A physician’s thoughts and tips for patients needing hip replacement surgery
By Bryan Wright
I can always tell someone has a bad hip without
an x-ray, without talking to them — if I can just see their hip move. My patients, all of them, all the time, every
operation, are allowed to do everything that they want. I’ll tailor the operation to
make sure that happens. We make an incision and we take the hip completely
out of the joint. Once we get it apart, we remove the ball in a typical hip replacement
and just take a saw and cut across the bone in the appropriate area, remove the ball,
then we work on the socket part of the hip. We put a new surface to replace the worn down
cartilage that we have and then after that we turn to replacing the ball itself. The common ones over and over would be basically
infection, a blood clot can occur, or some goal not met as far as the functional outcome.
For a patient, though, they have to be comfortable that they’ve been heard, so that their symptoms
have been listened to and the operation is matched to them, not to someone else, but
to them. You’ve got to get the joint surface directly
and fully restored and you have to get the length and leverage of the muscles around
the hip correctly adjusted — they can’t be off a little bit and that’s not just
leg length, it’s a thing called offset too that has to do with how far away the center
of the movement is from the center of your pelvis. Metal we know a lot about — it’s plenty
smooth and it will never break. Ceramic’s smoother, is why you would offer it to a patient.
It has better frictional characteristics. I’ve tried hard to break some of the new
ceramic balls and I haven’t figured out a way to do so yet. No, nothing. Not a scratch, not a crack — no
marks at all. And that’s after being used, hit with a hammer, dropped out of a second
story or so window, and now run over a few times with a car. Nothing. The majority of patients, it’ll last them
the rest of their life no matter what they do.