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    Hip Replacement Gets Personal

    The hip is one of the most heavily used joints in the body. If the cartilage wears away or arthritic bone impedes the function of the socket, the pain becomes debilitating and a replacement may be inevitable. But what is a hip replacement, really?

    Hip replacement is a highly technical procedure that involves a complete replacement of the ball and socket of the joint, including the pelvic bone. In some cases, the ball can be preserved in a procedure known as a "surface replacement", according to Charles N. Cornell, MD, a surgeon who specializes in hip replacement at Hospital for Special Surgery (HSS). "But surface replacement is generally a procedure reserved for younger patients without severe arthritis."

    Hip replacements are as individual as the hip, but what causes the damage is usually one of two things. "Rheumatic diseases (like rheumatoid arthritis) can affect the hip and many other joints," says Dr. Cornell, "but 90% of hip replacements are due to degenerative osteoarthritis."

    Hip replacement is by far the most performed procedure at the Hospital for Special Surgery in New York City, and indeed, no institution in the world is more experienced at replacing hips as HSS. So how does the world-renowned hospital provide custom care for the more than 5,000 patients who come in for hip replacements each year? It's all about preparation and precision.

    Proprietary Technology Ensures a Custom Fit

    Using innovative imaging, surgeons at HSS can perfectly fit a patient with a new hip socket and then essentially perform a patient's hip replacement virtually before even entering the operating room. "We have a pretty amazing computer program that's unique to HSS," says Dr. Cornell. "X-rays are taken of each patient's hip using an advanced high-power calibration device to conduct exact measurements." A computer-generated template then sizes the joint precisely in tiny, one-millimeter increments. "It's incredibly accurate," says Dr. Cornell.

    With such a high volume of surgeries, HSS maintains a vast selection of implants in a variety of sizes, and they can even customize implants to fit any patient. Since 1977, HSS has designed over 2,400 custom implants for its patients. "This means that regardless if a patient has a large or small stature, a severe deformity, or another clinical challenge," says Dr. Cornell, "The team at HSS can provide an expert solution."

    The Pathway to Success

    HSS has not only perfected customized surgery; its individual approach extends from pre-surgical planning to post-operative care with a personalized care pathway designed for rapid recovery. "We aim to have everyone up and walking and going up stairs on post-op day two," says Dr. Cornell. "We like our patients to go home!"

    Today, an average length of stay for a hip replacement patient at HSS is just two to two-and-half days. A generation ago, the average stay was more than two weeks. "We look at each patient's age and activity level and tailor their path to mobility to match their needs," says Dr. Cornell. "For instance, younger patients may be placed on an accelerated pathway, while older patients receive a special route that aims to prevent complications that are specific to them."

    HSS also recognizes that a tailored pain management consultation helps ensure that path is smooth and as pain-free as possible. "Many patients feel better on post-op day one than they did the day before surgery," says Dr. Cornell, who assures his patients that hip arthritis pain is much worse than the pain of a surgeon's incision.

    Satisfaction is Personal

    Just because you're a candidate for hip replacement, doesn't mean you're sick. And that's one reason to seek out a facility like HSS that has focused expertise and unlimited experience. "There's a huge difference in the way a hospital treats sick patients vs healthy patients," says Dr. Cornell. "Most of our patients are very healthy and choose to have these procedures to improve their quality of life."

    HSS is known for providing patients an enjoyable, positive experience in the hospital from the comfortable appointments of the room to the pleasantries of the staff. "Everything at HSS revolves around the comfort of the patient," say Dr. Cornell. "We've refined the way we take care of people to improve our results."

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