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There have been a myriad of changes during the past 10 years in the management of patients with hip pain. Improvements in implants, refinements in surgical techniques, and advances in non-arthroplasty treatments have led to excellent outcomes and many satisfied patients.

Hip implants have changed dramatically in recent years. Whereas historically almost every hip replacement patient received a metal femoral head and polyethylene socket, surgeons now have a wide variety of implants currently available for selection. The goal of all of these improvements has been to increase the longevity of the artificial joint. Surgeons can now choose from metal/metal bearings, ceramic/ceramic bearings, and cross linked ultra high molecular weight polyethylene. Ceramic and metal hips can be highly polished and have very low friction interactions. Cross linking of polyethylene through radiation results in increased durability and a dramatic reduction of wear. All of these bearing surfaces have been shown to reduce wear in artificial joints, frequently by 90% or more when compared to conventional hip replacements.

Reduced wear decreases the likelihood of loosening or failure of the artificial joint. In addition, the decreased wear allows surgeons to use larger diameter femoral heads, resulting in improved range of motion and reduced risk of dislocation. All of these changes mean better results for patients facing hip replacement surgery.

Surgical techniques have also improved over the past decade. Hip replacements typically required large incisions and a significant and prolonged recovery period. Now surgery is frequently done through incisions that are half the size of older incisions. New approaches, such as mini posterior incisions, anterior approaches and 2 incision techniques have allowed patients to recover more rapidly from the surgery. I have had patients who have played 18 holes of golf less than a month after hip replacement!

Not every patient with hip pain will require hip replacement. Problems such as impingement in the hip and labral tears are now much better recognized and diagnosed than in the past. The doctors at BRBJ have experience treating these problems, which may benefit from minimally invasive joint preserving options such as hip arthroscopy or osteotomy.

The hip replacement specialists at Blue Ridge Bone & Joint Clinic, most of whom have received fellowship training in caring for hip problems, continue to bring cutting edge treatments and technologies to our patients in Western North Carolina.

Bill Moyer — Back in the swing after Double Hip Replacement
A familiar face around Henderson County, Bill Moyer, chairman of the Henderson County Board of Commissioners, had been fighting more than budget battles in the last few years. He was fighting intense pain in both hips. "I was walking in a stooped position; I couldn't even bend to tie my shoes." So in December 2008, he decided to have both hips replaced, and chose Pardee's Center for Joint Replacement and Dr. Edward Lilly for the surgery. Though he was reluctant to enter Pardee's Joint Camp ("I'm independent and didn't think I needed group support."), Moyer quickly realized the many benefits to the group experience and being with others going through joint replacement. "Dr. Lilly did a tremendous job. The staff was excellent. I feel that my recovery (less than two months) has been swift, and I am able to do many things that hurt me in the past. My hobbies include gardening, golf and walking, and I have been able to enjoy all three again."