Feb 8, 2016
Strategies for Hip Joint Preservation
As we continue to live longer and lead more active lives, the wear and tear on our hip joints has become a focus of the medical community. In 2013, over 40,000 hip replacements were reported in Australia, increasing by 2.4% compared to the previous year (1). As we watch the number of total hip replacements increase and become more prevalent in younger patients year to year, attention should be directed to hip preservation strategies.(1)
Why do people need Hip Replacement Surgery?
Osteoarthritis is the most common type of arthritis that affects weight bearing joints, such as the hips. It is caused when the cartilage covering the ends of bones begins to wear away over time, typically affecting middle aged and elderly people.(2)
Although it’s not just older people who may need hip surgery. Hip dysplasia in adults is the most common cause of hip arthritis in young women, which also affects men. Hip Dysplasia typically refers to the improper formation of the hip joint at birth. If it is not treated, the condition will worsen and eventually require total joint replacement. Doctors monitor hip joint formation and correct improper formations at birth but it can frequently go unnoticed. In 2008, Norwegian researchers looked at total hip replacements in young people and found that 92% of the adult dysplasia had been missed in childhood.(2)
Other factors such as previous sport injuries, obesity, and family history may make you more likely to develop arthritis, which could ultimately result in the need for total hip replacement later in life.
What can you do to preserve your hip function and prolong the need for total hip replacement surgery?
Exercise and weight loss are the first line of defence, which may help decrease pain and prolong surgery.
The main component to avoid or prolong joint surgery is to strengthen the muscles that support the joint. Physiotherapy is often useful in helping strengthen surrounding muscles and maintaining good muscle tone and pelvic balance. Stretching is important to keep the muscles flexible and brings more blood flow to the area, which makes the muscle more susceptible to change. Physical therapy is often the first defence because damaged joints can worsen without movement.(4)
If you are overweight, weight loss may help to reduce pain in your hips. Our joints carry the weight of our bodies and the more weight, the more our joints have to work. Even small changes in weight make a significant difference in the forces on both our hip and knee joints. Exercising in a pool, walking, or swimming are activities that don’t put a lot of stress on joints while also help with mobility and strength.(4)
While there is no guarantee that a program of weight loss and muscle strengthening will help people avoid joint surgery, it is an important factor in keeping hip joints strong and healthy for as long as possible.
Hip Preservation Surgery
In certain situations, early hip preservation surgery is an option. This type of surgery is usually referred to as osteotomy of the hip, which aims to improve the hip joint without having to replace it by realigning the joint surfaces.
Femoroacetabular impingement (or FAI) has been implicated in the progression of hip arthritis and in some cases before significant arthritis in the hip has occurred, FAI can be managed with keyhole surgery.
Total hip replacements currently last up to 20 years, which after that period of time will need to be replaced. For a young adult this means the need to replace the artificial joint throughout their lifetime is very likely. Renewing an artificial hip joint is more complicated than the original operation because the existing artificial hip joint will need to be taken out before the new one is fitted.(5) Therefore, hip preservation surgery is preferred in young adults which may reduce the need for hip replacement later in life.(2)
This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon.
1. Aoanjrr.dmac.adelaide.edu.au. [Internet]. 2016 [cited 11 January 2016]. Available from: https://aoanjrr.dmac.adelaide.edu.au/documents/10180/172288/Lay%20Summary%202014%20Annual%20Report%20Hip%20and%20Knee%20Replacement
2. International Hip Dysplasia Institute. Hip Preservation Surgery for Adult Hip Dysplasia [Internet]. 2016 [cited 11 January 2016]. Available from: http://hipdysplasia.org/adult-hip-dysplasia/adult-treatments/hip-preservation-surgery-for-adult-hip-dysplasia/
3. Arthritisvic.org.au. Living with Osteoarthritis - Arthritis Victoria [Internet]. 2016 [cited 11 January 2016]. Available from: http://www.arthritisvic.org.au/Conditions-and-Symptoms/Osteoarthritis/Living-with-Osteoarthritis
4. Publications H. Avoiding knee or hip surgery - Harvard Health [Internet]. Health.harvard.edu. 2016 [cited 11 January 2016]. Available from: http://www.health.harvard.edu/pain/avoiding-knee-or-hip-surgery
5. Bupa.com.au. Hip Replacement Surgery and Recovery Information - Bupa [Internet]. 2016 [cited 18 January 2016]. Available from: http://www.bupa.com.au/health-and-wellness/health-information/az-health-information/hip-replacement-and-hip-revision
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