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How to Decide When the Time Is Right for Hip Replacement Surgery

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When should a damaged hip be replaced? In this excerpt from our Special Report on Making the Right Decisions About Hip Replacement Surgery, Frank Frassica, M.D. answers this common – and important -- question. 

I have been an orthopedic surgeon for 25 years, and in my experience the people who are least satisfied with hip replacements are those who had the hip replacement surgery too early. They were unsuitable hip replacement candidates because their pain and debilitation levels were too low to justify surgery. After the hip replacement, they still have some pain from the surgery, which leaves them not only uncomfortable and unhappy, but also angry. 

I regularly tell people to delay arthroplasty of the hip as long as possible. How long is long? People who can walk one to two miles, but can't walk five miles, are not good candidates for hip replacement. If you can still walk one to two miles, meet the demands of your job, go to the mall and buy groceries, then it is too early to have your hip replaced. 

On the other side of the coin, if you cannot walk one to two miles, can't shop or enjoy activities as you used to, if physical therapy sessions have not helped and if you have so much pain that you need a narcotic, then it's probably time for hip replacement surgery. 

What to expect from hip replacement surgery. Once the decision to have hip replacement is made, you need to have realistic expectations. When physically active people tell me they want a hip replaced so they can go back to competitive tennis or take up aggressive downhill skiing or jogging, I make it clear that there may be serious problems down the road. I can almost guarantee that if they try those activities with their new hips, the artificial joint will eventually loosen, wear out or fracture. 

Total hip replacement will provide complete or nearly complete pain relief to almost all patients. Moreover, those patients with stiff hips before surgery should be able to return to nearly normal hip motion. 

However, there are still some unsolved problems in the total hip arthroplasty procedure. For example, the materials we use for hip replacements don't last forever, although depending on the patient's age and activity level, a hip replacement can last for 15 to 20 years or even longer before it has to be revised (replaced). 

Posted in Arthritis on June 20, 2011

Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Health After 50 Disclaimer

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Health After 50 Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Scientific American Health After 50 or Remedy Health Media, LLC, which has no responsibility for any comments posted on this site.

I thought the current advice is not to postpone KNEE replacement surgery because the longer the condition exists the more worn down the joint becomes, leaving less bone for the surgeon to work with. Why, then, does the above article advise postponing HIP replacement as long as possible, until the condition is truly debillitating?

Posted by: Pyles | June 25, 2011 7:22 PM

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