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Need a Hip Replacement?

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Need a New Hip?What are the different types of hip replacements and how should you choose the right one for you?

As the baby-boomer generation ages, the amount of total hip replacement surgeries will sky rocket. Degeneration of the hip joint starts to occur as we age and as arthritis sets in, so does PAIN.hip replacement treatment Groin pain is usually the first sign of an arthritic hip. If a person starts to have groin pain they may not relate it to the hip at first, not until a doctor mentions hip arthritis and it is visualized through an x-ray or MRI. This would show bone against bone with no space in between, which equals PAIN.

Once someone is a candidate for a total hip replacement the next big decision is which approach to take. There are two surgeries that have become very common, and a third new approach that only certain surgeons are trained to perform.

  1. The posterior-lateral or "traditional" approach is one of the most common approaches being performed. Many orthopedic doctors are trained in this surgery and the hip joint is completely exposed for easy access. Although this surgery is common and has excellent results, there are many limitations put on the patient to avoid dislocation of the new hip. Several muscles must be cut with this surgery, therefore aggressive strengthening is required afterwards. If the muscles are not strengthened properly and safely the joint is unstable and at risk for dislocation. Physical therapy is extremely important for this reason!
  2. The anterior approach involves an incision on the front of the hip and there are fewer limitations after this type of hip replacement. The muscles and tendons are not cut, just retracted or moved to expose the hip joint. Physical therapy is still required but the length of recovery is less because the hip is not dislocated and all muscles stay intact. Infection at the incision site is more common with this approach because it is located where the hip bends when we are sitting, making it a little more difficult to heal. Less dislocations are reported with this compared to the "traditional" approach.
  3. The SuperPATH or "Northern" approach is the newest type of hip replacement. Again, no muscles or tendons are cut with this surgery and the hip is not dislocated. Recovery time and the average amount of time in the hospital is reduced. Most patients stay in the hospital 1-2 days with this approach, compared to the other hip replacements which is about 3-5 days. The SuperPATH is also considered to be a minimally invasive surgery for a few important reasons. First, the incision is above the hip joint and is much smaller than the incisions made with the other approaches. This leaves less room for infection. Once the hip is exposed there is no "unnatural" twisting to get the implant in place. The implant is being put together inside the body to be customized to each patient’s anatomical needs. Less blood is lost during surgery, which is better for the body overall. Surgeons trained in this type of hip replacement have found that there are less hip dislocations after surgery and even reports of the hip feeling "more like a natural hip" when compared to the other approaches.

As a Physical Therapy Assistant, I have treated all three of these hip replacements. My mother has had excellent results with her "traditional" hip replacement and is pain free. To date, I have seen a quicker recovery with the SuperPATH and the anterior approach, when compared to the "traditional."

It is important to realize that everyone is different and one approach may be better for someone and not others. If a hip replacement is possibly in your future, do your OWN research. Read about recovery time and limitations after surgery. Talk to your doctor and let them know any questions or concerns. This will be YOUR new hip for the next 15-20 years so be your own advocate and choose the best one for you!

Article contributed by Krista Magnoli, PTA @ The Physical Therapy Center of West Palm Beach.

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