Christopher J. Lyons, MD
Orthopaedics
Chester County Hospital; West Chester, PA

Published: January 19, 2016

Hip pain, resulting from hip arthritis, is common in the United States, and it is becoming more prevalent as the average age of the population increases. Pain in the hip joint is typically experienced as groin pain. Often there is diminished motion in the hip, and the pain increases with activity. Patients often note the pain is most troublesome at night.

Hip arthritis can be a result of degenerative joint disease, caused by wear and tear, which is most common. Post-traumatic arthritis, or rheumatologic arthritis, can also lead to hip pain.

People with hip pain should initially be evaluated by a physician, who will assess their levels of pain and limitations in range of motion and function. X-rays are used to establish the degree of deterioration present in the hip joint.

Often, conservative measures can be helpful in managing hip pain. This approach would include the use of anti-inflammatory medicines, physical therapy for stretching and strengthening the joint and surrounding muscles, and weight loss. Occasionally, an injection into the hip joint may be recommended to provide temporary relief of the pain.

If a patient's hip pain cannot be adequately controlled with conservative management then replacement surgery should be considered. Hip replacement involves removing the damaged portions of the hip joint and replacing these surfaces with prosthetic components. Devices that are commonly used today have an anticipated wear period of 25 to 30 years or more.

Hip replacement is one of the most successful procedures commonly performed in the U.S. About 300,000 total hip replacement procedures are performed annually. Most patients experience significant reduction in pain and improved capacity for walking and other activities.

Although complications are rare, patients considering hip replacement should be aware that infections, bleeding, blood clots and persistent pain can occur. Fortunately these hip replacement complications are rare. Blood clots are prevented by early mobilization of the patients and preventative medications immediately post-operative.

Patients contemplating a hip replacement need to be initially evaluated by their medical physicians to be certain that they are healthy enough for the procedure. They will be admitted to the hospital on the day of the hip replacement procedure, which will take between one to two hours. Most patients will begin physical therapy to help them start walking again on the first day after their hip replacement operation. Patients should plan to spend two to three nights in the hospital following hip replacement. Initially, the patient will use a walker but progression to a cane and then no assistive device will occur over the first few weeks. They are typically discharged to home with outpatient physical therapy or to rehab, depending on the needs of the individual patient.

While there is much discussion in the orthopaedic field about hip surgery techniques, such as the approach (posterior, lateral, anterior) and the length of the incision, the long-term analysis of these factors does not show significant differences. The patient and their surgeon will determine the best surgical method based upon the specific needs of the person receiving the new hip.

In summary, hip pain is a prevalent condition that can be successfully managed with hip replacement surgery if more conservative measures fail.



This article was published as part of the Daily Local News Medical Column series which appears every Monday. It has been reprinted by permission of the Daily Local News.


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