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Step Back to the Beat of Life
Specialty Orthopaedics

Spotlight on Hip Pain

Dr. Zelicof“Beyond pain relief, I think it's the desire to return back to an active lifestyle – go back to your job or sport, whether it be tennis, soccer, what have you. Those are the things that our patients really want to go back to.”

Dr. Zelicof, Cormet Hip Resurfacing Trained Surgeon

On the Acceleration of Hip Pain Treatments

“We've seen a whole new wave of opportunities, in terms of helping our patients get better. The initial advent of hip replacement came about around the mid-1960s, has been popularized, and there have been huge advancements in terms of hip replacement surgery. But with the advent now of improved bearing materials – things like ceramics, better implants, stems, cups, as well as the advent of hip resurfacing – we've really been able to address our patients needs.”

Raising the Bar for Hip Pain Treatment

“I think the thing that has changed most over the past decades is that our patients' demands have changed. Everybody initially came in with a painful joint, and their goal was pain relief, and it still is. But beyond pain relief, I think it's the desire to return back to an active lifestyle – go back to your job or sport, whether it be tennis, soccer, what have you. Those are the things that our patients really want to go back to, at this point. They've raised the bar in terms of what they ask of us surgically. Instead of having to tell them "no – you can't do that," the implants that we now have available to us, and the surgical procedures that we have available to us, really allow us to take care of our patients and get them back to the activities that they so strongly desire.”

Part 2: Hip Resurfacing vs. Hip Replacement

Osteoarthritis

To tackle the question, it first comes down to what “hip arthritis” is. Arthritis is basically an inflammation of the joint. What happens is that when you're born, you have a thick layer of cartilage (the lining of the hip) that is on the ball of the hip and socket. As time goes by, that lining wears away. So instead of having cartilage-on-cartilage, you have bone-on-bone. As the bone-on-bone starts coming into play, you end up with loss of motion as your hip becomes stiffer. You may have difficulty putting on your shoes and socks, crossing your legs, and carrying out many of the activities you may take for granted. Additionally, you have pain. The pain that's associated with hip arthritis tends to be mostly in the area of the groin and buttock area, and occasionally can radiate down toward your knee.

Patients come in with varying stages of arthritis, and will usually present with pain and will seek advice of the doctor. We'll get an x-ray that will show the changes with the narrowing of the joint.

Non-surgical Treatment Options for Osteoarthritis

At that point, you end up with an option: the option in terms of treatment comes down to physical therapy, more exercise, medications, things of that nature. You have to keep in mind that there's no such thing as a small operation. There are risks involved with anything you're going to do. You certainly don't want to jump into something. But when you've tried all these other things and you still have pain, it's important to keep in mind that you don't have to live with pain.

People that I take care of in their 30's / 40's / 50's say, “Doctor, am I too young to have surgery?” and my answer to them is “You're too young not to!”

This is a great operation to get you back to doing the things you want to do, but putting it off a year or two won't change anything. We come up with a decision how we want to take care of them.

Total Hip Replacement

One of the options historically has been total hip replacement, where we take the ball away from the hip and we put in a prosthesis, which is made out of metal - usually titanium, cobalt or chrome. There's a ball that's placed on top of the stem, made of metal or ceramic. There's a socket that's made out of titanium that's put inside the pelvis that oftentimes has a plastic or metal bearing inside of it. Hip replacement is a great operation - maybe the greatest operation of the 20th's century in terms of its reproducibility and its attempt to get people back to an active lifestyle.

Hip Resurfacing

What's become available to us over the last 5 - 10 years is hip resurfacing. It was popularized in England and recently brought to this country. Hip resurfacing works much like capping a tooth. Instead of removing the tooth, we actually put a cap on it. The same thing happens with hip resurfacing - instead of removing the bone from the ball of your hip, we're actually putting a metal cap on top of your hip and putting a metal cap inside of your socket. So instead of replacing your hip we're actually resurfacing it.

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