You can replace aching joints. You can’t replace precious moments. Deciding to have a hip replacement is a big decision, but in this podcast, Dr. John Chan will guide you through the process and share what to expect following a hip replacement.
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What to Expect After a Hip Replacement
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Learn more about John Chan, MD
John Chan, MD
John Chan, MD is board certified in orthopedic surgery. He earned his Doctor of Medicine from the University of Texas Southwestern Medical School in Dallas. He completed a general surgery internship and an orthopedic surgery residency at the Medical College of Virginia in Richmond. Dr. Chan has been in practice since August, 1997. His practice includes primary and revision total knee, total hip, and total shoulder surgery, including reverse total shoulder technology. He also has a busy sports medicine practice that includes the latest in shoulder and knee arthroscopy. Dr. Chan utilizes computer navigation for total joint replacement and will soon be bringing robotic joint replacement to St. Joseph’s Hospital. He has participated in clinical trials with Clinical Research of West Florida. He is a fellow of the American Academy of Orthopedic Surgeons and a member of the Orthopedic Trauma Association.Learn more about John Chan, MD
Transcription:
What to Expect After a Hip Replacement
Intro: This is BayCare HealthChat. Another podcast from BayCare Health System.
Scott Webb (Host): Welcome to BayCare HealthChat. I'm Scott Webb, and I invite you to listen as we learn about total hip replacement surgery, including computer assisted and robotic approaches to hip replacement. And I'm joined today by Dr. John Chan. He's an Orthopedic Surgeon at BayCare Health System. Dr. Chan, thanks so much for your time today. We're talking about total hip replacement. So, let's start here. What are the indicators that someone needs a total hip replacement or might be a good candidate for total hip replacement?
John Chan, MD (Guest): One of the primary indications for getting a total hip replacement is pain that we can't manage well without surgery. And the pain can come from multiple reasons. The most common reason would be for the hip to have arthritis. And that's probably our most common cause. There's different kinds of arthritis. The most common would be osteoarthritis and that's followed by various other types of arthritis, such as psoriatic arthritis or rheumatoid arthritis. And then there's other indications where there's some deformity and injury from prior trauma or falls or previous fractures.
Host: Yeah. And you know, it seems like years ago, total hip replacement was a big deal, big scar, big deal, not something to be taken lightly. And a lot of people would avoid it because of the scar, because of the recovery, because of, you know, it being seemingly a bigger deal, but it doesn't seem to be as big a deal anymore. They seem more commonplace, seem like a really great option for people almost irrespective of their age. Is that your sense of things?
Dr. Chan: Yeah, I think things are definitely going in that direction. There was a study, a number of years back that indicated that orthopedic knowledge is doubling at approximately every five years even compared to five, 10, 15 years ago. Our knowledge is better and we're trying to adapt that knowledge to bringing a better product to the patient. And part of that has to do with our techniques and our approaches to the surgery. Some of it has to do with medications and how we're managing people in the hospital. And part of it is newer technologies. The shapes of our hip replacements are different for the most part now. And there's also been the introduction of more technology such as computer navigation and most recently, robotic surgery.
Host: Yeah, it's pretty amazing. And that's what I want to talk about next is you mentioned the approaches, so let's talk about the different approaches to total hip replacement.
Dr. Chan: In general, there's probably three common ways to approach the hip for a hip replacement. Although there's probably a few others that are less common. The traditional approach is to go posteriorly or from the back and that is the oldest technique and was originally developed in England. And the majority of orthopedic surgeons in America have been trained in this approach. Other options would be to come directly from the side and the most recent adaptation or approach that we've been using is what's called the direct anterior approach. And they all have good results in the hands of people well-trained and experienced that are doing those approaches and they have different benefits and downsides also.
Host: Yeah, I'm sure. And I'm sure there are also probably some complications. So, what are some general complications that people need to be on the lookout for or prepared for as they think about total hip replacement?
Dr. Chan: Like you said, there's several complications. One of the complications that is talked about most frequently is dislocation of the hip replacement. And that's where the ball comes out of the socket portion of the hip. Traditionally, this is associated most commonly with a posterior hip approach. It's a little bit less common with the lateral approach and the anterior approach. Other problems include infection. Infection at this point, we really try to optimize the patient before we do an operation and that seems to have led us to controlling and reducing our infection rates. And we also do some pre-screening tests ahead of time as a part of the preparation, which has reduced the infection rate as well.
Host: You mentioned computer navigation as one of the innovations, one of the practices that's being used now versus, you know, years ago, even 10, 15, 20 years ago. So, tell us about that. Tell us about the role of computer navigation in total hip replacement.
