Hip replacement surgery is beneficial when joint pain prevents you from participating in your normal daily activities, such as walking, working and sleeping. Orthopedic surgeons at Bryan Medical Center have pioneered minimally invasive joint replacement procedures that make your recovery faster and less painful than with traditional surgery.
How does someone know that they need to have their hip replaced? Is there a way to delay having hip surgery or other treatment options before surgery? How do they decide if and when they should have surgery.
Listen in as Scott Bigelow, MD, orthopaedic surgeon, Lincoln Orthopaedic Center, discusses these and other great questions, and how Bryan Health is there for you from the start of your procedure, through to the end.
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Hip Replacement Surgery: Exploring Your Options
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Learn more about Dr. Scott Bigelow
Scott Bigelow, MD, Lincoln Orthopaedic Center
Dr. Scott Bigelow is an orthopaedic surgeon with Lincoln Orthopaedic Center.Learn more about Dr. Scott Bigelow
Transcription:
Hip Replacement Surgery: Exploring Your Options
Melanie Cole (Host): Whether you've just begun exploring treatment options or have already decided to undergo hip replacement surgery, it's important to understand the different types of hip replacement and what they entail. My guest today is Dr. Scott Bigelow. He is an orthopedic surgeon at Lincoln Orthopedic Center. Welcome to the show, Dr. Bigelow. Tell us about some of the conditions of the hip that might require intervention and the pain that they cause. Who is most at risk for these types of issues with their hip?
Dr. Scott Bigelow (Guest): The most common cause of hip pain that would require a hip replacement is the wear and tear type of arthritis, or osteoarthritis, or degenerative joint disease. All these terms are used kind of interchangeably. That's by far the most common thing that we see. That's what is typically the wear and tear kind of "old age" situation. Other conditions include rheumatoid arthritis, avascular necrosis of the femoral head, femoral acetabular impingement are various things that we also see, but they're not nearly as common.
Melanie: And, who most commonly comes to you with problems like these?
Dr. Bigelow: Generally, the elderly population but we see it as young as patients in their 30s and 40s.
Melanie: So, what do you do first for them? If someone comes to you with osteoarthritic hip pain or one of these other conditions, what's the first line of defense?
Dr. Bigelow: Typically, there are several conservative things that we can do including non-steroidal anti-inflammatory medications, physical therapy, modifying activities, sometimes using a cane, weight loss, things of that nature.
Melanie: So then, if you've tried all of these things including physical therapy and medications, anti-inflammatories and none of these seem to work for the pain and affect the quality of life, then how do you decide with the patient what type of surgical intervention is needed?
Dr. Bigelow: Well, one of the things that I tell patients all the time is I don't decide when you're ready for hip replacement, you tell me. So, basically, when their symptoms have gotten to the point where they can't do the things that they like to do; when the conservative things aren't helping; a lot of times when it's affecting their sleep. Basically, when their quality of life has gotten to the point where they say "Okay, I'm ready to do it," then it's time.
Melanie: So then, tell us a little bit about the different types of hip replacement surgery and the minimally-invasive ways that hip surgery is now being used on some patients.
Dr. Bigelow: Okay. So, the traditionally hip replacement is the traditionally approach is from the side. The incision is on the side. The newer thing that is popular now is an anterior approach. Basically, we move the incision to the front and it avoids cutting muscles. So, we basically spread the muscles apart to do the job. With that, we are seeing quicker recovery from the patient standpoint.
Melanie: So, what would you like patients to do if they're going to do the anterior hip replacement? Would you like them to do pre-hab before the surgery? What would you like them to do to prepare?
Dr. Bigelow: The things that help are certainly being in good shape before; if you can lose weight, that's helpful; trying to make sure that everything is optimized from a health standpoint. So, if you're a smoker, we'd like to have you stop smoking; get all your dental work done that you need to beforehand, and just kind of get your health optimized before surgery.
Melanie: So, what's the recovery like? Because people hear about the difficulties with shoulder replacement or knee replacement, but hip replacement has been, over the years, a little bit of a faster recovery. Is that correct?
