Q1. What are some of the biggest mistakes patients make when starting physical therapy after total hip replacement?
One of the biggest mistakes patients make is that they try to do too much too soon and then get too sore to exercise. Usually, we recommend walking as the best form of exercise in the early postoperative period.
Q2. I heard my recovery time will be shorter if I undergo a mini anterior hip replacement surgery instead of the more traditional posterior method. Is that true, and is the mini surgery an alternative for anyone who has to have their hip replaced?
The studies show that the difference in recovery for a mini-anterior hip incision and a mini-posterior incision is minimal after the first three days. Not everyone is a candidate for the anterior approach and there are pros and cons regarding the anterior approach that should be discussed with your physician.
Q3. I have osteoarthritis in both hips and was wondering if it’s possible to undergo a double hip replacement or if the procedures need to occur separately.
It is possible to have both hips done the same day, but not everyone is able to do this. We have strict criteria for patients considering bilateral hip replacement, and they need to be cleared by a cardiologist and anesthesiologist before surgery.
Q4. My mother is 82, and her doctor has recommended total hip replacement. She’s generally in good health otherwise. What are the risks and alternatives to her having surgery?
The major risks for surgery are infection, dislocation, blood clot, and leg length discrepancy. Healthy patients should tolerate surgery in spite of their age, especially when the surgery is performed with regional anesthesia. HSS has one of the lowest infection risks in the country. Alternatives to surgery include medications or injections which can mask the pain but not cure the arthritis.
Q5. What are the alternatives to hip replacement surgery? Are there some cases where replacement surgery is the only option?
Alternatives to surgery include medications or injections which can mask the pain but not cure the arthritis. Physical therapy is usually not helpful in late stage arthritis. Arthroscopic procedures may be helpful in impingement and labral tears but usually don’t help with arthritis. Often, hip replacement is the best option for improvement in quality of life for the patient.
Dr. Mark P. Figgie is an orthopedic surgeon at Hospital for Special Surgery and Chief of the Surgical Arthritis Service. He is one of the leading experts in joint replacement for inflammatory arthritis and performs more than 500 surgeries a year. His training in engineering and biomechanics has helped him become instrumental in the design of implants for elbows, knees, and hips, including the design of custom implants.