Hip Pain and Injuries
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Your hip is a ball-and-socket joint designed to withstand a large amount of weight, wear and tear. However, damage and overuse from activity can lead to a range of injuries, including muscle strain, cartilage deterioration or hip bone fracture. Age can play a factor here, too, as wear and tear might manifest over time, and some hip joint conditions may be caused by arthritis.
Hip pain from arthritis
Starting as early as age 50, people may develop osteoarthritis, which can cause painful movement, swelling and stiffness. This occurs as the smooth surfaces of the cartilage that line the bones of the shoulder joint are worn away. Osteoarthritis may be related to sports or work injuries, as well as chronic wear and tear. Treatment for arthritis depends on the severity of your pain. The usual treatments are rest, medications to help with inflammation and cortisone injections. In some cases, a replacement of the hip joint is needed.
Hip arthroscopy
If you're experiencing snapping, rubbing, inflammation or swelling in the hip, an arthroscopy could be performed, giving our orthopedic doctors a clear view of the inside of the hip to help them diagnose and treat your injury. During the procedure, your physician may repair or remove any damaged areas, helping to relieve your joint pain. Arthroscopy is a common outpatient surgical procedure.
Hip replacement
If you're in need of more serious relief, a hip replacement surgery may be performed to replace a worn or damaged ball and socket of the hip joint. With an anterior hip procedure (versus the traditional hip replacement procedure), hip muscles are spared – the surgeon uses smaller, specialized instruments to spread muscles and access the hip joint. This approach makes surgery less traumatic to the patient and reduces the time it normally takes for healing. To better understand the process and recovery expectations of surgery, review our most frequently asked questions about hip surgery.
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In the hip joint there is a layer of smooth cartilage on the ball of the upper end of the thigh bone (femur) and another layer within your hip socket. This cartilage serves as a cushion and allows for smooth motion of the hip. Arthritis is a wearing away of this cartilage. Eventually it wears down to bone. Rubbing of bone against bone causes discomfort, swelling and stiffness.
A total hip replacement is an operation that removes the arthritic ball of the upper thigh bone (femur) as well as damaged cartilage from the hip socket. Your surgeon will discuss what joint implant options are available and how he will choose the best one for you.
90-95 percent of patients achieve good to excellent results with relief of discomfort and significantly increased activity and mobility.
Your orthopedic surgeon will decide if you are a candidate for the surgery. This will be based on your history, exam and x-rays. Your orthopedic surgeon will ask you to decide if your discomfort, stiffness and disability justify undergoing surgery. There is no harm in waiting if conservative, non-operative methods are controlling your discomfort.
Age is not a problem if you are in reasonable health and have the desire to continue living a productive, active life. You may be asked to see your personal physician for his/her opinion about your general health and readiness for surgery.
We expect most hips to last more than 10-20 years. However, there is no guarantee, and 10-20 percent may not last that long. A second replacement may be necessary.
The most common reason for failure is loosening of the artificial ball where it is secured in the femur, or loosening of the socket.
Most surgeries go well, without any complications. Infection and blood clots are two serious complications that concern us the most. To avoid these complications, we use antibiotics and blood thinners. We also take special precautions in the operating room to reduce risk of infections. The chances of this happening in your lifetime are one percent or less. Dislocation of the hip after surgery is a risk. Your surgeon and care team will discuss ways to reduce that risk.
You will have discomfort following the surgery, but we will keep you comfortable with appropriate medication. The care team will monitor your level of discomfort frequently and treat you as ordered by your surgeon. We will discuss what pain interventions have worked for you in the past, and work with your surgeon to develop an individualized pain management plan.
We reserve approximately three hours for surgery and recovery time. Some of this time is taken by the operating room staff to prepare for the surgery. Individual recovery times may vary.
You may have a general anesthetic, which will put you to sleep. Some patients prefer to have a spinal or epidural anesthetic, which numbs your legs only and does not require you to be asleep. The choice is between you, your surgeon and the anesthesiologist.
After your surgeon has scheduled your surgery, hospital staff from the Bone & Joint Center will contact you. They will guide you through the program and make arrangements for both pre-operative and post-operative care.
Your orthopedic surgeon will do the surgery. An assistant often helps during the surgery.
Yes. You should follow the exercises listed in your NoteBook as instructed during your preoperative total hip class. Exercises should begin as soon as possible.
Every effort is made to control blood loss during surgery. However, you may need blood replacement and there are many choices to consider. If you have concerns, speak with your surgeon.
The frequency of follow-up visits will depend on your surgeon and your progress. Many patients are seen at six weeks, twelve weeks, and then yearly.
Yes. You will be using a walker or crutches. After hip replacement surgery, you may need a raised toilet seat. You will also be taught to use assistive devices to help you with lower body dressing and bathing. You may also benefit from a bath seat or grab bars in the bathroom.
A therapist will discuss your needs and help you decide what equipment you may need. The care team is available to assist you in getting your equipment arrangements made.
Most patients are able to go home directly after discharge. Some may transfer to another facility. The care team will help you with this decision and make the necessary arrangements. You should check with your insurance company to see if you have benefits.
The first several days or weeks, depending on your progress, you may need someone to assist you with meal preparation, etc. If you need home therapy services after discharge, the care team will arrange for services to meet your needs. Family members or friends may need to be available to help you, initially.
Preparing ahead of time, before your surgery, can make your discharge to home easier. Having the laundry done, house cleaned, yard work completed, clean linens put on the bed, and frozen meals available may reduce the need for extra help.
Your surgeon will discuss these needs with you before you leave the Bone and Joint Center.
Several options are usually available to you. Initially, you may arrange to have someone stay with you, with visits from home health services if ordered by your surgeon. Or you may consider a short stay at another facility following your hospital stay. The social worker is available to assist you if you have concerns.
Getting “back to normal” will depend somewhat on your progress, but consult your surgeon for advice on your activity. The ability to drive, for instance, generally takes at least six weeks, but this will need to be discussed with your surgeon.
The time it takes, and whether you my return to work, and other activities, will be a decision between you and your surgeon. Much depends on your job, the activities you wish to resume, and your progress after surgery.
You will likely be encouraged to participate in low impact activities such as walking, dancing, golf, hiking, swimming, bowling and gardening.
High-impact activities, such as running, singles tennis and basketball are not recommended. Injury-prone sports such as downhill skiing are also dangerous for the new joint. Be sure to discuss any specific activities with your surgeon.
You will be instructed on hip dislocation precautions that need to be strictly followed, until your surgeon tells you to stop.
In many cases, patients with hip replacements think that the new joint feels completely natural. However, you should avoid extreme position, or high impact physical activity. Some patients have aching in the thigh on weight bearing for a few months after surgery.