Amanda Wilde (Host): This is Woodlawn Health Doc talk. I'm Amanda Wilde, your host, joined today by orthopedic surgeon, Dr. Jeffery Sheedy from Woodlawn Health. We're talking about hip replacement surgery. We will cover prevention procedures and post-op secrets that can help you make more informed health decisions. Dr. Sheedy, welcome.

Jeffery Sheedy, DO: Thanks for having me.

Host: Let's start with prevention, just before we talk about actual hip replacement. Are there lifestyle changes or preventive measures people can take to avoid needing hip surgery in the future?

Jeffery Sheedy, DO: I think an active lifestyle is probably the number one preventative thing for medicine. You know, with walking be a good exercise or swimming or whatever makes the individual enjoyment. To do something on a regular basis, you have to enjoy it. So, I think each individual has to find what activity is good for them and that they can maintain to keep their legs strong and their body weight down as much as they can. And I think that's probably, along with a good nutrition, the best form of medicine in preventing joint replacement or joint arthritis in general.

Host: That's interesting, because I guess as a lay person, my impression has always been that it's overuse that causes the need for joint replacement.

Jeffery Sheedy, DO: Well, clearly, injury can add to that. Overuse can. Also, sedentary lifestyle can lead to it as well. So, I think you do want to be as active as you can be in a productive and safe manner.

Host: Could you share if there are some common signs that might indicate someone might need hip replacement surgery?

Jeffery Sheedy, DO: I think pain is generally the number one indicator. Hip pain is typically, though not always, felt more in not only the hip area, but into the groin. Many times, that starts out in the very beginning of the day, eases up through the day, and then gets worse near the end of the day.

If there's pain waking you up at night in that area, it is probably something that you definitely need to get checked out because that's probably a sign of being more advanced than just a little discomfort with extensive use.

Host: At what point should someone experiencing hip pain reach out to a specialist like you? You're an orthopedic surgeon.

Jeffery Sheedy, DO: I would say when it starts to interfere with your normal life, if you're having pain during activities of daily living or you're limiting the things like grocery shopping. You know, if you can't walk the grocery store or spend that quality time with your family because you are having pain and they're going out and doing fun things and you are not able to due to the joint pain, then I think it's time to get to the orthopedic specialist and have it checked out.

Host: Could you please walk us through the highlights of the hip replacement surgery process? And I don't mean the highlights like "Yay," but the postoperative steps people should take, and then kind of what the surgery process is, and then maybe some follow-up.

Jeffery Sheedy, DO: In terms of joint replacement itself, the process is intimidating, of course. When you're looking at joint replacement and as I shared with you earlier, I had my own hip replaced and it's something I do on a daily basis, and yet it was still intimidating for me. So, sort of back to what we talk about preparing yourself with proper nutrition, keeping your legs as strong as you can is always helpful.

When it comes to joint replacement, people don't realize how important upper body strength is when you are preparing for surgery. So, there's been a greater focus lately on prehabilitation, meaning preparing yourself for surgery. And we typically have the therapist evaluate someone even before surgery so that they are prepared for what's coming. So, it's not only important on the back end where we rehab after surgery. I think it's important to prepare your body on the front end as well.

Host: Can you explain what the process is of hip replacement in a sort of brief way? Give us the rough outline.

Jeffery Sheedy, DO: Yeah, I don't want to scare some of our viewers away, right? I think there is a misconception. Because when we say replacement, I think that what I'm finding with the patients is that brings to mind a huge removal of the hip. We call it arthroplasty, which is a fancy way of saying we really kind of resurface things. We are removing all the arthritis and only replacing the portions that we have to remove to eliminate the arthritis.

So, many people, when I show them in the office about what the implants actually look like and what we actually do, are a little relieved because I think the perception of replacement is very large incisions, very drastic replacement of our body. And it's really closer to a resurfacing. But we are obviously placing metal and plastic in the place of bone and cartilage.

Host: So, maybe we should call it hip restoration. That sounds more positive.

Jeffery Sheedy, DO: Yes, it certainly does.

Host: What kind of follow-up is needed after the surgery in terms of post-op visits or physical therapy?

Jeffery Sheedy, DO: Well, joint replacement is becoming an outpatient procedure. I went home the same day of my hip replacement. Many people are. So if there's not really medical reasons to monitor you more closely, most people are going home the same day, next day latest. And we are walking right away. And that's the design. And people actually reduce their risks of complications by early mobilization and getting us back to their normal lifestyle as soon as possible.

Having said that, there is, of course, pain associated that needs to be controlled. So, most people are going home sam day, next day, coming to the office in a week or two afterwards, and then again after about six weeks. And I found this out for myself, it takes a full year to 100% completely recover from a joint replacement where you never even think about your knee or hip being replaced. And you're back to all activities doing whatever you want without limitation or difficulty.

Host: So, a typical recovery period, you need to give it at least a year for full recovery.

Jeffery Sheedy, DO: Absolutely. Now, there'll be the lucky ones who feel like within months they're a hundred percent, but the typical patient takes a full year to completely recover.

Host: And after that year or so, what do you see as the primary benefits patient's experience after having a hip replacement?

Jeffery Sheedy, DO: I think it's restoration of their lifestyle. All the things that they stopped doing over the years. The ones I hear like, "I can't even walk with my wife along the beach. It hurts too much," or "My family went for a little hike, and I had to sit down and wait for them to come back down" or "I used to go shopping with my wife, and now I can't do that." I think it's restoration of their previous lifestyle that is the number one benefit and longevity. We know that you have to be active to live a long and comfortable life.

Host: Dr. Sheedy, are there any specific conditions that might make someone unsuitable for hip replacement?

Jeffery Sheedy, DO: Typically, most people can have a replacement. There may be some people that are more challenging and at a little higher risk. But the benefit is still there for most people. I can't think off the top of my head of anything that is an absolute disqualifier for getting your joint replaced other than medical conditions that are so severe that any surgery would place undue risk of upon the patient.  

Host: This is a kind of funny thought, but if a patient has surgery on one hip, is it more or less likely that they might need surgery later on the other hip?

Jeffery Sheedy, DO: I see both, where there's people who come in and they already have arthritis in both hips, but only one is hurting. And then, many times replacing the one that's hurting buys them, I think, more time for the one that's already showing some signs, but not really showing some symptoms. So many times you do benefit from getting the painful, more advanced joint replaced and get more time out of the less advanced and asymptomatic joint.

Host: You mentioned patients can go home much more quickly these days. What are the recent advancements you've seen in hip replacement surgery, say, in the last five to ten years?

Jeffery Sheedy, DO: Clearly, the implants that we use, the technology on those just keep getting better. You know, in many instances, we're using robotic assistance and computer navigation. And then, there's some medicines that reduce blood loss for folks that are helpful as well. And our techniques, I just think, keep getting better and more refined. That's really added to that early mobilization and outpatient-type joint replacement.

Host: Dr. Sheedy, thanks for all this insight and useful information for those of us contemplating hip replacement. And thanks for all you do to help patients get their lives back.

Jeffery Sheedy, DO: Thank you for having us on.

Host: That was orthopedic surgeon, Dr. Jeffery Sheedy from Woodlawn Health. For more information about Dr. Sheedy and his team, visit woodlawnhospital.org/orthopedics. If you enjoyed this podcast, please share it on your social channels and check out the entire podcast library for topics of interest to you. This is Woodlawn Health Doc Talk. Thanks for listening.