13 Things to Know Before Your Hip Replacement

By Lisa Esposito

Major surgery with a big impact

Could a 2-pound piece of titanium and ceramic change your life? Maybe, if a deteriorating hip joint — or two — is causing constant pain and threatening your ability to work, play and walk. While it’s a major surgery with weeks of recovery, nearly 300,000 total hip replacements take place in the U.S. each year. If medical solutions aren’t working, you may be wondering if an artificial hip could help.

When all else has failed

Anne Gittelson-Leck of Long Island is a repeat customer. She had her left hip replaced in February 2013 and came back for a matching right hip implant in June. Doctors determined that osteoarthritis (wear-and-tear arthritis) was causing her severe hip pain at a relatively young age. She tried physical therapy and other treatments before seeking evaluation for a possible hip replacement. “I wasn’t really ready to hear that yet,” she says, “but then the walking got more difficult.” Now 50, she says she waited too long — and that the results from her procedure are “amazing.”

After conservative measures — anti-inflammatory and pain medications, physical therapy, joint lubricants and cortisone shots — are exhausted, it’s time to talk about hip replacement, says Mathias Bostrom, the orthopedic surgeon at the Hospital for Special Surgery who operated on Gittelson-Leck.

Saying no to disability

Arthritis, trauma and degenerative disease can lead to excruciating hip problems. “Many of these patients can’t sleep through the night,” says Joshua Jacobs, a professor and chairman of orthopedic surgery at Rush University Medical Center in Chicago. “They’re unable to walk more than a few blocks.” As disease, pain and disability progress to the point where people can no longer perform activities of daily life, he says, “that’s when hip replacement should be carefully considered and discussed.”

“Osteoarthritis is the most common reason people have hip replacements, but there are others,” says Jacobs, immediate past president of the American Academy of Orthopaedic Surgeons. Inflammatory arthritis, like rheumatoid arthritis, can also wreak havoc on the joints. So can osteonecrosis — death of the bone cells — from decreased blood flow. Developmental dysplasia (instability) of the hip in childhood may lead to surgery as an adult. And a broken hip from trauma could require a partial or complete replacement.

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