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Ma's New Hip

In having her hip replaced yesterday, my mother joined a big and growing club: More than 235,000 people have hip replacement surgery in the United States each year, according to the American Academy of Orthopaedic Surgeons, and that number's expected to climb steadily higher as baby boomers reach 60 and over -- the prime time for hip fixes.

Ma (yes, that's what we've always called her, and no, we didn't grow up in a little house on the prairie), at age 82, only recently stopped horrifying her next-door neighbor by climbing out a second-floor window to clean the gutters. By Christmas time last year, though, she could barely hobble around the mall to do her shopping, and the pain in her hip and groin was so bad it kept her awake at night.

Turns out Ma was a prime candidate for hip replacement: The orthopedic surgeon's X-ray showed virtually no cartilage left between her femur and her hip socket. But doctors don't just hand out hip replacements. To warrant surgery, you need to have persistent pain that's not relieved by medication or cortisone shots or disability that makes it hard for you to do regular things like walk without an aid, climb stairs, or put on your socks and shoes.

In a standard total hip arthroplasty, or reconstruction -- the kind Ma had -- a prosthetic ball is attached to the top of the femur (held in place by a rod inserted in that bone) and an artificial socket inserted in the hip bone; the ball fits in the socket just like the original bones did.

(Here's a fun tool that lets you play hip surgeon: http://www.edheads.org/activities/hip/ )

Newer, minimally invasive procedures do the job with smaller incisions, reducing the damage to surrounding muscles and causing less scarring; another procedure retains the natural ball, resurfacing it with a synthetic material. The jury's out on how these compare to the standard procedure in cost and effectiveness.

The AAOS reports that complications of hip replacement surgery can be serious but are increasingly rare: They include blood clots, infection and bleeding. Rarely, one leg ends up a different length than the other. Down the road, the fake hip joint can get dislocated. To avoid this, patients are told not to cross their legs or bend the hips at more than a right angle. And sometimes the surgery needs "revision"--a do-over.

A new hip's likely to last 15 to 20 years and costs about $26,000 (a revision costs about $32,000). Medicare pays for about 60 percent of hip reconstructions.

As for Ma, she hopes to be home soon (after three days in the hospital, she may have to spend a few more days in a rehab center), climbing stairs and walking her dog. I do hope she has the good sense to stay off the roof.

How about you? Have you had a hip replaced? How'd that go for you?

By Jennifer LaRue Huget  |  April 8, 2008; 11:25 AM ET
 
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