where the hip joint can be exposed under direct vision. 

The procedure is designed to reduce trauma to the tissue surrounding the hip joint. While recovery varies from patient to patient, this approach may result in:

• Accelerated recovery time
• Fewer restrictions during recovery, including the bending of the hip and weight bearing
• Reduced scarring
• Faster implant stability
• Reduced chance of dislocation
• Less postoperative pain
• Faster return to daily activities

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