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People dealing with hip pain because of arthritis, a fracture, or other medical issues may think hip replacement surgery is their only option but, because of advancements in medicine, that is no longer the case.
“For decades, all we've done is replace hips, and that philosophy has served as our only solution for pain,” said orthopedic surgeon Ankit Bansal with Mercy Health. “And for decades, we haven't really had very many answers for young active patient on how to preserve their hip. But now, as of the last 5 or 10 years, we've really taken off in our understanding of what hip procedures can do. And the things that we can do can change natural history to some degree. We can even delay the need for replacement or even offset it all together.”
Hip preservation
Minor injuries, such as bone spurs or tissue tears, can lead to bigger problems, so addressing them early with preservation procedures helps people manage pain, improve mobility, and maintain hip health.
“The benefit is that you get to keep your own hip,” Bansal said. “You have no limitations for the rest of your life as long as your pain is at bay. So, the benefit is that you restore your function to where you were before, often times even better. And you can sleep at night, you can walk, and you can hike, you can get up and down stairs, you can run and be as active as you want without limitations.”
One preservation procedure is arthroscopy, which involves a surgeon poking two or three small holes into the skin, and then shaving bone spurs, tightening tissue, and addressing cartilage defects.
“The surgical pain only lasts for about a week to 10 days ” Bansal said. “But beyond that, the pain gets better over time. In about six weeks to two months is when the turnaround time happens.”
Hip reconstruction and replacement
A person might need a hip replacement because of heavy use or congenital abnormalities. Fortunately, medical improvements over the years have increased how long replacements last, opening the door for more candidates.
“I can now offer replacements to people at a much younger age,” Bansal said. “It is a final operation and, once you get pain relief, the new hip would be likely the one you live with for a very, very long time.”
The advancements at Mercy Health involve, perhaps counterintuitively, what surgeons don’t do compared to traditional hip replacement surgery.
“I don't cut any muscles doing hip replacements, and we make incisions that are more cosmetic — oftentimes even bikini type incisions for some folks, if they're candidates for that. I preserve a lot of the hip capsule within and around the hip to help them get better faster and have less tendonitis pain.”
The less invasive procedure means recovery is quicker than in the past.
“The hardest time I have is to slow down my patients to be able to allow proper time to heal,” Bansal said. “Most people want to jump out of the gates and be able to golf and hike within a month of surgery, and I have to tell them, ‘we have to slow down just a little bit to be able to allow the implant to heal the bone, to be able to allow the muscles to catch up and the tissues to catch up.’ After two or three months, we place zero restrictions on them, and we tell them, ‘You can do whatever it is you want to do.’”
