Hip Reconstructive Surgery

Do you experience persisting and worsening pain your hips? Does your hip pain affect your mobility and quality of life?

A hip reconstructive surgery procedure may restore your mobility and alleviate pain. In fact, many hip reconstructive surgery patients report becoming free of the chronic pain they had been suffering from for many years.

If your condition is severe, your doctor may recommend a total hip replacement, or “hip arthroplasty.” This is normally recommended when arthritis has caused the cartilage in the hip to deteriorate to the point that pain is debilitating. In hip arthroplasty, the ball-and-socket joint of the hip is replaced with metal and plastic parts made of durable material meant to stand decades of use.

Hip arthroplasty is a major surgery. However, some hip conditions may be treated with less-invasive procedures, such as hip arthroscopy. Arthroscopic surgery refers to a surgical procedure performed with the aid of a camera attached to a tube. The camera is inserted into the hip through a small incision and the surgeon is able to view the hip on a screen. The benefits of arthroscopic surgery are smaller incisions and quicker healing times.

The goal of hip reconstructive surgery is to restore range of motion of the hip and to relieve pain, offering the patient increased mobility, independence and an improved quality of life.

Why is hip Reconstructive Surgery Performed?

The largest joint in the body, the hip daily undergoes the stress of supporting much of your weight, as well as providing mobility and stability. The main components of the hip are the acetabulum, which is a concave indentation in the pelvic bone, and the femoral head, which is a rounded piece of bone on a stem that extends from the top of the thigh bone (femur). The femoral head rotates inside the acetabulum to provide movement. Cartilage covers the surface of the acetabulum and femoral head, providing lubrication and absorbing shock. The joint is stabilized by several ligaments.

Over the course of your life, the cartilage in your body’s joints experiences some wear. Significant degeneration of cartilage results in a condition called osteoarthritis, which often causes pain. As the cartilage wears away, bone may rub against bone when the joint moves. Osteoarthritis becomes progressively worse as an individual ages. Because of this, osteoarthritis is most commonly found in the elderly; however, it’s becoming more common in younger people. Obesity creates a higher risk of developing osteoarthritis because the excess weight causes extra strain on the body’s joints.

Osteoarthritis is the main reason that individuals receive total hip replacements. However, hip fractures may also require this surgery. The stem that connects the femoral head to the femur may fracture during a fall or other accident. Individuals with osteoporosis, or weakening of the bones, have an elevated risk of hip fractures.

Other conditions that may require hip surgery include:

• Rheumatoid arthritis and other types of arthritis
• Hip dysplasia, a misalignment of the hip joint that can be present at birth or acquired later in life
• Avascular necrosis, or death of bone cells due to loss of blood supply
• Impingement, which is when the femoral head cannot move freely in the acetabulum
• Failure of a hip replacement, requiring a revision surgery

Some hip problems can be treated with surgery that does not involve replacing the joint.

Hip Reconstructive Surgery Procedure

Hip replacement or “hip arthroplasty” is a generally successful procedure that provides relief from pain by replacing the hip joint with artificial parts, or prostheses. Hip arthroplasty is a major surgery, typically requiring general anesthesia. It is performed by an orthopedic surgeon in a hospital or surgical center. Although you will be encouraged to walk on your new hip right after surgery, recovery may take six weeks and involves physical therapy to restore range of motion.

The prostheses used to replace the hip consist of a cup-like component that will replace the acetabulum and a metal stem with a rounded end or ball to replace the femoral head. Your surgeon will first remove the femoral head from the acetabulum. Next, he or she will remove any remaining cartilage from the acetabulum before cutting and reshaping the acetabulum. The acetabulur component will be fixed into the reshaped socket using cement, screws or other fastening techniques.

To prepare the femur, the surgeon will remove the femoral head and stem and cut a cavity into the bone to fit the metal femoral component. Once this metal piece is fastened into the bone, your surgeon will place the prosthetic femoral head into the acetabular component, test the joint’s movement and evaluate the joint’s alignment and positioning.

