Often times, my patients experiencing severe hip pain appropriately ask me, “Are there any alternatives to hip replacement surgery?” This is a great questions which requires a meaningful discussion. As many of you know, I believe surgery should only be considered once the alternatives are researched and evaluated.

A partial or total hip replacement may be the best solution for some patients. However, there are alternatives that each patient might wish to explore prior to opting for the surgery. Individuals should review the possibilities with their physicians since every case is different. In general, surgery should only be considered if traditional treatments such as medications and physical therapy have not been successful.

If the pain is due to a misalignment of the joint known as hip dysplasia, a femoral osteotomy might be a suitable alternative. The procedure requires a patient whose weight-bearing hip area is capable of being broadened. The surgeon cuts the femur to realign it in its proper position. Recovery may be lengthy and is often longer than the recovery following hip replacement surgery.

Arthodesis is a procedure to fuse the femur head to the acetabulum. During surgery, a plate is normally screwed into place and some patients will need a cast to immobilize the joint while it heals. Arthrodesis is basically hip fusion, and therefore it eliminates the joint’s ability to move and leaves the patient with a limp. Because the patient’s back will have to compensate for lost hip movement, ideal candidates must not suffer from back pain or immobility. The procedure is not widely performed exempt in younger patients whose livelihoods depend on their ability to perform heavy labor.

With hip resurfacing the surgeon inserts a cap on top of the femur. This conserves the bone, and since he does not need to insert a stem into the femur. As the patient’s bone must be of good quality, patients with osteoporosis or similar conditions are not ideal candidates for the procedure. Many patients have been able to return to an active lifestyle, including running, after a hip resurfacing.

If the patient has a severe, uncontrollable infection or a physical condition that precludes normal walking, a resection arthroplasty may be performed. In this procedure, the surgeon removes the bone surrounding the hip joint. Scar tissue will eventually fill the space. Almost all patients undergoing the procedure will need to use some type of walking aid on a permanent basis.

I hope this helped you better understand hip replacement alternatives.

Until next time,
Stuart

About the Author: Dr. Stuart Gold, M.D. is a board certified orthopedic surgeon who has 23 years experience specializing in sport injuries, joint replacement, arthritis and limb salvage. As the Director of the Orthopedic Institute, Dr. Gold recently published The Patient’s Guide To Orthopedic Surgery to help patients better understand the challenges, risks and opportunities of orthopedic care.