If pain and stiffness caused by osteoarthritis of the hip limit your ability to participate in everyday activities, and if other types of treatment haven’t been successful, doctors may recommend surgery to remove damaged cartilage or replace the arthritic joint with long-lasting artificial parts.
Orthopedic surgeons at NYU Langone’s Joint Preservation and Arthritis Center are experienced hip specialists, and these procedures may reduce hip pain and stiffness and improve function and mobility.
In a joint affected by osteoarthritis, small pieces of cartilage or bone may become loose and get in the way of the joint’s smooth gliding motion. These loose fragments cause additional friction in the joint and can make movement painful.
Arthroscopic debridement is a surgical procedure to remove these fragments. After injecting an anesthetic into the spine to numb your body from the waist down, surgeons insert a pencil-sized instrument called an arthroscope through very small incisions in the hip. The arthroscope has a light and a camera lens on its tip and broadcasts magnified images of the inside of the joint on a monitor.
A surgeon uses the arthroscope to locate any loose fragments in the hip joint, removes them with small surgical instruments, and closes the incisions with dissolvable stitches. Many people experience pain relief in the hip joint soon after the procedure.
Arthroscopic surgery is almost always an outpatient procedure, and you can expect to go home within hours of surgery. Most people are able to walk with crutches almost immediately after the procedure. Our pain management specialists ensure you have the medication you need to remain comfortable during recovery.
Doctors recommend using crutches for two to three weeks, and your surgeon schedules a follow-up appointment two weeks after surgery to confirm that the incision wounds are healing normally. Your surgeon also examines your hip and asks you to rotate your leg gently in different directions to assess its range of motion after surgery.
Our doctors recommend starting physical therapy in the days after surgery. Physical therapy helps you to rebuild muscle strength, flexibility, and range of motion in the hip.
If you experience chronic hip pain because of joint damage caused by osteoarthritis and have difficulty walking or exercising because of joint stiffness, doctors may recommend surgery to remove the diseased joint and replace it with durable prosthetic parts. Total hip replacement eliminates osteoarthritis in the hip entirely. It may dramatically improve your quality of life by alleviating pain and restoring stability and range of motion to the hip.
A surgeon performs total hip replacement using spinal or general anesthesia. He or she makes an incision along the front, side, or back of the hip to access the hip joint. The surgeon removes the arthritic joint, as well as loose pieces of cartilage or other tissue. The surgeon then puts the prosthetic parts in place and closes the incision with stitches. Surgeons inject pain medication into the surrounding tissues of the hip to help control pain after the operation.
As soon as you are able, NYU Langone physical therapists help you to stand and walk. Getting out of bed and standing or taking a few steps helps you to retain strength in your muscles and joints, increases blood flow to the hip and leg, and may help speed your overall recovery. Physical therapists monitor healing and continue to help you learn to walk using your new hip. Pain management specialists ensure you are comfortable while your body heals.
Most people can go home as soon as they are independent. This may be on the same day as the surgery or one to three days later, depending on how quickly you recover.
After you can walk unassisted and without pain, NYU Langone physical therapists can help you to rebuild muscle and increase the flexibility and range of motion in the hip. Our rehabilitation doctors and physical therapists customize an exercise routine that you can do at home to continue to condition and strengthen your muscles. Physical therapy should continue for 6 to 12 weeks, at which time NYU Langone doctors assess your progress before determining if additional physical therapy is needed.
Most people return to the hospital for a follow-up examination two to four weeks after surgery. Crutches, a cane, or a walker are usually required for two to four weeks.
Today’s new joint implants are made with more durable material than in the past, and the majority of people with a prosthetic hip have no complications for 20 years or more. This longevity means that total hip replacement is now an option for young, active people, for whom this surgery may be the best option for eliminating chronic hip pain.
After 20 years, a small number of joint implants begin to wear out and may need to be replaced. Our doctors recommend annual or biannual appointments after surgery, so that our specialists can ensure your hip implant continues to perform well.
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