What We Know About Hip Replacement

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References

Rosinsky PJ, Bheem R, Meghpara MB, et al. Asymptomatic Gluteal Tendinopathies Negatively Impact Outcomes of Total Hip Arthroplasty: A Propensity Score-Matched Study. J Arthroplasty. 2021 36:242-249. doi:10.1016/j.arth.2020.07.063

van der Merwe, JM. Metal Hypersensitivity in Joint Arthroplasty. JAAOS. March 2021 5. doi:10.5435/JAAOSGlobal-D-20-00200

Bosker BH, Ettema HB, van Rossum M, et al. Pseudotumor formation and serum ions after large head metal-on-metal stemmed total hip replacement. Risk factors, time course and revisions in 706 hips. Arch Orthop Trauma Surg. 2015 135:417-425. doi:10.1007/s00402-015-2165-2

Gofton W, Beaule PE. Serum Metal Ions with a Titanium Modular Neck Total Hip Replacement System. J Arthroplasty. 2015 30:1781-1786. doi:10.1016/j.arth.2015.04.040

Blizzard DJ, Sheets CZ, Seyler TM, et al. The Impact of Lumbar Spine Disease and Deformity on Total Hip Arthroplasty Outcomes. Orthopedics. 2017 40:e520-e525. doi:10.3928/01477447-20170327-03

Harding P, Holland AE, Delany C, Hinman RS. Do activity levels increase after total hip and knee arthroplasty?. Clin Orthop Relat Res. 2014 472:1502-1511. doi:10.1007/s11999-013-3427-3

Chris Centeno, MD

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What Is Considered A Normal Amount Of Pain After A Hip Replacement Surgery

Some swelling and initial pain at the joint are normal after hip replacement. To help reduce pain:

• Take time to rest between therapy sessions.
• Ice the leg and the incision site.
• Take anti-inflammatory medications, after consulting with your doctor, to help with these symptoms.

Keeping the leg elevated above the heart when you lay down can also help the swelling to recede, advises Thakkar.

Its important to pay attention to your pain levels. If you feel like you are consistently at a 6 or more on a 110 pain scale, mention it to your doctor, because it could be a sign of infection or another complication. As you continue physical therapy, your pain levels should slowly decrease to about 1 or 2 in 12 weeks after the hip replacement.

What Is Iliopsoas And Hip Flexor Tendonitis

The hip joint is the largest in the body! There are many structures that constitute this joint, such as muscles and ligaments.

One of the greatest muscle complexes of this region is the Iliopsoas a high-powered team made up of three muscles: the Psoas Major, Psoas Minor, and Iliacus. This muscle group is commonly known as the hip flexors.

You can guess by the name what this muscle is made for: flexing the hip!

It is an essential worker when it comes to walking, sitting, standing, climbing. It stabilizes the pelvis, low back, and hip.

When overworked, the Iliopsoas can develop inflammation within the tendons, where the muscles connect to your bones, resulting in symptoms such as:

• Snapping in the hip

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Muscle Pain After Hip Replacement

Pain in the hip region is common, as well as groin and thigh pain. When your body adjusts to changes in the joints in that area, your joints can become fatigued. There may also be pain in the thigh or knee, which is usually associated with a shortening of the leg length.

The goal of hip replacement surgery is to repair damaged sections of your hip joint while replacing them with artificial parts. A hip replacement, like any other surgical procedure, may cause short-term pain. The discomfort you will experience after surgery varies greatly. If you require pain management, your doctor will determine whether or not a prescription pain killer is necessary. Following hip replacement surgery, it is expected that you will be in the hospital for three days. When you are in this position, crutches or a cane are usually used to stabilize your movement. A full recovery can take up to a year.

What Exercise Helps Sciatica

Gentle stretching exercises can help relieve sciatic pain in the lower back. It is especially beneficial for people who are overweight or pregnant, as it can help loosen up the tight muscles in the lower back. It should be done after a light aerobic exercise, but avoid twisting or bending forward. Also, do not force stretches, and stop immediately when the muscles become tense.

Regular exercise improves blood flow to the muscles and nerves, and promotes transportation of toxins and inflammation away from the affected area. Exercise also helps stimulate the nervous system, which may improve markers of nerve health. It may also reduce stiffness. Physical therapy can also help alleviate sciatic pain by limiting aggravating factors.

If youre still experiencing pain after your hip replacement, you can try strengthening exercises. Try to perform them three or four times a week. Dont do them two days in a row, as this may increase pain. You should also avoid doing high-impact activities, such as bending forward with straight legs or lifting both legs off the floor at the same time. In addition, avoid doing weightlifting exercises, such as bent-over rows, which put a lot of stress on the sciatic nerve, especially when the back is rounded.

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Pain After Hip Replacement: Causes And Tips To Help

It is natural to think that you will have no pain after your hip replacement surgery, but things may not work that smooth for some people. Pain after hip replacement is more common than you think. In fact, sometimes, the pain you experience is even worse than what you were experiencing before undergoing the surgery. A number of factors may be preventing you from getting the best results after your surgery.

