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Hip Replacement 101

The Martha Stewart Show, September 2007

Why is hip replacement surgery necessary and what exactly is being replaced?
Regular daily activities (getting out of chairs, walking, and climbing stairs) generate hundreds of pounds of force on the hip. Cartilage covers the bone surfaces, which allows a cushion for all that force. It's not even a quarter inch thick. But this cartilage can wear down, and you'll have raw bone rubbing on raw bone. In this surgery, the worn-out cartilage is replaced with a new artificial surface for the ball and socket. Usually that means removing the damaged head of the femur and replacing it with a new ball affixed to a stem to support it in the bone, and a new surface on the socket side as well.

When should someone have hip replacement surgery?
In the past, people were told to wait as long as possible to have this surgery because the replacements would wear out or loosen. But the new technology we have (ceramic, oxinium, metal on metal) can easily outlast any human lifetime. So it's now recommended to have surgery sooner rather than later because your muscles and conditioning will be better, and your recovery smoother.

What is the typical physical therapy session for most patients after surgery?
Therapy begins on the first day after surgery but varies depending on your medical history, secondary complications and previous activity level. A home care PT may be necessary, otherwise the patient may be sent to an outpatient center where he or she will be seen three times a week. Your physical therapist will give you exercises to be done at home daily. There are certain positions and activities you must avoid to prevent dislocation for at least three months. This requires changes in routine such as dressing. After six weeks, there is enough healing for patients to drive a car, return to work, and pursue most daily activities.

Dr. Stuchin's most frequently asked questions by patents considering this surgery:
How will my life change?
It's common to think that you can't continue with an active lifestyle after the surgery, but you may be able to do even more than you could before! You can walk, dance, swim, ski, etc. Doctors advise against high-impact activities, though, such as jogging and running as a form of exercise. Things do change, though. When you go through security in an airport, your parts will set off the metal detector.

What are the risks during surgery?
Like most surgeries, there's a possibility of heart attack, stroke, blood clots, and infections.

What are the complications after the surgery?
Dislocation of parts and limping, as well as germs getting into the bloodstream, which can travel to the hip joint and cause infection.

Special Thanks
Special thanks to Dr. Stuchin, Elliot Greenberg, and Martha's entire medical team.