"The benefits are overstated, overpromoted, and giving people false expectations"

Minimally Invasive Total Hip Replacement surgery. Those were the comments on such from Dr. Kristaps J. Keggi, an orthopaedic surgeon at Yale University.

Hip Replacement is my topic today as it’s been on my mind due to a patient I saw this morning for an evaluation. This man’s x-rays told the story of a severely degenerated hip, “with total loss of joint space.” This man needed a hip replacement. Here’s the catch: neither he nor his orthopaedic surgeon wanted to give him one. He was too active. Too active can be interpreted two ways: either he was still functioning at such a high level the insurance company would not reimburse it or, he was still to active so he obviously must not be in that much pain.

There is a segment of the population that will seek out surgery as an almost instant gratification, but that is another blog entry, and this man was surely not in this category. I was impressed by his tenacity in caring for his hip, his toughness in dealing with what must surely be a painful condition, and his pride for doing both of these things with class. Obviously, I was very motivated to help him. I was able to modify his exercise routine, prescribe some joint mobilizations, and work on improving adjacent joint actions. These things not only offered him some immediate relief, but I’m guessing will help him for some time until he is ready to have his replacement.

I like to keep this blog somewhat based on headlines I find and give my input on such. This article, in the New York Times discusses my headline about Minimally Invasive Joint Replacements. In short, it reads: make sure you need a joint replacement, make sure you have a joint replacement specialist who performs plenty of operations each year, and do not place so much emphasis on minimally invasive that you end up with minimally effective. Which ever way you look at it, it’s a major operation and results are the most important. As with most operations, good outcomes are a result of matching patients with the right procedure. So if your hips are hurting, take your time, maximize your strength, function and flexibility before hand, and talk to your health care team. Then come see me for therapy afterwards!

http://orthoinfo.aaos.org/

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