Dr. Troy Miles
Top Alternatives to Hip Replacement Surgery
Before any patient undergoes hip replacement surgery, I always recommend exploring every non-operative solution we have at our disposal. A few of the most popular alternatives to joint replacement surgery include pain medication (over-the-counter and prescription), physical therapy (PT), dieting or weight loss, injections, and the use of a walking aid, such as a cane or walker.
Non-prescription pain medications are the perfect place to start for people dealing with hip arthritis. Over-the-counter medications, such as Tylenol and non-steroidal anti-inflammatories, are often recommended to patients suffering from hip pain. However, I expect to see a decrease in the use of Tylenol for treating hip arthritis prior to hip replacement surgery over the next few years.
If pain is not being managed effectively by over-the-counter pain medications, then the next place we could go is to try prescription strength NSAIDs. Orthopedists should only recommend opioid pain medications in rare instances, and even then, these medications should only be taken for short periods of time. I would never recommend that a person suffering from hip arthritis take prescription NSAIDs unless absolutely necessary, as doing this will make it more difficult for us to control pain after surgery.
Rather than relying exclusively on pain medications, patients should consider physical therapy as an alternative to hip replacement. Physical therapy can help to to strengthen the muscle around the hip joint, which may increase stabilization. Physical therapy for hip arthritis usually includes things like isometric exercises, aqua aerobics, and endurance activities. Even if therapy is not a sufficient treatment for the pain, it still provides benefits. Any amount of physical therapy leading up to hip replacement surgery will help to ease the recovery process following surgery.
Weight loss can be difficult for patients suffering from arthritis. Pain caused by arthritis may limit a patient’s ability to exercise. We tend to approach weight loss in two ways, one being exercise and the other being diet. Unfortunately, pain caused by arthritis makes it difficult to exercise. As a result, we focus more heavily on diet for weight loss. Given the challenges that are common with diet-only solutions, it’s common for patients who are overweight to be referred to dieticians for assistance. This course of treatment is increasingly common before patients undergo joint replacement surgery.
For those patients who are on the younger side, or are averse to surgical intervention, injections can be a temporizing solution. Hip injections may control pain and allow for continued hip function. Injections are done under x-ray or ultrasound guidance, as frequently as once every three to four months. If the pain relief from an injection lasts fewer than three months, then it’s time to consider more invasive treatment options, such as surgery.
Finally, walking aids are often used by patients who want to hold off on surgery temporarily. Canes, walkers, walking sticks, and crutches can help patients get around and decrease pain, but these are not long-term solutions. Using a walking aid is very limiting. Usually, patients who are at this stage in the development of hip arthritis will benefit greatly from hip replacement surgery.
Research has shown that patients benefit when they try non-prescription treatment options prior to joint replacement, and only after patients have tried all of the alternatives mentioned above do I recommend surgery.
For more information, or to schedule a consultation appointment at my office, please call Shasta Orthopaedics at (530) 246-2467.