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Frequently Asked Questions About Arthritis of the Hip

What is arthritis and what causes it?

Arthritis is an umbrella term for a number of disease entities in which the joints become inflamed and the cartilage that lines the bones deteriorates. Eventually, bone on bone wear occurs. As the disease progresses, patients often experience pain, stiffness, and disability. The vast majority of people diagnosed have osteoarthritis and in most cases the cause of their condition cannot be identified. One or more joints may be affected. Rheumatoid arthritis (and other forms of inflammatory arthritis) is a disease that affects the entire system and multiple joints. This type of arthritis is an autoimmune disorder in which the body perceives the cartilage to be a foreign substance and attacks it.

If I have arthritis in one hip, will I get it in the other?

If you have been diagnosed with osteoarthritis, having an affected hip does not mean that you will develop arthritis in the opposite hip. In contrast, patients with rheumatoid arthritis often develop problems in both hips.

Can I have joint replacement on both hips at the same time?

Yes, healthy patients younger than 75 years old, with no cardiopulmonary disease, may be candidates for such surgery. Your orthopedist can tell you more about what is involved.

What is a prosthetic hip made of?

The implant for a total hip replacement is composed of 3 parts: the stem, the ball, and the socket. The stem is made out of metal, usually cobalt-chrome or titanium, and is placed within the native thighbone. The ball is usually made out of polished metal or ceramic, and fits on top of the stem. The socket is usually a combination of a plastic liner and a cobalt-chrome or titanium backing.

Will my new hip set off the metal detector at the airport?

While hip implants generally do not set off metal detectors, more sensitive machines may register the presence of the implant. Some physicians give their patients cards to show at the airport that explain that the bearer has received a hip implant containing metal.

How soon after surgery can I resume driving?

Most patients can resume driving at 2-3 weeks after surgery if off of narcotic pain medication.

How long will the replacement last?

Current studies indicated that about 80% of prostheses will function well for 20 years. If your prosthesis wears out you may be a candidate for a second hip replacement. Most replacements are modular so that if the plastic bearing wears away it can often times be replaced without revising all the parts of the hip.

What is the anterior approach to hip replacement?

The anterior approach to total hip replacement (sometimes called the “mini-anterior approach” or “muscle-sparing hip replacement”) has emerged recently as an alternative to the more popular posterior approach.

This procedure involves the surgeon making an incision through the front of the leg, rather than the back (the entry point for the more conventional posterior hip replacement surgery). The anterior hip replacement may result in a swifter recovery and shorter hospital stay for patients. However, the improvements only last for several weeks at which time both anterior and posterior approaches are equal in terms of function and pain.

Due to the different nature of the approach, there are fewer but different precautions to follow to prevent dislocation.

Disadvantages to the mini anterior hip replacement are both practical and medical. For medical experts, a special operating table or specialized retractors and specific tools are required. Patients also run a slightly higher risk of experiencing femoral and ankle fractures if the special table is used. In addition, due to the approach, there is a substantial risk of a numb, tingling or burning sensation along the thigh, referred to as lateral femoral-cutaneous nerve damage. Patients who have implants or metal hardware in the hip from prior surgery, those who are muscular, those who have a wide pelvis, or those who are very obese may not be well-suited for this procedure and if they do undergo it, it may require longer incisions.

It is important to note that the results of total hip arthroplasty are outstanding in terms of relief of pain and improvement in function. There has been, to date, no clinical study demonstrating the superiority of one surgical approach over another. The possible short term benefits of one surgical approach over another must always be balanced with the possible untoward side effects unique to that approach.

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