Dr. Bigelow: I would agree with that. I think most people have had say, a hip and a knee, would much prefer go through the hip before, and that's even with the traditional approach, as well as the anterior approach. So, most people, typically, with the hip, it's a couple of days in the hospital and then, most people are getting around pretty well after that. Depending on the patient, especially with an anterior approach, typically, we'll see them coming back to the office in two weeks to get their staples out not using anything to help them walk. They just walk in.
Melanie: Isn't that amazing? How soon can they resume exercise or sporting activities, things of that nature?
Dr. Bigelow: Again, it varies by the patients but it may be six weeks to eight weeks before you're getting back to doing a lot of the more vigorous activities.
Melanie: So then, how long does that hip last, Dr. Bigelow? Is this a lifetime thing, or might it have to be replaced?
Dr. Bigelow: All the hip replacements are mechanical devices. So, I always say if you last long enough, they're eventually going to wear out but the parts--the materials that we're using today--honestly, we don't really know how long they're going to last. The ones that we put in 20 years ago, over 90 percent of those are still working and I think the materials we use now probably are going to hold up longer than that.
Melanie: What about range of motion and scar tissue? Is this less likely with the anterior approach?
Dr. Bigelow: Typically, I think long-term, the range of motion and the results are going to be the same with the anterior approach and the traditional anterior lateral approach.
Melanie: So, what do you tell people about possibly developing scar tissue? Do they develop scar tissue after any type of hip replacement? Is there any limit to their movement as you see down the line?
Dr. Bigelow: Well, anytime you perform surgery, there's going to be scar tissue. That's how the incisions heal. That's how the tissue heals, by forming scar tissue, which isn't necessarily a bad thing. Again, that's how the tissue heals. So, as far as activity and range of motion, we really in the long term, don't really limit what they can do. I basically tell them I don't want them to put their foot behind their head but, other than that, whatever they feel that they can do, we'll let them do.
Melanie: That's fantastic. Dr. Bigelow, in the last few minutes, please give patients listening your best advice about their hips; the pain they might be experiencing; and when they should consider talking to a doctor about hip replacement surgery.
Dr. Bigelow: Well, I think it's important at some point to go and see a physician and get an accurate diagnosis so you know what you're dealing with. then, once you've spoken with your doctor that you've seen, you know what you're dealing with, then formulate a treatment plan and go forward with that.
Melanie: Thank you so much for being with us today and if you'd like more information about joint replacement surgery, you can go to bryanhealth.org. That's bryanhealth.org. You're listening to Bryan Health Radio. This is Melanie Cole. Thanks so much for listening.
Hip Replacement Surgery: Exploring Your Options
Melanie Cole (Host): Whether you've just begun exploring treatment options or have already decided to undergo hip replacement surgery, it's important to understand the different types of hip replacement and what they entail. My guest today is Dr. Scott Bigelow. He is an orthopedic surgeon at Lincoln Orthopedic Center. Welcome to the show, Dr. Bigelow. Tell us about some of the conditions of the hip that might require intervention and the pain that they cause. Who is most at risk for these types of issues with their hip?
Dr. Scott Bigelow (Guest): The most common cause of hip pain that would require a hip replacement is the wear and tear type of arthritis, or osteoarthritis, or degenerative joint disease. All these terms are used kind of interchangeably. That's by far the most common thing that we see. That's what is typically the wear and tear kind of "old age" situation. Other conditions include rheumatoid arthritis, avascular necrosis of the femoral head, femoral acetabular impingement are various things that we also see, but they're not nearly as common.
Melanie: And, who most commonly comes to you with problems like these?
Dr. Bigelow: Generally, the elderly population but we see it as young as patients in their 30s and 40s.
Melanie: So, what do you do first for them? If someone comes to you with osteoarthritic hip pain or one of these other conditions, what's the first line of defense?
Dr. Bigelow: Typically, there are several conservative things that we can do including non-steroidal anti-inflammatory medications, physical therapy, modifying activities, sometimes using a cane, weight loss, things of that nature.
Melanie: So then, if you've tried all of these things including physical therapy and medications, anti-inflammatories and none of these seem to work for the pain and affect the quality of life, then how do you decide with the patient what type of surgical intervention is needed?
