May 12, 2021

How Do You Know If You Need A Hip Replacement?

Hip pain should never be ignored, especially if it begins to interfere with your normal daily activities. Trying to figure out when is the right time to seek medical attention can be overwhelming. Which doctor do you call for an opinion? Is there a doctor near me that I can make an appointment with? Do I question if I may need a hip replacement? Anyone dealing with ongoing hip pain should start to wonder about possible conditions and treatments.

The most common hip pain is known as hip osteoarthritis (OA). This is the gradual wear and tear of the joint, which leads to hip replacement surgery. Each year, several hundred thousand in the U.S. will undergo a hip replacement. OA is slightly higher in women than in men and increases with age. Usually, it is offered for people between the age of 60 and 80 who have weak thigh bones. But occasionally, it is performed in teens and young adults in their early twenties.

There are three different types of major hip replacement surgeries:

  • Total hip replacement, also called total hip arthroplasty, is the most common of the three.
  • Partial hip replacement, called hemiarthroplasty, replaces only one side of the hip joint.
  • Hip resurfacing is most common in younger people.

If you are experiencing hip pain and are wondering if you might need a hip replacement, some signs could indicate you possibly do:

  • Intense hip or groin pain prevents you from participating in everyday activities or even sleeping all night.
  • Sudden swelling in your problem leg.
  • Alternative tried treatments that did not help alleviate the pain.
  • Stiffness in the mornings makes it difficult to put on socks and shoes.
  • Unable to perform the “one leg test” for at least a minute.
  • Develop a limp due to pain.
  • Joints begin to appear deformed.

Pain around the hip or groin area is one of the major indicators you have hip joint problems. The pain will feel dull, achy, and severe enough to cause you to limp. You may even rely on medication to cope with the pain. If you develop stiffness in the morning or after sitting for long periods, your range of movement may also become affected. You may even start to feel your hip click or grinding as you move.   

So, how does an Orthopedic Surgeon diagnose someone with hip osteoarthritis? They may have you do the one-leg test where the doctor will instruct you to flex as though you are taking a marching step while arching your back into extension. This is performed on both legs to assess the pain on each stance. You will also be required to test for pain through medical imaging:

  • An X-ray is performed to reveal an excess of bone on the femoral head or neck, which is the highest part of the thigh bone, and the acetabular rim that surrounds the femoral head.
  • Magnetic resonance imaging (MRI) is critical because it can reveal the labrum tears, which is the piece of cartilage that follows the outside rim of the hip joint socket.

If hip replacement surgery is necessary, your doctor may require you to make a few changes to better prepare for post-surgical recovery. People who go into surgery healthier tend to have a better recuperation period. Taking the proper steps to prepare for before and after the surgery can make the whole experience less stressful.    

  • Lose excess weight to help decrease complications and infection.
  • Quit smoking since nicotine can slow down blood flow.
  • Avoid blood thinners.
  • Stretch and strengthen muscles around your hip area.
  • Adjust the height of your bed to make getting in and out easier.
  • Have ice packs to be ready to use cold therapy to help relieve pain.
  • Arrange to have a walker, crutches, or cane available for use.
  • Remove possible tripping hazards such as electrical cords and loose rugs.
  • Find someone to drive you around as needed since you will not be able to drive for a few weeks after surgery.

Hip replacement surgery will take approximately 1.5 to 2 hours. First, you will be given either a spinal anesthetic where you are awake but have no feeling or a general anesthetic that will put you to sleep. Next, the surgeon will make an incision to remove the damaged bone and cartilage to be replaced with the artificial socket joint. The skin will then be closed with sutures, staples, or surgical tape. You will be set up with a physical therapist within 24 hours for rehabilitation. Now your recovery begins.  

After hip surgery, you will be restricted from doing normal daily acts for 6 to 8 weeks:

  • No crossing your legs at the knees.
  • Do not bring your knee up higher than your hip.
  • Watch not to turn your feet inward or outward when bending down.
  • Do not try to pick up things off the floor.
  • Do not lean forward when you go to sit down.

As daunting as hip surgery can be, choosing a qualified specialist to oversee your procedure and recovery is key. If you wait too long, the surgery will be less effective. In addition, as your joint deteriorates and mobility lessens, your health will get worse.  Dr. Paul Buzhardt is a medical doctor who practices in Acadiana since 2016. His focus is in Orthopedic, where he specializes in robotic and minimalist hip and knee replacements.