Morris orthopedic surgeon contributes to evolution of hip replacements
MORRIS – How much mileage can one patient get from hip replacement surgery?
If you’re Charles Smith of Streator, a Minonk letter carrier, it’s 40,000 miles, almost enough to trot around the world twice.
Since his surgeries in 1996 and 2000, Smith has walked 50 miles a week, 11 months of the year on those joints. For Smith, a mailman’s job has its good and bad points, he said.
“It’s paid the bills,” Smith said. “In the warm weather, it’s really nice to be outside. It’s kind of hard, though. There’s a lot of walking up and down stairs.”
Smith also walks along sidewalks, up driveways and in and out of his delivery vehicle. When he turned 50, Smith noticed discomfort in his left hip, the first signs of osteoarthritis.
The condition runs in his family, Smith said. His father, brother and sister had it and all the mileage from his walking contributed to Smith’s own joint deterioration. The discomfort eventually turned to throbbing and interfered with Smith’s sleep.
“Walking got hard to do,” Smith said. “Plus, I had a mailbag over my shoulder.”
Smith began taking Vicodin to help him get through his days. Walking up steps became “torture.” It was out of pure stubbornness, Smith said, that he waited a year to consider surgical options.
A friend recommended Morris Hospital orthopedic surgeon Dr. Keith Rezin, of Rezin Orthopedics and Sports Medicine in Morris, and Smith made an appointment. Rezin said Smith’s hip X-ray showed a classic presentation of severe osteoarthritis.
“It was bone-on-bone with spurs, with no cartilage left,” Rezin said. “He had an altered gait, and he couldn’t walk as much as he used to.”
Signs of osteoarthritis of the hip can include pain from the groin area down to the level of the knee. Hip pain can cause “referred pain” to the knee. That discomfort is mainly felt with weight-bearing movements.
Rezin scheduled Smith for hip replacement surgery.
“By far, the No. 1 reason for hip replacements is osteoarthritis,” Rezin said.
Rezin said, as the population ages and there is more need for hip replacement surgeries, the parts used for the procedure have evolved for better strength, mobility and longevity.
“The metals are better today,” Rezin said. “There is a lot of titanium used. But the biggest evolution has been the plastics. The plastics used today are much stronger, and they don’t wear out as fast.”
Ninety percent of Rezin’s hip replacement surgery patients – and Rezin performs about 70 hip replacement surgeries a year – take their first steps shortly after surgery. Rezin said one particular drug, Exparel, when injected before the prosthesis is placed, will give two to three days of pain relief at the site.
For total hip replacement surgery, such as Smith’s, Rezin replaces the diseased and damaged portions of the hip with implants. First, the femur – the large thigh bone – is removed from the hip socket. Then the damaged head is removed, and the bone is hollowed out. A long, sturdy metal implant with a large metal ball on top is placed inside the femur.
Rezin also removes the damaged areas from the hip socket. Then he places a metal shell implant into the hip socket and a plastic liner inside the shell. He then fits the new ball of the upper femur and socket of the hip together.
Incisions today are usually between four and five and a half inches, Rezin said, and post-operative therapy lasts three to six weeks. Smith said his first hip replacement surgery went “quite well.”
“I had it on Monday and was on my way home that Friday,” Smith said. “Three months later, I was back on my route.”
Within four years, Smith felt similar pain in the right hip.
“This time I didn’t wait,” he said.
Smith is happy for the return of the warm weather, especially since he enjoys golfing. He’ll visit with Rezin at the clinic’s annual golf outing where the two have enjoyed happy reunions for the last 13 years.
The American Association of Orthopaedic Surgeons recommends the following before undergoing hip replacement surgery:
• Make sure you fully understand the procedure. Learn what to expect before, during and after the surgery.
• Ask about rehabilitation and pain management.
• Ask about changes hip replacement surgery will make in your life.
• If you smoke, cut down or quit. Smoking changes blood flow patterns, delays healing and slows recovery.
• Don’t drink any alcohol for at least 48 hours before surgery.
• Tell your doctor about any controlled substances you use. Narcotics and other drugs can have an impact on your surgery.
• Eat well. If you are overweight, your doctor may recommend a weight loss program.
• Ask your doctor for pre-surgical exercises. You may need to strengthen your upper body to cope with crutches or a walker after surgery. Isometric exercises can also help maintain the strength of your leg muscles.
• Arrange for someone to take you home and stay with you several days after the surgery.
• Have items you use regularly placed at arm level.
• Remove throw or area rugs in your home.
• Consider modifying your bathroom to include a shower chair, gripping bar or raised toilet.
• Set up a “recovery center” in your home where you will spend most of your time. Things you need often should be within reach.