Dr. Joseph Hecht Answers Your Questions
How do I know if I have a hip problem?
The most common symptom in patients with hip disorders and labral tears is pain in the groin. Clicking or snapping in the groin may also occur. A bulging area in the groin is more likely to be hernia. Pain on the side of the hip is commonly related to trochanteric bursitis or gluteus medius tears. Pain in the buttock is generally related to the low back or sacroiliac (SI) joint but may be related to a hip problem.
How are hip disorders and labral tears diagnosed?
Hip disorders are evaluated by a thorough history (patient interview), physical exam, and appropriate imaging. Make an appointment to have your hip fully assessed.
What kind of imaging will I need?
The three types of imaging you may need are: 1) x-ray, 2) MRI, and 3) CT scan.
X-ray is the most common imaging modality we use and provides a good overview of the bony structure of the hip. Most patients will need to have x-rays taken when they come in for an appointment. Even if you have had x-rays taken in the past, we may obtain additional specialized views to look for FAI.
MRI is an imaging technique that uses magnets instead of radiation in order to obtain detailed images of the body. MRI gives us the best look at the soft tissues (labrum, tendons, cartilage). We often obtain an MR arthrogram, a special type of MRI in which contrast fluid is injected into the joint, when a labral tear is suspected. MRI is not performed in the office and requires an appointment. Dr. Joseph Hecht of Orthopaedic Specialists of Northwest Indiana provides onsite MRI machines so that most patients can schedule their MRI within a few days of getting insurance approval.
CT Scan is the third type of imaging we use and provides a very detailed picture of the bony anatomy of the hip. This is particularly important in cases of complex orthopedic conditions. With this advanced imaging technology we are able to create a 3-D map of your hip so that recontouring of the hip joint during surgery can be as accurate as possible.
Frequently Asked Questions About Hip Replacement
What is arthritis, and why does my hip hurt?
In the hip joint there is a layer of smooth cartilage on the ball of the upper end of the thigh bone (femur) and another layer within the hip socket. This cartilage serves as a cushion and allows for smooth motion of the hip. Arthritis is a wearing away of this cartilage. Eventually it wears down to bone. Rubbing of bone against bone causes discomfort, swelling and stiffness.
What is a total hip replacement?
A total hip replacement is an operation that removes the arthritic ball of the upper thigh bone (femur) as well as damaged cartilage from the hip socket. The ball is replaced with a metal ball that is fixed solidly inside the femur. The socket is replaced with a plastic liner that is usually fixed inside a metal shell. This creates a smoothly functioning joint that does not hurt.
When should I have hip-replacement surgery?
Dr. Joseph Hecht will decide if you are a candidate for the surgery. This will be based on your history, an examination and X-rays. Your orthopaedic surgeon will ask you to decide if your discomfort, stiffness and disability justify undergoing surgery. There is no harm in waiting if conservative, non-operative methods are controlling your discomfort.
Am I too old for hip-replacement surgery?
Age is not a problem if you are in reasonable health and have the desire to continue living a productive, active life. You may be asked to see your personal physician for an opinion about your general health and readiness for surgery.
How long will my new hip last, and can a second replacement be done?
We expect most hips to last more than 10–15 years. However, there is no guarantee, and 5–10 percent may not last that long. A second replacement may be necessary.
Why do hip replacements fail?
The most common reason for failure is loosening of the artificial ball where it is secured in the femur, or loosening of the socket. Wearing of the plastic spacer may also result in the need for revision.
What are the major risks?
Most surgeries go well without any complications. Infection and blood clots are two serious complications that concern us the most. To avoid these complications, we use antibiotics and blood thinners. We also take special precautions in the operating room to reduce risk of infections. The chances of this happening in your lifetime are 1 percent or less. Dislocation of the hip after surgery is a risk. Dr. Hecht will discuss ways to reduce that risk.
Should I exercise before the surgery?
Yes. You should discuss preoperative physical therapy and exercise with your surgeon. Exercises should begin as soon as possible.
Will I need blood?
You may need blood after the surgery. You may donate your own blood, if able, or use the community-blood-bank supply.
When will I be able to get out of bed?
