Formed by the ball of the thighbone and the socket of the pelvis, the ball-and-socket hip joint is one of the largest weight-bearing joints in the body. To provide support and flexibility, ligaments connect the components of the hip joint together. Both the ball and socket are covered with cartilage, a smooth tissue that acts as a cushion and protects the bones during movement.
The hip endures large amounts of stress during basic movements, such as walking. Damage to any of the hip components can result in severe pain symptoms that may significantly impact everyday life.
Causes of Hip Pain
Arthritis is the most common cause of hip pain, and osteoarthritis is the most common types of arthritis affecting the hip.
Osteoarthritis is a progressive joint disease that causes the cartilage that cushions the joints to decrease, exposing the bones to increased friction and potential surface damage. For many younger patients the arthritis starts as a very subtle deformity in the shape of the hip socket during their growth years. Arthritis can also result from trauma or certain diseases.
As arthritis progresses, the protective cartilage of the joint slowly wears away, either due to inflammation or natural friction. This exposes the bone surfaces of the joint so that they begin to rub together, resulting in increasing pain and joint stiffness.
Symptoms and Non-Surgical Treatment of Hip Arthritis
Patients suffering from arthritis of the hip will experience one or more of the following symptoms: a constant dull aching pain, decreased range of motion and flexibility, or weakening of the affected hip joints. Additional symptoms include limited mobility and locking of the joint, and as symptoms progress, patients may be unable to complete even basic tasks.
During the early stages of arthritis, the majority of patients are able to manage pain symptoms and slow the progression of the disease with a combination of the following treatments:
- Rest & activity modification - avoiding actions that cause joint pain
- Physical therapy & strengthening exercises - strengthening the muscles that support the hip to reduce its weight-bearing responsibilities
- Anti-inflammatory medications - use of medications that aim to relieve joint pain, including aspirin or ibuprofen
- Weight loss – reducing the amount of stress placed on the hips
For patients suffering from severe symptoms or patients whose symptoms persist even with conservative treatments, Dr. Pritchett will often recommend hip replacement surgery to help patients return to their normal life.
Total Hip Replacement Surgery Options
To determine the best surgical approach for relieving pain symptoms and returning joint function, Dr. Pritchett will complete an in-depth evaluation of the location and severity of joint damage. Patients suffering from severe arthritis of the hip, who continue to suffer from increasing pain symptoms even with the use of conservative treatments, or who have a decreasing range of motion and flexibility will often receive the most benefit from total hip replacement surgery.
During total hip replacement surgery, Dr. Pritchett uses the latest techniques to remove the damaged bone and cartilage on both the ball and socket of the hip joint. The damaged areas are then replaced with a metal, ceramic and plastic prosthesis designed to recreate the natural movement of the hip joint.
By using sophisticated surgical techniques, Dr. Pritchett can typically decrease the amount of disruption caused to the surrounding tissue during surgery, as well as create a more natural placement of the prosthesis. Depending on the patient’s needs and condition, Dr. Pritchett may recommend either the superior approach or the anterior approach.
Superior Approach to Total Hip Replacement
The superior approach to total hip replacement decreases pain from hip replacement and allows patients to recover from surgery without any restrictions on activity. During traditional hip replacement surgery, patients may not achieve a full and stable range of motion postoperatively. Using the superior approach, Dr. Pritchett will allow and encourage a full range of motion from the very start. Accessing the joint through the front reduces the chance of a hip dislocation to very unlikely. Due to the many benefits of the superior approach, Dr. Pritchett will use this advanced technique whenever possible.
The advantages of the superior approach include:
- Decreased length in hospital stay and freedom of movement
- Limited postoperative pain
- Minimal blood loss, eliminating the need for transfusion
- Better ability to perform high quality intraoperative imaging
- Decreased risk of dislocation and more natural-feeling joint placement
Anterior Approach to Hip Replacement
With the anterior approach, Dr. Pritchett makes an incision at the front of the hip. He may select this approach if there is a significant flexion contracture or if the patient has an anterior scar from prior surgical procedures or prior femoral artery catheterization. Like the superior approach, the anterior approach provides great stability to the hip, with a lower risk of dislocation after surgery. Intraoperative radiographs are also easier to obtain with the anterior approach, if necessary.
Recovering from Total Hip Replacement
Hip replacement surgery is performed as outpatient procedure for most patients. There are very occasional circumstances where an inpatient stay is advised. All patients, whether they are inpatient or same day patients meet the established discharge criteria prior to release. Immediately following surgery, patients will to learn how to use their new joint by practicing basic strengthening and walking exercises.
Upon returning home, patients will typically use a walker or crutches just for safety and balance, as they will be able to walk with full weight on their leg. By following a custom exercise regimen determined by the physical therapist and Dr. Pritchett, patients are typically able to return to their favorite recreational activities just weeks post surgery. Patients can typically begin driving and return to work after 2 weeks.
Total Hip Replacement in Seattle, WA
Dedicated to using the most advanced techniques, James W. Pritchett, MD is one of Seattle’s leading orthopedic surgeons. Dr. Pritchett specializes in the diagnosis and treatment of severe hip pain, including hip replacement. To learn more about Dr. Pritchett’s joint replacement specialties, schedule an appointment with Dr. Pritchett at his Seattle office at (206) 323-1900.