The incisions made by the surgeon vary depending on the technique the physician uses. Discuss with your doctor what technique he or she will use, how many incisions will be needed, and the size of the incisions.

Although most hip replacements involve a metal-on-plastic design, some techniques use other designs, such as ceramic-on-ceramic. All of the materials used in a hip replacement surgery are highly durable and made to last for decades. Research and innovations in hip replacement surgery center around finding more durable materials and combinations so the new hip will last longer.

Other Hip Reconstructive Procedures

Once conservative treatments fail to provide adequate relief for your problems, your doctor may recommend a surgical treatment. Some hip problems can be treated without full joint replacement.

You should always seek conservative treatments, such as physical therapy and medication, before considering surgical intervention. Your doctor will work with you to create a treatment plan.

Following is a description of a few surgical treatments that do not require full joint replacement.

Hip arthroscopy is a surgical procedure aided by the use of a long tubular device that is inserted into the hip and projects an image on a screen. This helps the physician to perform surgery without needing to make large incisions. For example, arthroscopy can be used to cut away torn flaps of tissue that cause problems in the hip. Arthroscopy is a minimally-invasive outpatient procedure that leaves only minimal scarring.

Hip resurfacing involves replacing only parts of the hip rather than the whole joint. A prosthetic acetabular socket is fixed to the pelvis, and a metal cap is placed over the femoral head. Because the femoral head is preserved, this replacement can later be revised into a total hip replacement if needed. Some believe this procedure may allow for more natural movement than a total hip replacement.

A hip osteotomy is a procedure in which a surgeon cuts and reshapes a bone and repositions the joint to allow for better alignment and function. This procedure is often used to treat younger patients who are not usually considered for total hip replacement due to their more active lifestyles. A hip replacement may last 20 years; for younger patients, this is not an acceptable amount of time, so hip replacement is usually put off as long as possible.

Your doctor can discuss other treatment options with you and will be able to explain which options are best for your diagnosis.

Find a Hip Reconstructive Surgery Doctor

Finding the right surgeon can make all the difference in your hip reconstructive surgery experience. We work hard to connect you with the best doctors in your area. Our physicians are skilled and qualified in cutting-edge reconstructive surgery techniques. They perform surgery in accredited medical facilities, keep abreast of the latest developments in their field, complete continuing education in reconstructive surgery and follow the highest standards in patient care and safety.

Click on “Surgeon Locator” to search our physician directory for a surgeon in your region. You can read about physicians’ credentials, visit their websites, learn about the reconstructive surgery procedures they perform and see pictures of their offices and patients.

The first step toward your hip reconstructive surgery is setting up a consultation with a surgeon. During your consultation, your doctor will gather information about your medical history and ask you questions about your goals in pursuing reconstructive surgery. He or she will determine whether or not you are a candidate for surgery and which procedure will work best for your situation and produce the best results. The only way to know for certain if you are a candidate for reconstructive surgery is to meet with a qualified surgeon.

The goal of reconstructive surgery is to improve your ability to accomplish everyday tasks, your sense of well-being and your life. We encourage you to take this important step by searching for a local doctor today.

History of Hip Reconstructive Surgery

Hip replacement surgeries have been performed since the early 1900s, when ivory was sometimes used for the femoral head. Early procedures were risky and mainly focused on relieving pain. Improving mobility of the joint was beyond the current technologies.

The modern process of hip replacement was pioneered by British surgeon Sir John Charnley, whose breakthrough came in the early 1960s. His method, called low-friction arthroplasty, allowed the patient to achieve mobility in the joint while relieving pain. However, the early prostheses had problems with durability and stability.

Advances in technology and technique have produced artificial joints that are much more stable and durable than Charnley’s. Improvements have led to hip replacements that show a very high success rate even up to 20 years.

