M30 — July 2012 — Hip Surgery Overview

Intro: If you have an achy hip that medications and even cortisone shots can no longer tame, you may be headed for surgery. You'll have a lot of company. A half million Americans have total hip replacements each year. Here's Dennis Douda for Medical Edge.

"At first I thought I pulled a muscle. It was kind of a stretching, burning pain in my right side."

For College Student Sara Segner, the pain was a symptom of something far more serious than just a pulled muscle.

"I have avascular-necrosis. It's basically where the bone doesn't get enough blood supply.

As bone tissue died, the cartilage in her hip joints deteriorated badly. Such painful bone on bone contact generally affects older adults with osteoarthritis. In both cases, eventually, the solution is likely to be the same.

"Once the patient has arthritis, independent of age, then that's when we have to discuss hip replacement."

"Surgery should be seen as a last resort."

"In a nutshell, the hip replacement is that you replace the socket bone, the bad socket cartilage, with a metal socket. And on the femoral side, you put a stem that goes down the shaft."

Mayo Clinic Orthopedic Surgeon Rafael Sierra says statistics show the average age of hip replacement patients is getting younger. Among the factors behind the trend, the growing obesity epidemic. He says because our hips and knees support many times our body weight, lightening the load lowers the risk of needing joint surgery.

Sometimes with young adults the decision when to proceed with a hip replacement isn't quite as obvious as it was for Sara. That's when Dr. Sierra says he and his patients have a very honest conversation about the possible risks and benefits.

"The one thing we have to consider before offering a hip replacement is the durability and longevity of our implants."

Advances in high-tech ceramic and plastic materials should allow the replacement parts to last longer, hopefully meaning more time before the contact surfaces need to be replaced.

"I'll be good for at least 20 years, which for me is exciting."

Modern approaches to recovery and rehabilitation had Sara on her feet the day after surgery and out of the hospital in 2-days. 3-weeks later, a slight limp is the only clue to the surgery that put her back on her feet.

For Mayo Clinic, I'm Dennis Douda.

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Dr. Sierra (See-AIR-ah) says when choosing a facility and surgeon for hip replacement, keep in mind that regular follow-up care is important. Research also shows that patients using surgeons who have performed higher numbers of procedures tend to have with fewer complications.

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