Houston Methodist. Leading Medicine

Hip FAQ

Question:

Mother refuses to consider having a total hip replacement because she has heard so many "bad" things about them. Despite our efforts, she can't seem to say exactly what those "things" are. What can we say to convince her that hip replacements are safe and reliable?

Answer:

Your mother may have heard some reliable new information to base her concerns on. Surgeons agree there are still many problems to overcome when it comes to hip replacement surgery. Two of the biggest dilemmas faced right now are the increasing number of older adults who need joint replacements and fewer surgeons specializing in this procedure. Some surgeons are shying away from hip replacement surgeries because of the high costs. There have been problems with the implants holding up. Product liability is a huge factor in this issue. It seems like the outcomes of hip replacement are less predictable and worse now than ever before. One of the reasons for this may be the fact that so many surgical techniques are available now. Which method works best for each individual patient problem has not been determined. Problems such as bone deficiency, infection, and hip dislocation add to the many challenges faced by patient and surgeon. There are also many more implant designs and materials to choose from. For example, more porous materials like titanium foam, cobalt-chromium foam, and tantalum foam are available. These materials make it easier for bone to fill in and around the implant to help hold it in place. The surgeon can also use cement and/or bone grafting to help seal the implant in place. All of these efforts are geared toward one thing: preventing loosening of the implant -- the most common complication of hip replacement. Research has focused on ways to prevent implant loosening. Some surgeons have advised their patients to limit physical activities the first 12 months after receiving a hip replacement. Others have suggested low-impact sports over high-demand activities. Some studies have concluded that patient selection is really the key factor here. By looking at who ends up requiring revision surgery, it's possible to make some observations that might help. Sometimes older adults have to come to their own conclusions about what they want and need. If they are afraid (as your mother seems to be) about problems and complications following surgery, they may not even be willing to discuss it with their doctors. Perhaps the best thing to do is encourage her to check out what she has heard with her medical doctor and see what he or she can offer. The decision to have a total hip replacement may take some time. A visit with her primary care physician or orthopedic surgeon is a good place to start. Michael H. Huo, MD, et al. What's New in Total Hip Arthroplasty. In The Journal of Bone and Joint Surgery. December 15, 2010. Vol. 92-A. No. 18.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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