One question we hear frequently in the orthopedic clinic concerns the timing of hip replacement surgery. The answer is simple— and complicated— because it depends on the individual. There is no absolute age limit for hip replacement. While we are now performing surgery on many older patients, the procedure is also appropriate for younger patients who have suffered some sort of trauma or who have a degenerative disease.
Our assessment depends on the condition of the joint, but also on its effect on your lifestyle. If you are in pain nearly all the time; if the pain keeps you from sleeping at night and prevents your involvement in activities that you once enjoyed . . . then we would certainly consider total hip replacement.
One thing’s for sure: We no longer require patients to wait until they are in the geriatric ward before we consider them surgical candidates. While the number of hip replacement procedures is growing phenomenally, the highest increase has been in patients between 45 and 64 years of age.
The number of people between the ages of 45 and 64 who have total hip replacement is growing more than twice as fast as the incidence of surgery in the older population.
There are a number of factors driving the demand for this procedure. One is the aging population. Damage from osteoarthritis usually occurs in people over the age of 50. (This type of arthritis can also develop after a hip injury such as a fracture.) But again, there’s no minimum or maximum age.
One of our patients (we’ll call him Dan) sustained an injury during his college football days. While he was able to sustain an active lifestyle for the next 30 years, he came to us recently complaining that he could no longer play golf, and that the pain was interferring with his ability to get a good night’s sleep.
At Dan’s age, he should have at least another 30 years of active life ahead of him. So yes, he could be a candidate for total hip replacement.
Surgery would enable Dan to walk the dog after dinner as well as swing a golf club, and would relieve the stiffness that is making it difficult for him to bend over to pull on his socks, or climb the stairs.
Look Ahead to the Post-Surgical Life
Total hip replacement is considered one of the great successes of modern medicine, with improvements in techniques and technology coming steadily since it was first performed in 1960. The principle is fairly straight-forward: Damaged bone and cartilage are removed and replaced with components made of metal, plastic or ceramic.
Post-operative patients are encouraged to get up and move around as soon as possible. Pain is managed with appropriate medication. The patient has physical therapy to help restore everyday movement. Above and beyond these simple rules, the patients with the best chance of success are those who closely adhere to the surgeon’s advice. In short, we ask our post-surgical hip patients to do the following:
- Avoid getting the wound wet until it has thoroughly healed
- Follow a balanced diet and drink plenty of fluids
- Gradually resume your daily activities over the course of three to six weeks
- Follow your physical therapy regimen
- You may also be asked to wear a back brace and to refrain from traveling for six to eight weeks.
Tell Your Surgeon How You Feel after Hip Replacement
Orthopedic surgeons are trained to evaluate symptoms and signs and then make recommendations. The best guide to whether you are a good candidate for total hip replacement involves a team approach. You need to be honest with your surgeon and have realistic expectations about what you can achieve, post-surgery. If you follow your doctor’s advice, the odds are greatly in your favor— whether you are looking forward to your 27th or 87th birthday— for a re-invigorated lifestyle.