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Tips on options for hip replacements
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Bal M Rajagopalan, MD posted:
In today's competitive markets, many companies and surgeons are advocating and pushing their own prosthesis, when it comes to hip replacements. You may even go to a surgeon where the hospital dictates what is being used, based on price. It is so important to be educated and involved in the process of decided what implant is best for you, and why. In a day where there are recalls and aggressive advertising, all of this information can be overwhelming.

First, make sure your surgeon is board certified. Being board certified means that you surgeon has surpassed the highest qualifications to practice as a surgeon. There are many non-certified surgeons practicing today. Second, do some research on your surgeon to make sure that their patients have been happy with the work they have done. Remember that any negativity travels fasters than positivity. Make sure you and your surgeon can freely communicate and there is a positive working environment. When you are in a waiting room, talk to some of your surgeon's patients.

With implants, there are options and it is overwhelming. The general rule of thumb is to ask questions and realize that not all implants are a fit for all people. With respect to approaches, you will have surgeons going anteriorly, posteriorly, or lateral. The simple basic rule is both anterior and posterior are great in someone who does them often. The advantage of these two approaches are they are muscle sparing, and can prevent limping.

On bearing surfaces you can use metal, polyethylene and ceramic. The best of these three is a tough answer. There have been issues with ceramic on ceramic cracking, metal on metal causing increased ions. The safest in my opinion, is ceramic on polyethylene. As surgeons, we aim for the biggest heads to enhance stability and prevent dislocation.

** Ask your surgeon if there is a risk of leg length discrepancy, due to any anatomic issues.

Nowadays, we aim for press fit to allow immediate weight bearing. Immediate weight bearing is very important, as it prevents issues with bedsores, infection, pneumonia, and blood clots. So, ask your surgeon when you will be able to walk and when you will be at full weight bearing.
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annette030 responded:
Great explanation!!

My husband had his hip replaced two years ago due to AVN of the femoral head. His bad leg was well over 1 1/2 inches shorter than the good leg preop, he just put shims in his shoes to make them close to the same. The surgeon told him he would do his best to make the legs match in length but he wasn't sure he could fix that completely. He did it though. He was up the same day and walking with a walker the following day. He had surgery on Tesday and was home on Friday with a walker, which he quickly exchanged for a cane, then nothing.

I am a retired nurse, so I had vetted the doctor and hospital pretty thoroughly.

Take care, Annette
 
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Bal M Rajagopalan, MD replied to annette030's response:
That is great! Research and good questions go a long way!


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