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Sun December 15, 2013
Health

Hip hip hooray! One of the most common joint replacement procedures greatly improved

In the past, hip replacement surgeries were generally reserved for elderly people. Long recovery times and expensive materials sometimes deterred people from getting the procedure. But, as minimally invasive techniques and materials have improved in recent years, the population of people getting hip replacements has changed as a result.

This week on Take Care, Dr. Seth Greenky discusses the current state of hip replacement surgeries. An associate professor in orthopedics at Upstate Medical University in Syracuse, NY, Dr. Greenky also co-directs the Joint Replacement Program at St. Joseph’s Hospital, also in Syracuse.

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The most traditional form of hip replacement is replacing the entire ball and socket joint with a metal ball and a plastic-lined metal socket. Dr. Greenky points out that many variations of this procedure have been developed over time, making things easier for both doctors and patients.

The most commonly used of these new variations is a called a surface replacement. This is needed when the body stops lubricating the surface of the hip joint, usually due to genetics or an injury. This causes the surface, which is supposed to be smooth, to get wear out.

“What eventually happens is it gets completely worn out, and instead of a smooth, gliding surface covering the ball and socket, it becomes bone on bone. And when bone articulates on bone, it hurts,” says Dr. Greenky.

A surface replacement, instead of replacing the entire hip, involves covering the joint with a new metal surface. Dr. Greenky compares it to retreading a tire.

The use of new types of materials has allowed replacements to last longer than in the past.

“The new materials are different forms of metal— like cobalt, chrome and titanium—and then ceramic and plastic. Not plastic like a container you’d store food in, but a high density plastic that has very good longevity,” he said.

Non-invasive techniques that have been developed allow for not only a quicker recovery time, but for doctors to perform more hip replacements at a quicker rate. All these advancements have opened the doors for more people to get the procedure done.

“You know, we used to only perform joint replacements on people over the age of 70. But as the techniques and materials have improved— there are people that are in their 20s that sometimes get them, all the way up to, my oldest person was 96,” says. Dr. Greenky.

The changes have improved hip replacement surgeries so much, Dr. Greenky says, “If you took a surgeon who was doing hip replacements ten years ago, and brought them into the operating room now, and showed them what we did, it’d shock them. They’d be so surprised of how fast we do the surgery, of how fast the patients were mobilized and how quickly they got out of the hospital.”

Developing arthritis and joint problems is often based on genetics, so if you come from a family that has these problems, Dr. Greenky says that while you may not be able to stop the problems from happening to you, you can stave off the symptoms.

“The fitter you are, the longer it’s going to take to develop symptoms. So, staying in shape, keeping your weight down, and keeping your strength up are techniques to stave off the inevitability if it’s a genetic situation.”

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