Dr. Bigelow: Well, one of the things that I tell patients all the time is I don't decide when you're ready for hip replacement, you tell me. So, basically, when their symptoms have gotten to the point where they can't do the things that they like to do; when the conservative things aren't helping; a lot of times when it's affecting their sleep. Basically, when their quality of life has gotten to the point where they say "Okay, I'm ready to do it," then it's time.
Melanie: So then, tell us a little bit about the different types of hip replacement surgery and the minimally-invasive ways that hip surgery is now being used on some patients.
Dr. Bigelow: Okay. So, the traditionally hip replacement is the traditionally approach is from the side. The incision is on the side. The newer thing that is popular now is an anterior approach. Basically, we move the incision to the front and it avoids cutting muscles. So, we basically spread the muscles apart to do the job. With that, we are seeing quicker recovery from the patient standpoint.
Melanie: So, what would you like patients to do if they're going to do the anterior hip replacement? Would you like them to do pre-hab before the surgery? What would you like them to do to prepare?
Dr. Bigelow: The things that help are certainly being in good shape before; if you can lose weight, that's helpful; trying to make sure that everything is optimized from a health standpoint. So, if you're a smoker, we'd like to have you stop smoking; get all your dental work done that you need to beforehand, and just kind of get your health optimized before surgery.
Melanie: So, what's the recovery like? Because people hear about the difficulties with shoulder replacement or knee replacement, but hip replacement has been, over the years, a little bit of a faster recovery. Is that correct?
Dr. Bigelow: I would agree with that. I think most people have had say, a hip and a knee, would much prefer go through the hip before, and that's even with the traditional approach, as well as the anterior approach. So, most people, typically, with the hip, it's a couple of days in the hospital and then, most people are getting around pretty well after that. Depending on the patient, especially with an anterior approach, typically, we'll see them coming back to the office in two weeks to get their staples out not using anything to help them walk. They just walk in.
Melanie: Isn't that amazing? How soon can they resume exercise or sporting activities, things of that nature?
Dr. Bigelow: Again, it varies by the patients but it may be six weeks to eight weeks before you're getting back to doing a lot of the more vigorous activities.
Melanie: So then, how long does that hip last, Dr. Bigelow? Is this a lifetime thing, or might it have to be replaced?
Dr. Bigelow: All the hip replacements are mechanical devices. So, I always say if you last long enough, they're eventually going to wear out but the parts--the materials that we're using today--honestly, we don't really know how long they're going to last. The ones that we put in 20 years ago, over 90 percent of those are still working and I think the materials we use now probably are going to hold up longer than that.
Melanie: What about range of motion and scar tissue? Is this less likely with the anterior approach?
Dr. Bigelow: Typically, I think long-term, the range of motion and the results are going to be the same with the anterior approach and the traditional anterior lateral approach.
Melanie: So, what do you tell people about possibly developing scar tissue? Do they develop scar tissue after any type of hip replacement? Is there any limit to their movement as you see down the line?
Dr. Bigelow: Well, anytime you perform surgery, there's going to be scar tissue. That's how the incisions heal. That's how the tissue heals, by forming scar tissue, which isn't necessarily a bad thing. Again, that's how the tissue heals. So, as far as activity and range of motion, we really in the long term, don't really limit what they can do. I basically tell them I don't want them to put their foot behind their head but, other than that, whatever they feel that they can do, we'll let them do.
Melanie: That's fantastic. Dr. Bigelow, in the last few minutes, please give patients listening your best advice about their hips; the pain they might be experiencing; and when they should consider talking to a doctor about hip replacement surgery.
Dr. Bigelow: Well, I think it's important at some point to go and see a physician and get an accurate diagnosis so you know what you're dealing with. then, once you've spoken with your doctor that you've seen, you know what you're dealing with, then formulate a treatment plan and go forward with that.
Melanie: Thank you so much for being with us today and if you'd like more information about joint replacement surgery, you can go to bryanhealth.org. That's bryanhealth.org. You're listening to Bryan Health Radio. This is Melanie Cole. Thanks so much for listening.