Arthritis can wear down the cartilage in the hip, leading to pain and stiffness. In some cases, the pain and stiffness may be so severe that it interferes with daily life, making even simple activities like walking, sitting, and standing difficult.
For these patients, hip replacement surgery may be an option to reduce pain and improve function in the hip.
Anatomy of the Hip
The hip is a “ball and socket” joint. The ball-shaped upper end of the thighbone (femur) fits into a socket in the pelvic bone. A smooth tissue called articular cartilage covers the bones in the joint, cushioning them and enabling movement. A thin tissue called the synovial membrane also surrounds the joint, secreting a small amount of fluid to lubricate the hip and eliminate friction. Ligaments hold the joint in place.
When arthritis is present in the hip, the cartilage is damaged and begins to wear away. Eventually, the bones may begin to rub together, leading to pain and stiffness in the hip.
Candidates for Hip Replacement Surgery
For some patients, nonsurgical treatments like physical therapy and medications may provide sufficient relief from hip arthritis. When nonsurgical treatment does not relieve a patient’s symptoms, hip replacement surgery may be recommended.
Candidates for hip replacement surgery typically have hip pain that affects their daily lives, limiting activities like walking and bending. For some, the pain continues even while at rest. Stiffness can also affect a patient’s mobility, limiting range of motion of the leg.
For these patients, hip replacement surgery can help to improve function in the hip and allow patients to resume their normal activities with less pain.
During a hip replacement procedure, Dr. Tiberi removes the damaged cartilage and bone in the hip. The joint is then replaced with metal, ceramic, and plastic implants to allow for better function in the hip.
The “ball” portion of the hip is replaced with a metal or ceramic ball attached to a stem that is fitted inside the upper end of the thighbone. The socket is resurfaced with a metal shell and a plastic liner. These implants typically have a porous surface that allows the bone to grow into the implant, holding it in place.
There are a few different approaches to hip replacement surgery. Dr. Tiberi employs the anterior approach, making an incision at the front of the hip, rather than the more traditional incision at the side or back. This approach allows him to work between the muscles in the hip to perform the surgery, rather than cutting or detaching them. This technique can reduce recovery times and the risk of dislocation.
Dr. Tiberi also specializes in the latest techniques in hip replacement, including robotic-arm assisted surgery and minimally invasive hip replacements.
Robotic-Arm Assisted Total Hip Replacement
Mako Robotic-Arm Assisted Technology allows Dr. Tiberi to customize his surgical plan for each patient. With this technology, a CT scan of the hip is uploaded to the Mako System software, creating a 3D model of the hip. Dr. Tiberi then uses the 3D model to plan the procedure and guide him during surgery using the robotic-arm. This allows for more accurate sizing and placement of the hip implants.
Minimally Invasive Total Hip Replacement
A minimally invasive total hip replacement is similar to a typical hip replacement procedure. Dr. Tiberi uses the same implants, but performs the procedure through a smaller incisions. This approach allows for minimal disturbance of the soft tissues in the hip, which can reduce pain after surgery.
Minimally invasive hip replacement may be an option for patients who are younger, thinner, healthier, more active, and motivated to participate in physical therapy and rehabilitation. This approach may not be suitable for patients who are overweight or very muscular, have a significant hip deformity, or have conditions that slow wound healing.