Dr. Chan: It's actually been around probably for about 15 or 20 years and it continues to become a little bit better and more sophisticated as time goes on. The general idea is that we are trying to get a sense of the relationship of the hip itself to the pelvis in order to place our prosthetics or the hip replacement into a better position to reduce complications, such as dislocation. What they have found on some of the midterm studies, meaning the early to mid-range. And we're talking probably about 10 years and a little bit plus, is that navigation clearly appears to help us at positioning the total hip better. They haven't actually proven that it increases longevity. And so some of the thoughts are that computer navigation probably helps the occasional total hip surgeon a little bit more than someone who has a lot of experience, but it definitely helps us in positioning things into a more optimal alignment.
Host: It maybe makes the surgery a little bit easier and smoother. Is there a role for a robotic assisted technology in this type of surgery? Are you using robots?
Dr. Chan: Robots are becoming more common now. And it's a very interesting technology. So, robotic surgery is using some of the knowledge that we gain from navigation to also help us position our total hip replacements in what we think is the optimal position. And one of the ways it does that is to help position our instruments in a more optimal position. And so there's less variability. The robotic technology is so new in the hip, however, we don't really have much data on whether, similar to navigation, whether the mid-term or long-term results will be good, but it definitely adds a significant amount of information to the operating surgeon that they can utilize to hopefully give you a better result.
Host: This has been really informational doctor, as we get close to wrapping up here, what should be the expectations after total hip replacement? You know, how long is the recovery time, physical therapy what can people generally expect? When can they get back to their lives after receiving a new hip?
Dr. Chan: The hip replacement can be a life changer for a lot of people, especially if they've been suffering for a long time from whatever's causing their hip pain. In general, a lot patients nowadays can actually go home the same day of surgery. Previously even probably about five or 10 years ago, patients were staying in the hospital typically three or four days while they're convalescing and getting better. Now, we typically will do the operation and patients will walk the very same day. And like I said, some of them can go home the same day. Almost probably 99% of people go home, at least after just a one night stay in the hospital now. So, people are getting home where they're more comfortable and they’re actually rehabbing more quickly.
Typically, all lower extremity joint replacements, hips and knees are really designed to try to make walking a painless or as close to painless process. And so you can definitely do as much walking as you want. Bicycle riding is excellent. Swimming is usually great. People can tolerate a little bit higher impact kind of things on occasion, such as skiing and occasional jogging. But typically we discourage high-impact activities on a regular basis just because we want to try to get our mechanical device to last as long as possible.
Host: Yeah definitely and if you've got a painful hip, if you have arthritis, there are options, surgical options, numerous surgical options, computer navigated, robots, all that sort of thing. People just need to reach out and we hope they do. And Doctor, thanks so much for your time. You stay well. And to learn more about hip replacement surgery and all the services at BayCare, please visit baycare.org. And that wraps up this episode of BayCare HealthChat. Always remember to subscribe, rate, and review this podcast and all the other BayCare podcasts so we can share the wealth of information from our experts together. I'm Scott Webb. Stay well.
What to Expect After a Hip Replacement
Intro: This is BayCare HealthChat. Another podcast from BayCare Health System.
Scott Webb (Host): Welcome to BayCare HealthChat. I'm Scott Webb, and I invite you to listen as we learn about total hip replacement surgery, including computer assisted and robotic approaches to hip replacement. And I'm joined today by Dr. John Chan. He's an Orthopedic Surgeon at BayCare Health System. Dr. Chan, thanks so much for your time today. We're talking about total hip replacement. So, let's start here. What are the indicators that someone needs a total hip replacement or might be a good candidate for total hip replacement?
John Chan, MD (Guest): One of the primary indications for getting a total hip replacement is pain that we can't manage well without surgery. And the pain can come from multiple reasons. The most common reason would be for the hip to have arthritis. And that's probably our most common cause. There's different kinds of arthritis. The most common would be osteoarthritis and that's followed by various other types of arthritis, such as psoriatic arthritis or rheumatoid arthritis. And then there's other indications where there's some deformity and injury from prior trauma or falls or previous fractures.
Host: Yeah. And you know, it seems like years ago, total hip replacement was a big deal, big scar, big deal, not something to be taken lightly. And a lot of people would avoid it because of the scar, because of the recovery, because of, you know, it being seemingly a bigger deal, but it doesn't seem to be as big a deal anymore. They seem more commonplace, seem like a really great option for people almost irrespective of their age. Is that your sense of things?
Dr. Chan: Yeah, I think things are definitely going in that direction. There was a study, a number of years back that indicated that orthopedic knowledge is doubling at approximately every five years even compared to five, 10, 15 years ago. Our knowledge is better and we're trying to adapt that knowledge to bringing a better product to the patient. And part of that has to do with our techniques and our approaches to the surgery. Some of it has to do with medications and how we're managing people in the hospital. And part of it is newer technologies. The shapes of our hip replacements are different for the most part now. And there's also been the introduction of more technology such as computer navigation and most recently, robotic surgery.