Lateral Femoral Cutaneous Nerve

During the anterior approach to a hip replacement, the lateral femoral cutaneous nerve travels near the incision. The nerve can be stretched or cut during surgery. Injury to the nerve can cause numbness to the thigh region. Sometimes the damage can create a neuroma, which can become painful.

Some surgeons routinely cut the nerve during an extensive surgical approach to the hip. Dr. Morton is a fellowship-trained hip specialist and is careful to minimize this risk as much as possible by performing a minimally invasive procedure.

Suppose you are having pain or numbness to your anterior thigh. In that case, a physical examination will help determine if this is the cause.

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Do I Still Take My Normal Medications Before Surgery

Inform your surgeon about all of your medications, both over-the-counter and prescription. Some medications dont react well with anesthesia, and others such as aspirin, ibuprofen and blood thinners increase bleeding. For these reasons, you may need to stop taking certain medications before your hip replacement. If youre taking aspirin or aspirin-based medication for arthritis, you must stop taking these two weeks before your surgery. If youre taking medications for other medical problems, dont discontinue taking these without checking with your primary healthcare provider. Make sure to bring a list of all medications, the dosages and how often you take them. This includes all herbal supplements and vitamins. This is important information that will be documented in your hospital records.

How To Avoid Butt Pain After Hip Replacement

How can you avoid pain after hip replacement? Many times these tendon issues will be talked about on your MRI report. So look for terms like tendinopathy,tendinosis, or tendon tear in muscles like:

• Gluteus maximus

If you dont have an MRI, take some time to press on these spots:

Matis75/Shutterstock

If theyre tender, get an MRI to check if you have gluteal tendinopathy.

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How Soon Will I Be Up And About

The staff will help you to get up and walk as quickly as possible after surgery. If you’ve had minimally invasive surgery or are on an enhanced recovery programme, you may be able to walk on the same day as your operation.

Initially, you’ll feel discomfort while walking and exercising, and your legs and feet may be swollen.

A physiotherapist will teach you exercises to help strengthen your hip and explain what should and should not be done after the operation. They’ll teach you how to bend and sit to avoid damaging your new hip.

Muscle Not Repairing After Hip Operation

jean91901

Hi, Can anyone explain what the procedue is after a hip operation when the muscle does not repair itself? Does anyone know of an expert in this field? I limp to one side badly and this is causing pain in the hip area and lower back.

I do a lot of physio anyway, such as exercises, aqua fit, rehab swimming, I assume this all helps or is it a waste of time?

Jean

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What Happens Without Surgery

The natural history of denegeratie arthritis is that symptoms tend to progressively worsen over time. Arthritis may have a “waxing and waning”pattern, with good days and bad, but over the course of time, symptoms have a tendency to become persistent. Typically the progression is slow, generally over several months or years, but this is generally very difficult to predict.

Arthritis is not a life threatening condition however. There is, generally speaking, never a “need” to have surgery for arthritis may have effects on a patients cardiovascular health, weight, etc. which are difficult to predict or quantify.

How To Relieve Muscle Spasms After Hip Replacement Surgery

After hip replacement surgery, it is common for patients to experience muscle spasms. While these spasms can be painful, there are a number of things that patients can do to relieve the pain and discomfort. There are a number of over-the-counter and prescription medications that can be used to treat muscle spasms. Ibuprofen and acetaminophen are two common over-the-counter medications that can be used. If these medications are not effective, patients may need to use a muscle relaxant. There are also a number of home remedies that can be used to treat muscle spasms. Applying a heating pad or ice pack to the affected area can help to relieve pain and discomfort. Patients may also find relief by massaging the affected area. If muscle spasms are severe, patients may need to be hospitalized so that they can receive intravenous medication. In most cases, however, muscle spasms can be treated at home.

How long would you expect the pain to last and how much would you expect to be able to tolerate it? Each type of surgery is typically accompanied by some level of pain. According to Eduardo M. Fraifeld, MD, president of the American Academy of Pain Medicine, many people experience spasms of the muscles following back surgery.

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Greater Trochanteric Pain After Hip Replacement

Many surgeons consider trochanteric pain a relatively minor complication following arthroplasty, however the impact can be substantial, with significant reductions in post-operative satisfaction, quality-of-life and functional outcomes.1,2,3 Those with greater trochanteric pain have been reported to have quality-of-life and levels of disability similar to those with advanced hip osteoarthritis.4 Therefore, the benefits of alleviation of joint pain by arthroplasty may not be realised by many patients who experience abductor pain and dysfunction after hip replacement surgery.

Abductor dysfunction in the form of weakness and functional deficits such as a Trendelenburg gait may also persist or worsen after hip arthroplasty. This may be related to trochanteric pain or to neurological injury or mechanical impairment associated with the surgical technique. Even in the absence of hip pain, a significant gait disturbance associated with iatrogenic hip abductor muscle impairments may result in a longer-term reliance on walking aides. Pain may also develop in adjacent regions, most commonly the lumbar spine or knee, due to the hip abductor muscle dysfunction, altered kinematics and loads transferred to these regions.

