Hip Arthritis FAQs

What does it feel like when you get a hip replacement after suffering from hip arthritis?

After getting a hip replacement, the pain from the hip arthritis is immediately gone. What you have is surgical pain which only gets better with time. The pain in the groin from the arthritis is gone. The pain typically after hip replacement is there at the region of the incision irrespective of whether it’s anterior or posterior approach.

Can arthritis of the hip cause lower back pain?

Patients with arthritis of the hip limb and their gait is altered because of the limp. Additionally, patients with arthritis of the hip have a flexion contracture of the hip joint, which means that they cannot completely extend their hip to maintain a stable straight posture especially when the arthritis of the hip is advanced. In such a condition the patient can get secondary low back pain.

After the hip replacement procedure, if the back pain is coming from the altered gait, the back pain goes away. If the back pain is coming from issue in the back, a lot of patients feel that the pain has actually increased! This is because the pain in the hip has gone after hip replacement surgery and only pain left is in the lower back. If there is any confusion as to where the pain is coming from, I give a cortisone or lidocaine injection in the affected joint.

The pain in the joint that gets the injection is completely gone and the pain that remains is the pain that comes from the reminder of the body. This is one excellent way to differentiate pain if the surgeon is not 100% sure which joint the pain is coming from and if the patient has arthritis in numerous joints. I usually inject cortisone injection with lidocaine so that the relief lasts for a much longer period than taking an injection only with lidocaine.

Why does my knee hurt with hip arthritis?

That supply the hip joint also supply the knee joint. Therefore, a patient with hip arthritis can also have knee pain. The knee pain also could be from the arthritis in the knee joint. Physical examination and X-rays usually can tell which joint is the most symptomatic. If there is any question or any confusion about which joint is the main source of pain, we can give injection of cortisone and lidocaine in one joint and the pain that remains is from the reminder of the body.

How painful is hip replacement?

We use multimodal pain management after hip replacement surgery. Medications to control the pain after the surgery are started even before the start of the surgery. In the surgery we have anesthesia and while the surgery is being performed, there is absolutely no pain. In the surgery we give an injection of a combination of agents that helps in controlling the pain after the surgery.

After the surgery we use anti-inflammatory medication to control the inflammation and the pain and we have minimized the use of narcotic medications to decrease the risk of side effects happening from narcotic medication like constipation and drowsiness.

How long does it take to recover from a hip replacement surgery?

Hip replacement surgery is now done is a very minimally invasive manner. Patients stand up and walk the same day of surgery. They walk with a walker with or without help. The next day they’re walking with a walker mostly on their own without help. Then as their muscles rehab, they progress to walk with a cane in the other hand. Eventually, they walk with no support.

What are the symptoms of bone cancer in the hip?

Bone cancer in the hip typically presents as pain or as a fracture of th bone or it is detected by radiology. Adults do not usually get primary bone cancers. Primary bone cancers are usually seen in growing kids. In adults, we usually see metastasis which means that the main problem or the main cancer is elsewhere in the body and the seeding has happened to the bones.

The main cancer could be in the lungs or could be from the prostate. If there are metastases to the bone, the bone can be weakened which can give rise to fractures. If fractures happen in hips that have metastasis, routine hip replacement surgery does not suffice. I do a cemented hip replacement after fixing the broken bone.

I also use Zoledronic acid with the cement to decrease the proliferation of cancer in the tissue around the prosthesis. If the cancer has affected the cup of the hip in addition to the thigh bone, then I use a cemented cup on the acetabulum. In conclusion, for patients needing total hip replacement secondary to metastasis in the hip, cemented joint replacement surgery in combination with Zoledronic acid is an option which provides excellent relief of pain.

Can sciatica cause hip pain?

Sciatica will typically cause pain at the back and will radiate down the leg to the ankle joint. Hip pain from arthritis is the front of the joint and presents as groin pain. On examination, certain tests can clearly differentiate where the pain is coming from. In addition, X-ray or MRI will be useful in differentiating sciatica which comes from the back from hip pain which is coming from the hip arthritis.

Can weather have an impact on joint pain severity?

Patients have always told me that weather impacts the severity of their joint pain. However, this is not very well researched by orthopedic surgeons in studies. Patients who have implants also complain of increased pain with weather changes. Very little research has been done with the belief held by most arthritic patients that changing weather patterns influence their pain severity.

How much weight should I lose to reduce arthritic pain? How much does weight affect arthritis?

Pain from arthritis of the hip and knee is increased with increased body weight because more weight goes through the joint. Weight loss is an important factor influencing joint pain. Before any surgical intervention, the patient is always advised to decrease their weight if they have a high BMI.

How much weight should I lose to reduce arthritic pain?

If the patient’s Body mass Index (BMI) is high, the more weight they lose, the better. Patients who are significantly overweight may consider weight loss surgery prior to hip or knee replacement surgery if they need one. Patients having weight loss surgery should be advised to take vitamin D after getting the vitamin D level down because most patients who have undergone weight loss surgery have a low vitamin D level because of absorption issues.

How should the patient stand, how should the patient sit, how should the patient sleep if they have arthritis?

Patients do activity modification so that the pain coming from the arthritis is reduced. I want my patients to be active and pain free. The idea of any treatment is to ensure that the patient can stand, sit, and sleep without any pain and without any activity modification.

What are the best ways to do household chores?

Patients with arthritis have difficulty walking, sitting, squatting, climbing stairs and certain modifications to their living may be necessary to accommodate the pain coming from the arthritis especially if they’re not surgical candidates. Having a ramp for patients who are wheelchair bound, having transportation for shopping outside the house and having support system and having ambulatory aids inside the house help. Avoid bending, squatting. Avoid lifting heavy weights like laundry. Insurance is able to cover some of these items that are associated with cost.

What is the best way to go up and down stairs?

After joint replacement surgery, in the post-operative period, I tell my patients “the good goes to heaven, the bad goes to hell!” This means that while going up stairs you use the contralateral extremity and while coming down you use operative extremity.

What is the best way to get in and out of the car?

Patients who have hip and knee arthritis have trouble getting in and out of the car. For patients with knee arthritis, especially medial joint arthritis of the knee (inside of the knee), the pain from the arthritis is aggravated if they sit with their knees separated because the inner part of the joint is compressed in that position.

For patients with the medial joint line arthritis, I advise them to sit in a manner they’re looking on the outside of the knee joint. This decreases the compression on inside of the knee and alleviates the pain on the inside of the knee joint. Conversely, if the most of the arthritis is on the outside of the knee joint, if the patient is sitting and looking at the inside of the knee, then the part which is arthritic is not compressed and the pain on the outside of the joint is alleviated.

When should a patient with arthritis ask for help?

If pain from the arthritis starts interfering with activities of daily living and the patients have to alter their activities of daily living, it’s time to seek help.

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