Researchers at Sahlgrenska Academy have designed a new model to help doctors and patients decide whether or not to proceed with total hip replacement surgery. The researchers have also surveyed patient wellbeing after surgery: patients with high education achieve greater outcome scores, while those with antidepressant prescriptions do not.
Larry Kufel had always been an active man, tall and rangy, who worked out regularly and picked up basketball games at the gym. But age was taking a toll on his joints, and it had become clear that he needed a hip replacement.
“It got to the point, if I did any exertion, even getting out of a chair, it felt like the muscle was tearing away from the bone,” he recalled.
Still, Mr. Kufel, 63, a financial controller in Roanoke, Va., worried that conventional hip replacement surgery would mean a long, painful recuperation. Instead, his doctor proposed an alternative …
Runners rely on mobility when hitting the track or trail on any given day. Running is a high-impact activity that relies not only on your legs to move, but also your hips; and according to the American College of Sports Medicine, about 500,000 hip replacement surgeries occur yearly in the United States.
According to Dr. Stickney, “The decision on whether to have hip replacement should be a cooperative decision between you, your family and your orthopedic surgeon. After review of your symptoms, x-rays, and your personal expectations, recommendation for surgery is based primarily on the extent of pain and disability, and not on age or necessarily x-ray findings.”
The hip is one of the body’s normal weight-bearing joints made up of a ball and socket frame covered by articular cartilage, lined with synovial membrane that produces the lubricating fluid for movement. Over time, wear and tear of the ball and socket causes the pain and can lead to osteoarthritis and traumatic arthritis.
Running after hip replacement requires rehabilitation, physical therapy and a graduated activity program to avoid stiffness as well as build stamina and strength. Below are some tips on how to build up to your normal running pace:
- According to the American Academy of Orthopedics (AAOS), start with a slow walking regimen with the aid of a walker, crutches or event trekking poles. These tools will help increase your energy as you continue to heal. Once your surgeon feels that you are ready to put more weight into your step, then and only then, should you increase your walking pace.
- It is also important to rebuild the muscle strength in your legs by participating in a mild swim exercise with the help of swim fins. Fluid movement in the water minimizes weight-bearing stress to your hip while you are still recovering.
- A low-impact activity like riding a stationary bike is also a great way to build the muscles in your leg and hip, prevent stiffness and keep it flexible.
- Lastly, after your walk or run, don’t forget to ice the hip to reduce or prevent inflammation and rest the affected hip.
Dr. Stickney specializes in hip, knee and shoulder surgery in his Kirkland and Redmond locations. If you are a runner considering a hip replacement, contact Dr. Stickney at (425) 823-4000 to schedule an appointment or email him at ProOrthoAppointment@proliancesurgeons.com. Watch Dr. Stickney’s video and learn more about hip replacement surgery.
Considering a hip replacement is no easy decision. There are various procedures in the orthopedic marketplace. There are 3 common approaches to the hip replacement. The Posterior Approach is the most common traditional approach. The lateral approach has a lower dislocation risk but a much higher incidence of limp after surgery. I have been performing the anterior approach for total hip replacement for years. In fact, I am the only orthopedic surgeon in Kirkland, WA that performs this procedure.
How does the anterior approach to total hip replacement differ from the traditional hip replacement surgery? For one, the anterior approach is a tissue-sparing alternative. The approach to the hip from the front does not involve cutting any major structures to get to the hip. Instead, the interval between two muscles is separated, leading to the hip capsule. I work between your muscles and tissues without detaching them from either the pelvis or thighbones – sparing the tissue from trauma. The Traditional posterior approach from the back requires dividing the gluteus maximus (butt) muscle and splitting part of the ilio-tibial band on the side of the hip and then cutting several small tendons off the back of the hip.
Many surgeons are hesitant to perform the anterior approach because it is new since their training. The special equipment necessary to perform this approach has only been popularizer in the past 5 years. This approach is through a much smaller incision and is technically demanding. The anterior approach uses a special table called a Hana table that allows me to position the leg in a very specific way to place the hip components. All of the operating room staff and my assistants are used to doing this approach.
Benefits to the anterior approach for hip replacement include:
- Faster recovery time and improved mobility – The muscle tissues are spared during the surgical procedure
- Less pain – No hip precautions when at home like having to put a pillow between the legs when at rest
- Limping is eliminated on average 16 days after anterior hip approach vs. 24 days after a posterior approach. Pain relief is faster, 98% of patients are off narcotics 2 weeks after an anterior approach, vs. 70% off narcotics after a posterior approach.
- Agility – There are no restrictions on hip flexion after an anterior approach.
If you are considering hip replacement and would like more information, please call me at 425-823-400 or email me at ProOrthoAppointment@proliancesurgeons.com to schedule an appointment.