If a patient presents to your clinic with abductor pain and dysfunction after hip replacement surgery, there are usually 3 main scenarios:

How Do I Safely Walk After A Hip Replacement

Youll need to use a walker or crutches which your occupational or physical therapist will provide for you. Make sure to stay on your crutches or walker until your healthcare provider or physical therapist advises that you use a cane. Your provider will decide how much weight you can put on your surgery leg. In most cases, you will be able to put 100% of your weight on your surgery leg.

Your physical therapist will help you learn how to use your walker or crutches correctly and help you get the right equipment. A bag or basket attached to your walker will allow you to carry small items when walking. Keep in mind that walking does take effort following surgery. While physical therapy will help you learn how to correctly use a walker or crutches, your recovery is based on your dedication to therapy and exercises following surgery.

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How Will It Affect My Sex Life

If you were finding sex difficult before because of pain, you may find that having the operation gives your sex life a boost. Your surgeon can advise when it’s OK to have sex again.

As long as you’re careful, you should be able to have sex after 6 to 8 weeks. Avoid vigorous sex and more extreme positions.

What Could Slow Down My Recovery

As with any surgery, there is some risk of complications during and after a hip replacement, which may include infection at the incision site, bone fractures and hip dislocations, explains Thakkar. If you notice a fever, drainage from the incision site, difficulty moving your hip or severe pain that is not relieved by your medication, contact your doctor immediately.

Taking rehabilitation at a comfortable pace and avoiding sudden, sharp movements can help prevent dislocations and falls that may delay the recovery.

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Incidence And Risk Factors

Total hip replacement is one of the most common operation performed in the United States, with over 300,000 procedures performed yearly. This number is expected to likely double in the next 20 years, partly due to patients living longer, having higher expectation as to quality of life and function than previous generations, and having better access to health care.

The direct anterior approach is performed by a relatively small minority of surgeons performing hip replacement. This is largely due to the fact that this approach has only gained popularity in the last 10 years, primarily due to more active patients wanting a less invasive technique allowing for a quicker recover. As such, many surgeons were not trained in this advanced technique. It is generally considered more technically difficult than the other approaches, so specialized trained is often necessary.

Iliopsoas Tendonitis After A Hip Replacement

A hip replacement can be a life changer! Your pain and mobility can greatly improve after surgery, improving your quality of life and daily activities. Butwhat happens when you start to feel a different pain in the hip? Hip Flexor tendonitis can sneak up on anyone after surgery and is a pain in the.well hip!

Its very common for patients to develop Iliopsoas, or hip flexor, tendonitis after a hip replacement. Heres what you can do to relieve that pain and get back to life!

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What Hurts The Most After Hip Replacement Surgery

Most people have a difficult time getting over the pain that they feel after hip replacement surgery. While it is true that the procedure is not fun, most people find that it gets easier after each week. After six weeks, they can resume their normal activities, but it is not advised that they return to high-impact sports. Instead, they can do low-impact activities like yoga or golf. They can even have sex again.

Rehabilitation is key to a successful recovery. Your physical therapist or physician will teach you how to walk and to avoid any risk factors after your surgery. A physiotherapist will work with you to develop exercises to strengthen your hip and improve your range of motion. Your recovery time depends on your activity level and the type of surgery you had done. You should be sure to follow your healthcare providers instructions closely, as the first few days following your surgery can be difficult.

The most common risks of hip replacement surgery are infection and fractures. An infection can occur at the site of the incision. If the infection is severe, it can require the removal of the artificial parts. A hip fracture can also occur after surgery and may require further surgery.

Mayo Clinic Q And A: Pain Near Artificial Hip Should Be Evaluated Without Delay

DEAR MAYO CLINIC: Six years ago, at age 67, I had my right hip replaced. Id been feeling fine until about eight weeks ago, when it started to hurt toward the front of my hip when I lift my right leg. The pain is quite significant to the point where it hurts every time I get in my car or attempt to put on socks. What could be causing this to happen?

ANSWER: There are a number of possible reasons for the discomfort youre experiencing. It might be a problem with the artificial joint, or you may have an infection. The pain also could be related to a condition called hip flexor tendinitis. To find out the underlying cause, make an appointment to see your surgeon to have your situation evaluated soon.

Hip replacement surgery involves removing the hip joint and replacing it with an artificial joint that typically consists of metal, ceramic and hard plastic. The implants used in hip replacements are made to resist corrosion and wear. For most people who undergo the surgery, hip replacement successfully relieves hip pain and restores hip function.

When, as in your situation, people have pain after the surgery, theres often an underlying problem that can be diagnosed and effectively resolved if its treated promptly. Its possible that youve developed an infection around the artificial joint. Many infections can be treated effectively with antibiotics. But a major infection near your artificial hip joint may require surgery to remove and replace the joint.

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