Your surgeon may request that you get out of bed the day of your surgery. The next morning you will get up, sit in a chair or recliner and walk with a walker with help from the staff.
How long will I be in the hospital?
Most hip-replacement patients are hospitalized for three to four days after surgery. If you need more time for rehabilitation, other options might be available to you. Make arrangements before your surgery to have someone stay with you after you are discharged.
How do I make arrangements for surgery?
Dr. Joseph Hecht and his physician extenders will assist you in making arrangements for your hip procedures.
How long does the surgery take?
We reserve approximately two to two-and-a-half hours for surgery. Some of this time is taken by the operating-room staff to prepare for the surgery.
What are my anesthesia options?
You may have a general anesthetic, which most people call “being put to sleep,” or a spinal anesthetic. The choice is between you and the anesthesiologist.
Will I have pain after surgery?
Yes, but we will keep you comfortable with appropriate medication. Generally most patients are able to stop very strong medication within one day. The day of surgery, most patients control their own medicine with a special pump that delivers the drug directly into their IV. Your surgeon will discuss with you what pain control option is best for you.
How long and where will my scar be?
The scar will be approximately 6–8 inches long. It will be along the side of your hip.
Will I need a walker, crutches or cane?
Yes. Until your muscle strength returns after surgery, you will need a walker, a cane or crutches. Your equipment needs will be determined by Dr. Joseph Hecht and his medical team.
Will I need any other equipment?
After hip-replacement surgery, you will need a high toilet seat for about three months. If needed, you will also be taught by the occupational therapist to use adaptive equipment to help you with lower body dressing and bathing. You might also benefit from a bath seat or grab bars in the bathroom. Your home equipment needs will be arranged while you are in the hospital.
Where will I go after discharge from the hospital?
Many patients go directly home when discharged. The physical therapist will be scheduled to come to your home three times a week. You should check with your insurance company to see what rehabilitation benefits you are eligible for.
Will I need help at home?
Yes. In the first several days or weeks after surgery, depending on your progress, you will need someone to assist you with meal preparation, housekeeping, etc. Family members or friends must be available to help. Preparing ahead of time, before your surgery, can minimize the amount of help required. Having the laundry done, house cleaned, yard work completed, clean linens put on the bed, and single-portion frozen meals will reduce the need for extra help.
Will I need physical therapy when I go home?
Yes. Physical therapy will continue after you go home with a therapist in your home or at an outpatient facility. The length of time required for this type of therapy varies with each patient. We will help you with these arrangements before you go home.
how soon after surgery will i be able to drive?
The ability to drive depends on whether surgery was on your right hip or your left hip and the type of car you have. If the surgery was on your left hip and you have an automatic transmission, you could be driving within two weeks. If the surgery was on your right hip, your driving could be restricted as long as six weeks. Consult with Dr. Joseph Hecht for advice on your activity. You should not drive if you are taking narcotic pain medicine.
When will I be able to get back to work?
We recommend that most people take at least one month off from work, even if your job allows you to sit frequently. More strenuous jobs will require a longer absence from work.
How soon after surgery can I have sexual intercourse?
The time to resume sexual intercourse should be discussed with Dr. Hecht.
How often will I need to see my doctor following the surgery?
Two to four weeks after discharge, you will be seen for your first post-operative office visit. The frequency of follow-up visits will depend on your progress.
How will my physical activity be restricted after surgery?
High-impact activities such as contact sports, running, singles tennis and basketball are not recommended. Injury-prone sports such as downhill skiing are also dangerous for your new joint. You will be restricted from crossing your legs. Dr. Hecht and therapist will discuss further limitations with you following surgery. You are encouraged to participate in low-impact activities such as walking, dancing, golfing, hiking, swimming, bowling and gardening.
Will I notice anything different about my hip?
In many cases, patients with hip replacements think that the new joint feels completely natural. However, we recommend always avoiding extreme positions or high-impact physical activity. The leg with the new hip may be longer than it was before, either because of previous shortening due to the hip disease, or because of a need to lengthen the hip to avoid dislocation. Most patients get used to this feeling in time or can use a small lift in the other shoe. Some patients have aching in the thigh when bearing weight for a few months after surgery.