Prescription for Health

Pros and cons of hip replacement surgery

And how does it compare to 'hip resurfacing'?


More than 330,000 hip replacement surgeries are performed in the United States each year. 

A hip replacement may be done for various reasons. Certain conditions can damage the hip joint and result in needing to have the joint replaced -- the two most common conditions being rheumatoid arthritis and osteoarthritis. 

Rheumatoid arthritis is an autoimmune disorder which produces a type of inflammation that can erode bone and cartilage and deform joints. This disorder is characterized by an irregular assault of the immune system on the lining of the joint, the synovium.  As a result, the joint becomes inflamed and fluid builds up resulting in pain.

Osteoarthritis on the other hand is commonly known as wear-and-tear arthritis.  And it is this type of arthritis that we have more control over.  Osteoarthritis damages the cartilage that covers the ends of bones and helps joints move smoothly. Cartilage acts as a cushion between the bones, protecting our joints from the stresses of daily activities. This degenerative joint disease is characterized by changes in the cartilage that normally sits between bones at the joint. As the cartilage wears away the space between the bone narrows, until the underlying bone is exposed. Pain eventually results from wear on the naked bone, as well as increased stress and fatigue of the muscles that support the joint.

There is no single cause of osteoarthritis, but rather, the condition is due to the accumulation of various stresses. For instance, those who are obese are at an increased risk. Not only does the extra weight translate into an increased load on your joints, but recent research suggests that body fat produces chemicals which appear to further harm the joint. Moreover, many individuals with chronic joint pain can cite an injury or a history of overuse. Some jobs, like athletics, manual labor, machine operators and typists carry an inherited increased risk of developing joint problems. 

Regardless of what leads to your hip replacement surgery, going under the knife even to reduce great pain and increase quality of life, can be a difficult decision to make. 

The risks associated with hip replacement surgery may include:

  • Fracture during surgery.
  • Blood clots can form in your leg veins after surgery.
  • Infection at the site of your incision and in the deeper tissue near your new hip.
  • Change in leg length due to weakness in the muscles surrounding the hip. In this case, progressively strengthening and stretching those muscles may help.
  • Dislocation from certain positions.
  • Loosening is rare with newer implants, but your new joint may not become solidly affixed to your bone or may loosen over time, causing pain in your hip.

Thankfully, there are many ways we can prevent damage and ease the pain of existing injury. Good hip health starts with exercise and maintaining a healthy weight. Although pain medication can be helpful, non-pharmacologic interventions should be recommended as the first line treatment. Chronic use of over-the-counter pain medications can have consequences for your liver, kidneys and stomach, while not getting to the root of the problem. Weight loss, on the other hand, can greatly reduce the development of hip-damaging arthritis, as well as lessen the pain. This effect is further amplified when combined with exercise -- particularly exercises like yoga, which incorporates physical stretching with deep breathing, helps focus on the tendons and ligaments, are key to preserving joint health.

Dr. Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is chairman of urology, chief of robotic surgery at Lenox Hill Hospital and professor of urology at Hofstra North Shore-LIJ School of Medicine. He is a medical correspondent for the Fox News Channel's Medical A-Team and the chief medical correspondent for am970 in New York City. Learn more at Visit Dr. Samadi's blog at Follow Dr. Samadi on Twitter and Facebook.