Host: Yeah, it's pretty amazing. And that's what I want to talk about next is you mentioned the approaches, so let's talk about the different approaches to total hip replacement.
Dr. Chan: In general, there's probably three common ways to approach the hip for a hip replacement. Although there's probably a few others that are less common. The traditional approach is to go posteriorly or from the back and that is the oldest technique and was originally developed in England. And the majority of orthopedic surgeons in America have been trained in this approach. Other options would be to come directly from the side and the most recent adaptation or approach that we've been using is what's called the direct anterior approach. And they all have good results in the hands of people well-trained and experienced that are doing those approaches and they have different benefits and downsides also.
Host: Yeah, I'm sure. And I'm sure there are also probably some complications. So, what are some general complications that people need to be on the lookout for or prepared for as they think about total hip replacement?
Dr. Chan: Like you said, there's several complications. One of the complications that is talked about most frequently is dislocation of the hip replacement. And that's where the ball comes out of the socket portion of the hip. Traditionally, this is associated most commonly with a posterior hip approach. It's a little bit less common with the lateral approach and the anterior approach. Other problems include infection. Infection at this point, we really try to optimize the patient before we do an operation and that seems to have led us to controlling and reducing our infection rates. And we also do some pre-screening tests ahead of time as a part of the preparation, which has reduced the infection rate as well.
Host: You mentioned computer navigation as one of the innovations, one of the practices that's being used now versus, you know, years ago, even 10, 15, 20 years ago. So, tell us about that. Tell us about the role of computer navigation in total hip replacement.
Dr. Chan: It's actually been around probably for about 15 or 20 years and it continues to become a little bit better and more sophisticated as time goes on. The general idea is that we are trying to get a sense of the relationship of the hip itself to the pelvis in order to place our prosthetics or the hip replacement into a better position to reduce complications, such as dislocation. What they have found on some of the midterm studies, meaning the early to mid-range. And we're talking probably about 10 years and a little bit plus, is that navigation clearly appears to help us at positioning the total hip better. They haven't actually proven that it increases longevity. And so some of the thoughts are that computer navigation probably helps the occasional total hip surgeon a little bit more than someone who has a lot of experience, but it definitely helps us in positioning things into a more optimal alignment.
Host: It maybe makes the surgery a little bit easier and smoother. Is there a role for a robotic assisted technology in this type of surgery? Are you using robots?
Dr. Chan: Robots are becoming more common now. And it's a very interesting technology. So, robotic surgery is using some of the knowledge that we gain from navigation to also help us position our total hip replacements in what we think is the optimal position. And one of the ways it does that is to help position our instruments in a more optimal position. And so there's less variability. The robotic technology is so new in the hip, however, we don't really have much data on whether, similar to navigation, whether the mid-term or long-term results will be good, but it definitely adds a significant amount of information to the operating surgeon that they can utilize to hopefully give you a better result.
Host: This has been really informational doctor, as we get close to wrapping up here, what should be the expectations after total hip replacement? You know, how long is the recovery time, physical therapy what can people generally expect? When can they get back to their lives after receiving a new hip?
Dr. Chan: The hip replacement can be a life changer for a lot of people, especially if they've been suffering for a long time from whatever's causing their hip pain. In general, a lot patients nowadays can actually go home the same day of surgery. Previously even probably about five or 10 years ago, patients were staying in the hospital typically three or four days while they're convalescing and getting better. Now, we typically will do the operation and patients will walk the very same day. And like I said, some of them can go home the same day. Almost probably 99% of people go home, at least after just a one night stay in the hospital now. So, people are getting home where they're more comfortable and they’re actually rehabbing more quickly.
Typically, all lower extremity joint replacements, hips and knees are really designed to try to make walking a painless or as close to painless process. And so you can definitely do as much walking as you want. Bicycle riding is excellent. Swimming is usually great. People can tolerate a little bit higher impact kind of things on occasion, such as skiing and occasional jogging. But typically we discourage high-impact activities on a regular basis just because we want to try to get our mechanical device to last as long as possible.
Host: Yeah definitely and if you've got a painful hip, if you have arthritis, there are options, surgical options, numerous surgical options, computer navigated, robots, all that sort of thing. People just need to reach out and we hope they do. And Doctor, thanks so much for your time. You stay well. And to learn more about hip replacement surgery and all the services at BayCare, please visit baycare.org. And that wraps up this episode of BayCare HealthChat. Always remember to subscribe, rate, and review this podcast and all the other BayCare podcasts so we can share the wealth of information from our experts together. I'm Scott Webb. Stay well.