Hip replacement refers to removing the ball and socket of a hip joint. So we remove a
diseased and worn out femoral head, which is the ball. Then we remove a worn out and diseased acetabulum, which is the socket. And we replace that with artificial implants. By far and away, the most common reason that people come to hip replacement is osteoarthritis. Osteoarthritis is the most common form of arthritis. We refer to it as a wear and tear type arthritis, simply where the hip joint has worn out. Most of our patients present to us because they have developed pain that really is no longer responsive to non-operative measures, such as over the counter medicines, exercise and weight loss. That's when we typically start talking about surgical intervention. The decision to proceed with surgery, it's a big one. It's a big decision to make. It's a decision that we make in conjunction with the patient. So we can advise the patient as to whether or not we think they're a good candidate for surgery, whether or not we think surgery would benefit them. We have a whole team that works with patients to get them ready for surgery. A big part of hip replacement and knee replacement and having a
successful outcome is making sure that the patient is really as healthy as we can get them before surgery. We also do discharge planning, making sure that the patient has a good plan for how they're going to recover at home after they're discharged from the hospital. Lengths of stay have really come down substantially over the last decade. Ten years ago, patients would routinely stay in the hospital for two or three days after the operation. Now, many times patients are able to go home the same day as the joint replacement itself. After surgery, of course there's pain, pain is part of any surgical procedure. We help manage that pain with multiple different types of medications. We try to limit opioids. Patients are up on their feet, moving around very quickly with modern joint replacement. For most patients, after a few days, things have really started to improve substantially and they're back on their feet getting back to a lot of normal activities now, after a week or two, following their hip replacement surgery. Thankfully moderate implants have gotten substantially better than older implants that we were putting in a decade or two ago. So the wear rates now are an order of magnitude lower than they used to be. There still is the possibility for wear, and there still is the possibility that the joint replacement has to be redone for other reasons, infections, loosening, breakage
of the implants. Thankfully, those rates are pretty, pretty low for the first 20 to 30 years after the joint replacement is put in.