Nonsurgical Hip Treatments
Depending on the condition, a physician may recommend a course of nonsurgical treatment. This may include pain relievers such as acetaminophen or non-steroidal anti-inflammatory medications. Another option is a cortisone injection, which can help reduce swelling and provide pain relief in some patients. Alternatively, a physician may recommend an injection of hyaluronic acid directly into the joint to provide lubrication and reduce pain. In some cases, weight loss may be recommended, and can substantially reduce the pressure on the hip, while increasing the patient’s mobility. Physical therapy may also be recommended.
Surgical Hip Treatments
Pelvic osteotomy is a procedure used to correct several conditions, one of which is hip dysplasia. In instances in which the hip socket is misshapen and does not fit well with the ball portion of the joint, surgically re-orienting the socket, called a pelvic osteotomy, may be recommended. This surgery helps to stabilize the hip and can prevent the onset of early osteoarthritis. Pelvic osteotomy is performed on children, teens, and adults without significant arthritis.
Hip arthroscopy, a procedure used to treat a patient’s condition, involves tiny incisions (minimally invasive). With the arthroscope, a flexible thin tool fitted with a camera, surgeons can view all of the hip joint on a monitor real-time. The surgeon can then make small holes in which to extend various instruments in order to perform the necessary surgery. Arthroscopy is typically performed to remove bone spurs, repair a torn labrum, or treat femoral acetabular impingement.
Total Hip Replacement
Most patients who undergo a total hip replacement, known as hip arthroplasty, are suffering from severe arthritis that is causing pain and interfering with their daily functioning. Total hip replacement involves the removal of the diseased or damaged portions of the hip (the ball and socket) and the replacement of those parts with an implant. Most physicians today use a prosthesis that features a titanium stem and metal or ceramic ball. The socket is typically composed of titanium, but has an inner polyethylene plastic spacer that allows for a smooth gliding movement.
Approaches to Total Hip Replacement
The method in which a surgeon accesses the hip during a procedure is called the approach. With total hip replacement, the two most popular options are:
Dr. Sporer at Midwest Orthopaedics at Rush examining patient hip.
- Posterior Approach
The majority (about 70 percent) of hip replacements performed in the U.S. involve the posterior approach. A surgeon taking this approach will make a curved incision from the patients’ side or back. Recently, the procedure has been improved, and is now performed in a minimally invasive manner, which means a smaller incision and less damage to the muscle and surrounding tissue.
Dr. Berger from Midwest Orthopaedics at Rush explaining hip replacement procedure to patient.
- Anterior Approach
The anterior approach involves accessing the hip joint from the front of the body. The last few years have seen an increase in this approach as the instrumentation has been refined and a smaller incision is now possible. Because of this, there is potentially less trauma to the muscle and tissue. Studies reveal the anterior approach can result in a quicker recovery and better overall pain scores in the first few weeks after surgery. This particular approach tends to require special training, so patients should ensure that their surgeon is very experienced with this procedure.
Research shows that the outcomes for most patients are the same no matter what technique or approach the surgeon uses. Experts say patients should select the surgeon rather than the approach to hip replacement. It is important to make sure the physician has performed several hip replacement procedures and is experienced in the technique. There are risks and benefits of each surgical approach and patients should discuss these with their physician when deciding on the approach that is right for them.