A patient has consistent pain in his hip joint, which has made it difficult for him to walk. The patient, now in his 60s, played sports as a young man and has been aware of the deteriorating cartilage in his hip for some time. Recently, though, the problem has become so severe that he has sought medical advice for how to handle the pain. Is it time for a hip replacement?
Osteoarthritis, a degenerative condition of the cartilage that lubricates a joint, can be a very painful condition. It’s characterized by pain and stiffness in the joint and it can attack the hips, knees, hands, ankles, feet, shoulders – and the list goes on. Fairly common among older Americans, osteoarthritis often develops over a long period of time, eventually leading to pain and immobility so severe that a joint replacement seems like the only sensible option.
Osteoarthritis of the hip affects one in four Americans, with an equal rate for men and women, whites and African-Americans. Also, it varies little based on education levels. Though obesity is often tied to osteoarthritis, the CDC reports that the lifetime risk of osteoarthritis of the hip is equal for people of all body mass indexes.
Ultimately, the decision to have a hip replacement is based on a person’s pain tolerance (or intolerance) and the lack of mobility they experience. Rarely can a doctor definitively say that, based on an X-ray, someone needs a replacement without that person reporting significant pain and immobility. Usually a person’s life has been so compromised by their inability to walk or their resistance to pain medication that they believe a hip replacement is the only way they can regain a semblance of the life they knew.
To determine if the procedure is appropriate and safe, a doctor will first perform a battery of tests, including X-rays, physical exam, CT scan, biopsy or bone scan.
The surgery has evolved significantly over the last several decades. A hip replacement used to take several hours, require considerable time in the hospital and come with a lengthy, painful recovery. Today, robotics and new surgical methods preserve as much bone as possible and involve cutting through fewer muscles as part of the process to replace the joint. Now, hospital stays are much shorter and patients are usually back on their feet in a matter of weeks.
That said, caution should be taken as a person starts developing mobility on a new hip. Regaining the ability to walk is an incremental process – first using a walker, then a cane, then moving slowly, but without assistance, to walk freely again. The timetable for being able to drive, use stairs and return to work varies from person to person, but the surgeon should be able to provide a realistic timeline.
Source:Burnett, Stephen. (11 July 2005). Hip Replacement. HealthCentral.com. Retrieved from http://www.healthcentral.com/encyclopedia/408/283.html.