Hip to It

Cast away any preconceived notions that hip replacements are only for the elderly. While you’re at it, throw aside the idea that the procedure’s path to recovery is a long, drawn out affair. As a matter of fact, a larger percentage of people in the 40s and 50s are having the procedure done as outpatient surgeries. They literally walk away from the hospital under their own power within days or even hours of having the procedure done.

The difference between what you’ve probably heard or imagined about hip replacement surgery and what is actually happening today is all based on where the incision is made. In the past, incisions have been made from the back or the side, which involved the cutting of muscles—and the potential to damage nerves in the process—to access and replace the hip joint and socket lining.

In most surgeries done today, the incision is made from the front—a procedure called direct anterior hip replacement. By going in from this direction, doctors can make a small incision no more than 10 centimeters long (about four inches) and simply push the muscles and soft tissue housing the nerves aside to access the hip.

“When you go in through the front, it’s a short access to the hip,” says Dr. Boyd Haynes III, a surgeon with Orthopaedic & Spine Center in Newport News. “You can get to the hip more quickly, so there’s less disturbance of the muscles. You don’t cut any of the muscles at all—you just separate them, do the hip replacement, and the muscles come back together almost like a curtain closing.”

Another benefit of the direct anterior approach is you have fewer problems with dislocation of the hip. “Since we’re not cutting any muscles, the procedure is much more natural,” Dr. Haynes says. “So the chance of the hip coming out of the socket is almost non-existent, and the return to recovery comes at a much quicker pace.”

According to Dr. Wilford K. Gibson, a surgeon with Atlantic Orthopaedic Specialists in Norfolk, the hallmark for hip pain begins with groin pain in the front. “Hip pain that requires surgery is most commonly from osteoarthritis—or wear and tear arthritis—but there are other causes as well such as inflammatory-type arthritis like rheumatoid arthritis or vascular necrosis, which is the death of the bone,” Dr. Gibson says.

Only a small percentage of the patients that Dr. Gibson sees for pain are candidates for hip replacement surgery. “I can do a thorough evaluation and usually figure out where the pain is coming from through examination and X-rays,” he says.

In addition to the direct anterior approach making hip replacement surgery a better option for patients, advances in materials are insuring those new hips have a longer wear life, so younger patients won’t have to worry about future replacements for a long time, if ever.

So now that you have the facts, there is no reason to live with pain. If you have soreness that is increasing over time, have a hard time getting out of a chair or exiting a vehicle, and can’t sleep at night because of it, see your doctor and get your life back.

Read this article in full in the November/December 2015 issue of Coastal Virginia Magazine.

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