Hip pain can signal the need for hip replacement surgery—or not. It depends on some factors.
Out of over 231,000 hip replacements performed in the U.S. every year, how probable is it that some small percentage of these aren’t really necessary—or, to put it another way, can be delayed for quite some time?
Here is what a sports medicine doctor, Dr. Scott Levin, says: “Hip arthroscopy is a less invasive outpatient procedure that may be a viable alternative to open surgery for some patients.”
Dr. Levin is with the Somers Orthopaedic Surgery & Sports Medicine Group.
He further explains that with arthroscopy, the incisions are very small, and that this procedure is less costly, causes less blood loss, is usually less painful, and has a faster recovery time than the invasive hip replacement.What exactly is hip arthroscopy?
A surgeon uses an arthroscope, a thin instrument through which he can view the inside of the patient’s joint.
The arthroscope can diagnose, do surgery and remove a loose item in the joint. It can also monitor disease.
Arthroscopy can delay or even eliminate hip replacement. In a replacement, the implants (metal or plastic) do deteriorate over time and will need eventual replacement.
If hip replacement is delayed by arthroscopy, then by the time you absolutely have to have the invasive surgery, the implant technology will be more advanced than if you did not delay, since this field of surgery is always evolving.
Dr. Levin explains, “Arthritis of the hip causes a gradual loss of cartilage and alters the chemical composition of the joint fluid.
“This leads to irritation of the lining and fraying of the joint, causing further inflammation and fraying. Since arthroscopy staves off this damage, it may eliminate the need for an implant altogether.”
As good as all this sounds, there is a caveat: The ideal candidate for hip arthroscopy is 15 to 55 years old.
Arthroscopy is often performed for hip pain that is non-arthritic and related to sports injuries in this age group. But remember, the technology is always advancing.
Hip arthroscopy isn’t just for senior citizens. It has the potential to give athletes another chance to get back into their sport at pre-injury level, says a study from Rush University Medical Center in Chicago.
It’s easy to say that hip pain is caused by the destructive process of cartilage that’s between bones.
This cartilage provides lubrication between the bones so that the joint can move efficiently.
Destruction of the cartilage causes diminished range of motion, not to mention pain. However, what causes the destruction of the cartilage in the first place?
We can go back further and explain the pain as arising from arthritis (but what causes that?), past stress fracture (can be caused by physical activity), or spinal problems.
If muscles about the hip and pelvis are strained, this too can cause the pain. So can congenital hip displacement that eventually catches up to a person as they age.
My father not too long ago successfully underwent total hip replacement on one side.
An X-ray had revealed no cartilage present; it was bone on bone. How did this happen?
My father was never an impact-sports athlete (played golf and bowled) and had not sustained injury to the hip.
From a common sense perspective, I can surmise that the joint degenerated because over the years, it was not used nearly as much as nature intended it to be used.
The human machine is a walking machine. Our bodies need to do a lot of walking.
For many decades my father had an office job, then came home to be waited on hand and foot my mother.
That’s a lot of steps he gave up on a weekly basis: thousands. Multiply that out by the months, years and decades, and that’s tens of millions of steps he cheated his hip joints out of.
My mother did and continues to do lots of walking around the house to conduct tasks. She has absolutely no evidence of hip degeneration.
I don’t think this is a coincidence at all. “If you don’t use it you’ll lose it” seems to be a very strong factor here.
Dr. Levin says to see a doctor when walking becomes uncomfortable; the pain lasts longer than a few days; the hip can’t be moved without pain; there is swelling; presence of fever, redness or warmth; the hip pain interferes with activities.
If you’re told you need hip replacement surgery, inquire about arthroscopy as an option.
