UnderstandingTotal Hip Replacement
Total hip replacement is the ideal remedy for chronic hip pain or severe hip damage, this procedure entails replacing the entire hip joint with a prosthetic implant. It’s known for its high success rate in restoring mobility and enhancing quality of life.

Hip Arthritis

Also known as: Hip Osteoarthritis (OA)

  • Osteoarthritis is the most common type of hip arthritis. It is a degenerative joint disease that affects the cartilage in the hip joint.
  • Cartilage is a firm, rubbery tissue that cushions and protects the bones in the joint; it can gradually wear away, causing the bones of the hip socket to rub against each other.
  • This can result in pain and stiffness in the groin and hip.

Check out this great educational handout on Osteoarthritis from our partners at the AAOS & OrthoInfo.org.

For Hip Arthritis

From Conservative Care to Hip Replacement Surgery

Treatment for hip arthritis is similar to the treatment of knee arthritis, which starts with conservative treatment. The following treatment options are always a first step if patients can tolerate them:

  • Over-the-counter pain relief and anti-inflammatory medication like Extra Strength Tylenol, Aleve, or Ibuprofen
  • Prescription anti-inflammatory medication like Mobic (meloxicam) or Celebrex (celecoxib)
  • In-office hip injection with an anti-inflammatory medication like cortisone
  • Nutrition optimization
  • Physical therapy
  • Avoiding painful activities

Conservative management is always the first step of treatment. For many patients, conservative treatment can offer months to years of pain relief without the risks of surgery.

While joint replacement is one of the safest surgeries, all surgeries carry the risk of infection, nerve or blood vessel injury, or complications from anesthesia. Once patients have exhausted conservative treatment, they are usually candidates for hip replacement, which The Lancet named the “Operation of the Century” in 2007.

Total Hip Replacement

MIS: Minimally Invasive Surgery

My approaches are considered minimally invasive, which minimizes or avoids damage to muscles, tendons, and ligaments around your hip joint while still replacing the arthritic joint. The steps of a hip replacement are as follows:

  1. Before the surgery, you will receive epidural anesthesia to numb your legs and sleeping medication to allow you to sleep through the procedure while still being able to breathe on your own without a breathing tube.
  2. Next, the surgical area is cleaned with a series of antiseptic solutions, and sterile drapes are applied to reduce contamination.
  3. A small incision is made over your hip joint, and the hip joint is exposed in a way that avoids the tendons and ligaments around your hip
  4. The arthritic surfaces of your hip are removed with specialized surgical instruments
  5. Then, I select the correct shape and size components and place trial implants to ensure the form and function of your hip are optimal.
  6. Small adjustments are made until I am 100% satisfied with the outcome of your surgery.
  7. Permanent implants are placed with a fit that provides instant stability that will grow into your bone over the next few weeks
  8. The hip is closed in layers with sutures that will dissolve over the next few weeks. The top layer is glue that will fall off on its own. A waterproof dressing is applied that stays on for seven days.
  9. After surgery, patients are taken to the recovery room where they will practice walking with an assistive device, eat and drink, and work with a physical therapist to practice going up and down stairs, either returning home or staying overnight in the hospital.

Expected Outcomes

The materials used in modern hip implants are designed to last a lifetime. I always use the latest generation of ceramic on plastic bearing surfaces whenever possible. It’s worth noting that around 95% of patients are still doing well with their hip replacement at the 15-year mark.


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Frequently Asked Questions Total Hip Replacement

Dr. Keating has trained with every major orthopedic device company and has most implants available. His current preference is to use a ceramic head with a highly cross linked polyethylene liner, which is the most advanced bearing surface available. The stem and cup are both manufactured from titanium.

Yes. Dr. Keating learned anterior hip replacement from the pioneers of the operation and performs it with specialized instruments that avoid the use of a traction operating table.

Yes. Dr. Keating has access to every surgical robot on the market. For most patients, Dr. Keating prefers to use the latest generation of surgical navigation. This includes using a sterile camera to track your bones in space during the operation to ensure that component placement and leg length is accurate within millimeters.

Every joint replacement has a plastic bearing that can be removed and replaced without disturbing the metals parts fixed to your bones. This allows a new bearing to be placed with a minor surgery compared to the first joint replacement surgery you had.

No! Dr. Keating does not restrict his patients from doing things that they love after surgery. However, patients must understand that the plastic bearing of their joint replacement will wear out faster with higher impact activities.

No. Dr. Keating does not prescribe hip precautions after surgery as the surgical approaches he uses have a low dislocation rate compared to other approaches.

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