Not your mother's hip surgery

Arthritis Today—August 16, 2017

In a feature story by Arthritis Today, HSS hip and knee surgeon Michael B. Cross, MD and HSS surgeon-in-chief emeritus Thomas P. Sculco, MD discussed recent medical advancements in hip replacement surgery.

In the past, most patients underwent general anesthesia for surgery. Dr. Sculco said that now "we use epidural or spinal anesthesia and rarely if ever general anesthesia. This makes a huge difference in patient rapid recovery." The use of regional anesthesia decreases the need for pain medication, and helps patients start physical therapy on the same day of surgery.

Another advancement is that surgeons make smaller incisions during surgery today than what was done in the past. Surgeons use smaller incisions to avoid damaging muscle so patients can recover more quickly said Dr. Cross.

"It’s not the approach that leads to the rapid recovery, it’s the surgeon, the pain control, the implant choices," he added.

Additionally, better plastics, such as highly cross-linked polyethylene, have made implants last longer. Dr. Sculco noted that the new plastic coatings of the hip implant encourage the bone to integrate with the implant surface and improve fixation.

Patients of Dr. Cross were featured in the article and shared their positive experiences with hip replacement surgery.

Mark Donovan said he needed both of his hips replaced after developing bone-on-bone osteoarthritis. After each surgery, Donovan was able to get out of bed right away. "From the time I woke up…they had me out of bed, and I walked maybe 100 yards with a walker in the recovery room." Mr. Donovan was back to work within 10 days.

Another patient, Elizabeth Walters, said she also was able to get up right away after hip replacement surgery. "Even the first time you get up, that bone-on-bone pain you’ve been living with is gone." Two months after surgery, Ms. Walters was walking two miles a day.

Raymond Carr experienced so much hip pain that he wasn’t able to sleep.  After his hip replacement, "the pain level was very manageable". Within six weeks, he was back to walking up seven flights of stairs to his office and playing a round of golf.

Dr. Cross noted that all of the medical advances combined have led to a better patient experience for joint replacement.

This article appears in the October 2017 print issue.