One sign that we are indeed living longer and healthier lives is in our hips. One of every four people develop painful osteoarthritis of the hip at some point in their lives, yet we no longer limp into old age. In fact, hip replacement patients are getting younger even as the numbers of operations are growing.
In Grandpa’s day, only old people had hip replacements and such procedures were rare. Last year, nearly 330,000 patients elected to have the surgery. The vast majority said afterward that the operation was a success. And each year, the average age of hip patients has been going down.
Studies now show that patients under 30 and those over 70 have equally good surgical outcomes. Today it’s believed that the age of the patient matters less than the stage of osteoarthritis: The earlier the intervention, the better the results.
A Pivotal Joint That Needs to Move
Osteoarthritis is the most common source of hip pain, but it’s not the only potential problem. It’s the nature of this ball-and-socket to be susceptible to wear and tear.
The hip joint is where the major bone of the thigh, called the femur, meets the pelvic bone. The femoral head, as it’s called, fits into a socket where it can rotate and pivot when you walk, swim, bend, or swing a golf club or tennis racquet.
The cartilage that lines the femoral head allows the bone to slide easily in its socket. A chicken drumstick has the same type of cartilage covering the end bone; a healthy femoral head gliding in its socket is more slippery than a hockey puck on ice. When this cartilage starts to wear away, which happens to many of us over time, you can start to feel pain in the hip joint, groin area, back or front of the thigh. These are all symptoms of osteoarthritis.
Other indicators for hip replacement include injuries such as a fracture, tumor, rheumatoid arthritis (chronic inflammation caused by an immune response) or necrosis, a result of poor blood supply to the bone.
Whatever the cause, a painful hip joint can seriously affect your quality of life. Movement— moderate exercise or physical therapy— is believed to help people retain flexibility and strength. We may prescribe pain relievers or physical therapy to help you stay mobile.
When movement becomes painful, the hip deterioration may worsen and become a vicious cycle. At this point, if conservative therapy isn’t working, we may consider hip replacement surgery.
More Options For The Surgical Candidate
Surgery can take the form of total hip replacement or synovectomy, which is a procedure to remove the synovium, or mucuc-like lining of the joint. The type of surgery depends on the source of the pain, the condition of the joint, the stage of disease and your general age and fitness level.
Synovectomy is effective if the disease has damaged only the synovium and not the articular cartilage that covers the bone. We generally recommend this type of treatment only for patients who are in the early stages of inflammatory (rhumatoïde) arthritis.
In total hip replacement, the head of the femur and the socket are replaced with an artificial joint made of metal alloy and polyethylene. Patients usually spend a few days in the hospital. Some may book a short time at a rehab facility where they are taught how to transition back to full independence.
Medical technology has made great strides since the first total hip replacement in the 1960s, and the procedure is now generally considered among the most successful in medicine.
It’s worth noting that not all hip pain is due to arthritis. Spinal stenosis, bursitis (greater trochanteric bursitis, to be exact) and sometimes hardening of the arteries can also cause hip pain. With a complete physical exam and imaging tests, we can usually nail down the source of the pain and design a treatment plan to fit your condition. Contact our office today if you’re suffering from hip pain or would like to learn more about how we can help.