A boon for boomers: many ways to replace a hip
We're living longer — many of us can expect to be around into our 90s and beyond. We're playing harder — grandmothers are rollerblading; grandfathers are running marathons. And, we're demanding a higher quality of life. The rub is this: Though our enthusiasm for life may be endless, our joints wear out a lot sooner.
A major culprit is osteoarthritis, a degenerative joint disease where the protective cartilage covering the ends of our bones progressively wears away. The result: bone starts to rub against bone, and this causes pain — sometimes excruciating — and stiffness in the hips, knees and other joints. Some people with severe osteoarthritis are so disabled, they can barely walk across a room, climb stairs or even fall asleep without great discomfort.
Physicians usually first offer these patients conservative remedies to control pain. Among them are medications, exercise, weight management and rest. If, over time, non-surgical treatments do not work, the surgeon may suggest a total hip replacement.
Different procedures for different folks
Gerald Hayken, MD, chief of orthopaedic surgery, Virtua Memorial Hospital explains: "In a total hip replacement, the diseased portion of the hip bone and cartilage is surgically removed and replaced with an artificial part called a prosthesis. The type of surgical technique and prosthesis a surgeon uses depends on the severity and type of problem, a patient's age, body size and level of activity along with other health issues."
Then there is the issue of holding the prosthesis in place. Robert Taffet, MD, orthopaedic surgeon at Virtua West Jersey Hospitals, explains: "In the past, our only option was to use cement to hold the metal parts of the joint in place and, in rare instances, we still use this method. But now, we primarily concentrate on a method whereby the implant is coated with a sandpaper-like surface. The bone is attracted to this surface and molds with it, creating a single unit.
New, high-tech parts and techniques
"We've come a long way since ivory billiard balls replaced diseased hip balls in the early 1900s," says Brian Zell, MD, orthopaedic surgeon, Virtua West Jersey Hospitals. Today, the standard artificial hip prosthesis is a metal ball placed into a plastic hip socket. For younger individuals, those under 50, we might use the most recent innovation: a ceramic-on-ceramic prosthesis where a ceramic hip ball fits into a ceramic socket. Although it is more costly, the ceramic prosthesis lasts a longer time, making it ideal for patients in their 40s and 50s.
There's also a new minimally invasive hip replacement technique. Here, the surgeon makes two incisions as small as two inches each, instead of the standard eight to 10 inches. Scott Schoifet, MD, orthopaedic surgeon and medical director of the Total Joint Replacement Program at Virtua, explains: "This new procedure means shorter hospital stays, less scarring, reduced pain during rehabilitation, and a faster return to daily activities." Dr. Schoifet recommends the procedure for a specific group of people. He says: "People should be under age 75, have good bone quality, normal hip anatomy and weigh less than 200 pounds."
Regardless of the approach, the goal of all total joint replacements is to relieve pain and to get people back to doing the things they enjoy. The Virtua Total Joint Replacement Program offers a continuum of leading-edge surgical, nursing and rehabilitative care — all right here in South Jersey, close to home, family and friends. For more information or to schedule an appointment with a Virtua orthopaedic surgeon or rheumatologist, call 1-888-Virtua-3.