Osteoarthritis, or degenerative arthritis, is a wear and tear disease that affects joint articular cartilage. The articular cartilage is worn away, creating painful bone-on-bone contact. As osteoarthritis becomes more severe, the joint loses range of motion, becomes increasingly painful, and may stop responding to conservative non-surgical treatment. It is at this point that hip replacement surgery becomes an option for restoring motion to the affected joint and decreasing pain.

The most common symptoms of osteoarthritis are:

• Severe hip pain, usually in the groin, that limits everyday activity
• Hip pain at night causing sleeplessness
• Chronic swelling of the hip with morning stiffness
• Grinding pain during movement

• Health and activity history
• Range of motion limitations
• Observation while walking or standing

• X-ray(s) taken while standing

Some of the most common treatments include assistive devices such as walkers or canes. If a patient with osteoarthritis is overweight, weight-loss may be recommended to reduce the amount of stress placed on the joints. Physical therapy may also be used to help reduce joint pain and increase range of motion. Nonsteroidal anti-inflammatory medications, pain medications and/or cortisone injections may also be used to reduce joint pain. When these treatments fail to alleviate the painful symptoms of osteoarthritis, joint replacement maybe recommend.

There are several indications for total hip replacement including rheumatoid arthritis, osteoarthritis, arthritis resulting from previous injury to the bones in the joint, various bone deformities, direct trauma to the joint (such as a fracture), and avascular necrosis (lack of blood supply that leads to bone death).

• Assistive devices such as a cane, or a walker may provide some pain relief.
• Exercise or physical therapy to strengthen the muscles around the affected joint(s), possibly providing relief from pain while improving mobility and function.
• Medical management including nonsteroidal anti-inflammatory medications or steroid injections to reduce painful joint inflammation and restore function.

The average age for hip replacement is 65-80 years; however, hip replacement is indicated at younger ages when other disease processes occur and over 80 years of age in a relatively healthy, active patient.

• Surgical incision approximately 4-6 inches on the side of your affected hip.
• Length of surgery will be approximately one and a half to two hours. Preoperative care and time spent in the recovery room can add an additional 2-3 hours before you are back in your hospital room.
• Rehabilitation and walking begin the day after surgery.
• Hospital stay is normally 3 to 4 days.

Exercise is necessary for proper healing. Therapy is recommended to assist you with gentle leg movement, strengthening, and mobility exercises between 24 and 48 hours after surgery. Formal physical therapy may begin in the hospital and usually continues after discharge for approximately 6 weeks.

Patients with total hip replacement can typically participate in low-impact activities after surgery. Golf, walking, and swimming are a few examples of low-impact activities. Talk to Dr. DeLee before participating in any activity.

Yes.

• Do not cross legs or ankles when sitting, standing, or lying down.
• Keep knees below hips at all times.
• Do not bend at the hips for more than a 90-degree angle.

Dr. Delee will set a follow-up schedule for the first year after surgery to evaluate your progress. You will then be seen regularly thereafter. Complications can occur with implants, so if you notice a change in symptoms, call to be seen to assist in evaluating any changes that may occur with your new joint.

• Reduced joint pain
• Increased mobility and leg function
• Return to a more active lifestyle

Yes, the risk of total hip replacement will vary from patient to patient due to each patient's medical condition. These can include infections, loosening, implant failure, wear, instability, leg length discrepancy, deep veinous thromboses, and pulmonary embolism.  These are all discussed at your pre-operation office visit.

Diligent physical therapy, proper diet, and a willingness to follow all of the surgeon's recommendations will promote a more complete recovery after surgery. Most patients should be able to walk unassisted and drive from 3 to 4 weeks after surgery. However, each patient's recovery time may vary. After a thorough evaluation by the physician, activities such as golf, bicycling, and swimming may be resumed.

Most commonly, joint replacement recipients must avoid moving their hip into  greater than 90 degrees of flexion and sitting for long periods of time. It is also important to avoid crossing legs while sitting, standing, or lying down. Avoid sleeping on your side, bending at the waist, and pivoting or twisting your legs.