Hip Replacement Surgery: Myths, Choices and Outcomes

Sept. 6 seminar to address these issues and more

On Tuesday, Sept. 6, at 6:30 p.m., orthopedic surgeon John Dearborn, MD, FAOSS, will present a virtual talk, “Don’t Let Hip Pain Win: Updates in Hip Replacements.” Dr. Dearborn founded the Joint Replacement Program at Washington Hospital Healthcare System in 1999, where he performs more than 400 hip replacement surgeries each year.

During the talk, Dr. Dearborn will address some of the myths about hip replacement surgery, discuss the role of pain management in recovery, and recommend how to choose a surgeon.

“Over the past three decades,” says Dr. Dearborn, “hip replacement surgery has become one of the most reliable orthopedic procedures for patients with severe arthritis in their hips. The success of this procedure has been further enhanced by modern techniques that have evolved to minimize pain, blood loss, and the amount of time spent in the hospital.”

The hip joint is a ball and socket where the femoral head (the ball) moves within the acetabulum (the socket). The surfaces of the joint can become damaged due to arthritis, fractures, or other conditions, resulting in pain and limited mobility. Hip replacement surgery involves removing the damaged sections of bone and replacing them with implants that can restore both the structure and function of the hip.

Originally, the useful life of an implanted hip was 20-30 years at most, so the procedure was generally recommended for people over the age of 50. With the advent of cross-linked polyethylene in 1999, hip replacements are now expected to last much longer.

Pain management plays a key role in recovery

Now that reliable implants can last a lifetime, the focus in hip replacement has shifted to improving pain management on the day of surgery and thereafter. The development of rapid recovery protocols has resulted in shorter hospital stays and faster recovery.

Dr. Dearborn explains that managing surgical pain has come a long way since the development of hip replacement surgery in the 1960s and the launch of the Joint Replacement Program.“We used to use epidural anesthesia, similar to what was used on Labor and Delivery, and left the epidurals in overnight. The epidurals worked beautifully for pain control but delayed patients from getting up and walking with physical therapists.”

“Today,” he continues, “we use a spinal anesthesia, which does not require an indwelling catheter. We give patients light opioids and anti-inflammatory medications preemptively, allowing our patients to get up within a couple of hours after surgery and be comfortable doing so.” With this approach, patients often go home on the day of surgery, or the following day.

Surgical methods - There is no one best

Various surgical techniques have been developed to improve outcomes in hip replacement surgery. The traditional approach used a large incision extending over the back of the hip joint. Several less invasive methods have become popular in the past 20 years, all employing shorter skin incisions and less muscle damage. Nationwide, the leaders are the mini-posterior and the various anterior methods. The mini-posterior approach uses a lateral incision. The anterior approaches use an incision on the front.

But Dr. Dearborn comments that “there’s no magic in any one of these techniques. The perioperative pain management protocols have a greater effect on early recovery and length of hospital stay. Many studies have been done comparing the less invasive approaches, and the recovery speeds of all of them are similar, but all provide a quicker rehabilitation than the traditional methods. Our aim is to use a method that will best help the patient get back to their normal lifestyle quickly, with the least amount of risk.”

Choosing the “right” physician

Dr. Dearborn suggests that people considering hip replacement surgery do some research prior to deciding where to have the surgery and who will perform it. “You definitely want someone with a lot of experience,” he notes. “It’s true that the more you do something the better your outcomes.”

Websites such as Healthgrades.com has greatly increased the transparency of outcomes and complication rates of hospitals. Dr. Dearborn adds, “You want someone you can trust, a physician-partner that you feel comfortable with.”

Join the seminar – learn more

The Sept. 6 seminar is available to view live on Facebook by signing into an account and going to the facebook.com/WashingtonHosp page. A live view on YouTube is also available at YouTube.com/whhsInHealth and does not require an account.

Questions can be submitted in advance by emailing: CommunityOutreach@whhs.com. Facebook viewers can submit questions live and they will be addressed at the end of the seminar. This seminar, like many previous presentations, will be featured on their YouTube channel the following day.

If you would like more information about the Institute for Joint Restoration and Research at Washington Hospital, visit IJRR.

To watch “Don’t Let Hip Pain Win: Updates in Hip Replacements” seminar on our YouTube InHealth channel, click here.