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Activities, Symptoms, and Expectations of Patients Undergoing Hip Surgery

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Hip Joint Restoration

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Abstract

Does hip surgery restore normal hip function? While it is generally accepted that surgery is performed to avoid, or overcome, pain and deterioration of function, the underlying pathologies of hip deformity and dysfunction differ. Three common surgical procedures—hip osteotomy, hip arthroscopy, and total hip replacement—treat hip pathologies at three very different stages of life.

Surgical techniques and literature evaluating the relationship between hip dysplasia and secondary osteoarthritis have advanced hip osteotomy tremendously over the past 50 years. The few studies that have undertaken the challenge of quantifying the activity levels of individuals with symptomatic hip dysplasia sought to analyze changes in gait and overall activity level in patients with periacetabular osteotomy (PAO). While studies demonstrate overall postoperative improvement, early diagnosis of hip dysplasia is particularly effective in improving clinical outcomes.

Patients undergo hip arthroscopy for a variety of reasons; however, it is important to identify the primary goals of each patient before undertaking an arthroscopic procedure and the likelihood that it can be achieved. The primary complaint of patients with intra-articular hip pathology is pain and pain-induced limitations to function, describing a feeling of “giving way” in the joint. Research in pain measurement scales, such as Visual Analog Scale (VAS), has found substantial improvements in pain, postoperatively; however, fulfillment of a patient’s preoperative expectations is often found to be overly optimistic.

Total Hip Replacement (THR) is currently the only solution for end-stage hip osteoarthritis (OA), though the physical activity level of patients seeking this treatment varies widely both before and after surgery. Despite the variance in a patient’s leisure and social activities, age has the greatest impact on the extent to which patients participate in physical activities. In view of the emerging status of all three approaches to the treatment of hip pathology, and the differences in their outcomes, we recommend that clinicians provide preoperative counsel to every individual patient regarding the likely outcome of treatment options, especially in terms of expected function with respect to each patient’s lifestyle and aspirations and the extent to which preoperative symptoms will be eliminated.

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Authors and Affiliations

  1. Institute of Orthopaedic Research and Education, 6550 Fannin Street, Suite 2501, Houston, TX, 77030, USA

    Michael G. Hogen BA, Ardavan Ariel Saadat BS, MD & Krissett A. Loya-Bodiford MPH, BS

  2. Department of Orthopaedics, Kaplan Joint Center, Newton Wellesley Hospital, Newton, IA, USA

    Maureen K. Dwyer PhD, ATC

  3. Department of Orthopaedics, Massachusetts General Hospital, Boston, MA, USA

    Maureen K. Dwyer PhD, ATC

  4. Joseph Barnhart Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX, USA

    Ugo N. Ihekweazu MD, BS

  5. Department of Orthopaedic Surgery, University of Illinois College of Medicine at Chicago, Chicago, IL, USA

    Ardavan Ariel Saadat BS, MD

  6. Director of Research, Institute of Orthopedic Research and Education, 6550 Fannin Street, Suite 2501, Houston, TX, 77030, USA

    Philip C. Noble MD

  7. Director of Research, Institute of Orthopedic Research and Education, Houston, TX, 77030, USA

    Philip C. Noble MD

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  1. Michael G. Hogen BA
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Correspondence to Philip C. Noble MD .

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Editors and Affiliations

  1. Orthopedic Surgery, Hip Joint Arthroplasty, Hip Arthroscopy Massachusetts General Hospital, Boston, Massachusetts, USA

    Joseph C. McCarthy

  2. Institute of Orthopedic Research and Education, Houston, Texas, USA

    Philip C. Noble

  3. Consultant Orthopedic Surgeon Orthopedics, The Villar Bajwa Practice, Spire Cambridge Lea Hospital, Cambridge, United Kingdom

    Richard N. Villar

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Hogen, M.G., Dwyer, M.K., Ihekweazu, U.N., Saadat, A.A., Loya-Bodiford, K.A., Noble, P.C. (2017). Activities, Symptoms, and Expectations of Patients Undergoing Hip Surgery. In: McCarthy, J., Noble, P., Villar, R. (eds) Hip Joint Restoration. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0694-5_84

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