Dr. Broome DIVES INTO: TOTAL HIP REPLACEMENTS
Dr. Broome explains the replacement of a Total Hip Replacement
Q: What is a Total Hip Arthroplasty?
A: With hip arthroplasty or hip replacement, basically, the ball and socket have become arthritic and so the cartilage over the joint surfaces doesn't have nerves.
So normally, the ball and socket move very freely and it doesn't have pain. With arthritis, you lose that cartilage and those raw bone edges have nerves, so it becomes extremely painful and you lose your flexibility.
With hip replacement arthroplasty what we do is we have an implant that basically resurfaces the hip so you have a hemispherical part that goes into the socket with a new liner on the inside and the bone actually grows into this implant. On the thigh bone side, you have a part that goes inside the top of the thigh bone. The bone will grow into this with a new ball. So that then makes up the new bearing surface. So if you can imagine now, artificial parts that are rubbing in there, don't have nerves, and hence the pain goes away and you restore your motion and your function.
Q: When Should A Patient Consider A Total Hip Arthroplasty?
A: When it's time for hip replacement we try every non-surgical option available first. Surgery is always our last resort. We really start considering hip replacement when:
You have end-stage arthritis on your X-rays,
We find complete bone on bone,
You lose your flexibility like it's hard to put on your shoes and socks,
And your pain and discomfort are directly impacting your quality of life.
Q: What Are Some Common Misconceptions of A Total Hip Arthroplasty?
A: The internet really takes a big role in misconceptions and people are more likely to read about the bad outcomes rather than the good. This makes it tough on the patient needing surgery because they think it’s nothing but bad outcomes when in reality it’s just the opposite. One of the things that we take pride in and really try to flatten the rate of bad outcomes is that we are specialists, meaning I do nothing but hip and knee replacements. I'm not dabbling in shoulder surgery or other things. I've got a partner, Dr. Marx, that's the expert in that. And with this, the goal is to eliminate complications that are found in a more generalized hospital setting. We have a special table that we use in the operating room, we use an X-ray during the surgery, so our accuracy is within two millimeters. We have invested in techniques and technology that minimize the risks of infection and negative outcomes.
Q: What Are The Risks Of Undergoing A Total Hip Arthroplasty?
A: It was only about 20 years ago when a lot of the techniques that we have now did not exist. And today a lot of people go online and research hip replacement. There, they see the horror stories like blood clots, huge incisions, the hip popping out of the socket, or limitations on mobility. And that's really obsolete.
In today’s hip replacements, our newer techniques have really improved. For instance, the way we do the hip replacement now is a small incision in the front of the hip. We don't cut any muscles or tendons like they use to. Because we don't cut those muscles, the hip is extremely stable post-surgery. We see minimal mobility restriction and we get you up walking much quicker.
Lastly, the risk of infection or blood clots is less than 0.5% at our facility. We've done all we could to mitigate the risks, and it's really a very rewarding procedure.
Q: What Does A Hip Arthroplasty Recovery Look Like?
A: The recovery from hip replacement has really changed drastically over the last ten years. Back when I started my residency, almost every hip replacement patient was admitted to the hospital for at least two to three nights. Then they almost all went to a rehab facility and it took some four to five days to start walking or putting pressure on their hip.
Where a,s today, we have you have walking within a couple of hours of the surgery. Some patients go home the same day and most patients go home the morning after the procedure. There is minimal discomfort, we encourage most patients to take it easy the first couple of weeks.
Overall, the big picture recovery is it really depends on the person and what they do for work and what they're trying to get back to. By three months, in general, I expect everyone to be back resuming all normal activities.