Modern hip replacement techniques have built on the foundation of Charnley’s work to provide patients with an unprecedented opportunity to lead full, active lives without hip pain. Further research and development are geared toward continually increasing the number of years artificial hips last so that younger patients may receive more benefit.

Am I a Good Candidate for Hip Reconstructive Surgery?

Whether you are a candidate for hip reconstructive surgery depends on the nature and severity of your hip problems. Typically, hip problems are treated with conservative options first, such as physical therapy or medication. However, if you have persisting debilitating pain or a severe reduction in the range of motion of your hip, you may be a candidate for hip reconstructive surgery.

Only your doctor can determine for sure whether or not you are a candidate for hip reconstructive surgery. If you experience pain or loss of motion in your hip, you should see a doctor to ensure you are receiving the treatment you need.

Some hip problems can be treated with minimally-invasive procedures, such as hip arthroscopy. However, your doctor may determine that you need a total hip replacement (hip arthroplasty).

To determine the extent of damage to your hip, your doctor will perform a physical examination and talk to you about your symptoms. He or she may order x-rays or an MRI to determine whether damage has occurred in the bones, cartilage and ligaments.

Hip Reconstructive Surgery Risks

As with any surgical procedure, hip reconstructive surgery is not without risk and should be taken seriously. Risks that come with any major surgery include:

• Risks of anesthesia, including allergic reactions
• Bleeding
• Infection
• Need of a blood transfusion
• Damage to nerves

Risks of hip reconstructive surgery include:

• Breaking or dislocating of the prostheses
• Misalignment due to the surgeon’s placement of the prostheses
• Problems stemming from debris of the metal parts or bone cement

Although hip replacement surgery is generally successful and relieves hip pain, a small minority of patients have chronic pain even after a hip replacement.

Before Hip Reconstructive Surgery

Hip replacement is major surgery, so your doctor will do thorough pre-surgery testing and will bank blood in case you need a transfusion. X-rays of your hip will be taken.

Before your procedure, you should discuss with your doctor any drugs you take, including non-prescription drugs and supplements. It’s important that you are honest and upfront about your drug use, smoking habits and use of alcohol, as these substances may affect your recovery.

Your doctor will give you specific instructions regarding which medications you should stop temporarily and which you may continue taking. If you take maintenance drugs for a medical condition, such as heart disease or diabetes, you should discuss these medications and your upcoming surgery with the doctor who treats these conditions.

Your doctor will direct you to refrain from eating for a specified number of hours before your surgery and will give you further instructions to follow to prepare for your hip reconstructive surgery. It’s normal to be nervous before surgery. You must follow your doctor’s instructions carefully and be sure to ask him or her any questions you may have.

Some procedures, such as hip arthroscopy are minimally-invasive outpatient procedures that may not require such an extensive preparation. Your doctor will give you pre-surgery instructions to follow and will let you know what to expect.

After Hip Reconstructive Surgery

After your surgery, you will need to remain in the hospital for a few days or weeks. Your doctor may encourage you to get up and walk right away after surgery to reduce the risk of stiffness and muscle atrophy. It may be necessary to walk with the aid of crutches for a while.

Your doctor will dress your wounds and give you instructions for how to care for them until the incisions heal. Your doctor may prescribe medications to relieve pain. You can also discuss with your doctor which over-the-counter medications may help you manage your pain. Some post-surgery pain and discomfort is unavoidable, and your doctor can explain how much pain is normal and to be expected.

Full recovery will take several months and will involve physical therapy. It’s important to follow your physical therapist’s instructions carefully to ensure proper strength and mobility of your new hip.

Hip Reconstructive Surgery Results

Hip replacement surgery is highly successful and considered to be very safe. Most patients report a relief of pre-surgery pain and improvement in the range of motion of the joint. Most patients are able to perform normal daily activities without pain and lead full, active lives. Research suggests that hip replacements can last up to 20 years. At that point, a revision surgery may be necessary.