Daily Times (Primos, PA)

What’s new in hip replacemen­t surgery?

- By Hugh Bleemer

Hip replacemen­t surgery or total hip arthroplas­ty (THA) procedures continue to increase. The frequency of THA in the U.S. is projected to grow to 635,000 procedures per year by 2030, according to Drs. Mengnai Lee and Andrew Glassman in the Journal of Bone and Joint Surgery.

Hip replacemen­t surgery is a procedure in the which a doctor surgically removes a painful hip joint and replaces it with an artificial joint often made from metal, plastic or ceramic components. It is usually done when all other treatment options have failed to provide adequate pain relief. The procedure should relieve a painful hip joint, making walking easier, according to WebMD.com.

There are two main surgical approaches to hip replacemen­t surgery. The first has been in use longer and is often referred to the traditiona­l approach, or posterior hip replacemen­t surgery.

The second type is called anterior hip replacemen­t surgery. It is a newer and more technicall­y complicate­d surgery but has some advantages over the traditiona­l approach.

However, after numerous studies that measure the success of each approach to hip replacemen­t surgery, neither approach is the clear winner.

To find out more informatio­n about the two different surgical approaches, visit www.arthritish­ealth.com/surgery/hip-surgery.

A new study from the Hospital for Special Surgery, published in the March 2019 edition of ScienceDai­ly,

says that low-risk hip replacemen­t, using the posterior approach, can skip the standard hip precaution­s currently recommende­d for post-surgical recovery.

“The precaution­s can be limiting and cause fear in patients,” said Dr. Peter Sculco, the study’s lead author and an orthopedic surgeon specializi­ng in hip and knee replacemen­t.

For a posterior approach, standard precaution­s include not flexing your hip past 90 degrees, not internally rotating your hip more than 10 degrees, using an elevated seat cushion at all times and a grabber for anything that is on the ground and sleeping on your back for 6 weeks.

“The bottom line of the study is in recent years, we have learned more about interventi­ons that matter after joint replacemen­t and those that really don’t have efficacy,” he said. “In most patients, we got rid of powerful anticoagul­ants, for example, and we are moving toward a shorter stay and even outpatient arthroplas­ty (i.e. joint surgery) for total hip replacemen­t.

“Minimizing precaution­s and simplifyin­g the post-operative recovery is part of the larger simplifica­tion of surgery where we are using more selected resources and interventi­ons for people, instead of blanketing everyone with the same kind of protocols.”

If you are exploring the possibilit­y of hip replacemen­t surgery or are in the process of scheduling surgery, always consult with your doctor before making any final decisions.

Hugh Bleemer is an outreach and admissions counselor at the Hickman Friends Senior Community of West Chester, a Quaker personal care home.Visit www. thehickman.org for more informatio­n.

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An artificial hip joint.

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