Hip Replacement – The Nebraska Medical Center


People get back to exercise, they get back
to work, they sleep better; it has a dramatic impact on people’s activities of daily living. I think the return to independence is probably
the most dramatic thing people feel after having joint replacement. Hip replacement is usually indicated when
patients are suffering from pain and they’re unable to do their activities of daily living.
The pain typically is severe pain that may disrupt their sleep or prevent them from walking
any distance. The location of the pain is also very important. Hip disease usually causes
pain that’s in the groin area and thigh, and less likely pain in the buttocks, which
is usually attributable to diseases of the spine or problems of the spine. Very often
having trouble walking and a lot of people have trouble sleeping at night and that’s
usually a pretty good indication that their non-operative treatment is not working. When
people have trouble sleeping, they’re not very good at their job, they often become
irritable and it changes their whole personality. And that’s often the last step when people
really can’t sleep at night because of their pain. In often times they’ve tried other
medications or they’ve been to see other doctors. Sometimes they will come in and someone
has told them they have hip arthritis and so we can go from there. For hip replacement, what we do is take the
part that’s worn out (which is in the hip join here) at the ball and socket and remove
the ball by cutting this part off with a saw and getting rid of the arthritic thermal head.
The other part, the arthritis in the socket, we ream away the remaining cartilage and then
put a metal cup into that part (usually with a screw or two, also to help with the fixation).
And then the stem goes down into the femur, into the top of the thigh bone and then we
put a metal ball on top of that, which makes the new hip joint with the socket. So patients often want to know how long is
the operation, how long will they be in the hospital and what’s the recovery and the
operation has been around for decades, so it is about an hour. People are usually in
the hospital for one to three days. And usually we’ll protect their gate with crutches or
a cane for the first three to six weeks. And by six weeks, their starting to get back to
most activities. But we usually ask them to wait until about three months before they
start to do recreational activities. And those recreational activities might be doubles tennis,
golf, hiking, dancing, etc. I would say one thing that sets us apart is
the combined experience that we have. We have a team approach to joint replacement here.
We have a dedicated floor where the nurses primarily take care of orthopedic patients
and a large percentage of those patients are patients who have had hip and knee replacements.
I think one of our responsibilities is to educate and also be on the cutting edge with
research and new developments for prosthetic joint replacement, or for that matter, arthritis.
So we collaborate with our bio-mechanical engineers and the development of new products,
improved ways to do the operation, better ways/other ways to improve the outcome as
well. I think the return to independence is probably
the most dramatic things people feel after having a joint replacement. They’re not
reliant upon family members and friends to go grocery shopping for them or to go walk
their dog for them. People have a new ability to do the activities they enjoy, that they’ve
often been slowly giving up over time without even realizing it was due to their arthritis
that they were not being able to do these things. People get back to exercise, they
get back to work, they sleep better, it has a dramatic impact on people’s activities
of daily living.

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