After non-operative treatment options like anti-inflammatories, intraarticular injections, activity modifications and weight loss have failed, patients with osteoarthritis that complain about persistent pain and stiffness in their hip might be a candidate for total hip replacement. Total hip replacement surgery aims at removing the diseased cartilage and replacing it with an artificial joint. Over the last four decades, the technique for total hip replacement surgery has continuously improved and total hip replacement surgery today is one of the most successful surgeries. We today usually perform un-cemented Press-Fit fixation (Image A) of the components. Occasionally in older patients with poor bone stock Dr. Boettner still utilizes cement for stem fixation (Image B).
Implants today are made out of titanium and coated on the outside with a porous surface structure that allows the bone to grow into it. There are different bearing options that are available today.
In general, we usually pick between metal-on-plastic or ceramic-on-plastic bearings. For young and active patients, metal-on-metal resurfacing is a treatment option and should be discussed with Dr. Boettner if you feel that your activity level or age might require this procedure.
Standard total hip replacements are done in our practice using a minimal invasive approach. Currently, there are two established approaches. One is the minimal invasive anterior approach, the other one the minimal invasive posterior approach. Both of these approaches have certain advantages and disadvantages. Dr. Boettner performs both of them and will discuss which one might be beneficial in your individual situation.
Usually, a total hip replacement is done under spinal epidural anesthesia and you will stay in the hospital for approximately two or three days. After a rehabilitation period, which ranges from three and eight weeks, you can return to work and driving. We do recommend to limit high-impact sports after a total hip replacement. However, lower-impact sports such as tennis, golf, swimming, biking, hiking, skiing, golf and work outs in the gym are no problem after a standard total hip replacement.
This video was mailed to Dr. Boettner by one of his patients 9 months after total hip replacement. Dr. Boettner does not advise his patients to do all the activities that are shown in this video! Please discuss risks and benefits of different activities with Dr. Boettner after your surgery.