There has been some new research reported on EurekAlert about post operative pain following hip replacement surgery.
There have been a relatively high incidence of this with metal on metal implants and this research was attempting to answer why this was occurring more often following hip replacement surgery.
What doesn’t surprise me is the answer to the study.
The pain comes from tissue damage. By tissue the researchers mean:
1. Muscles: these are the tissues that make your hip move.
2. Tendons: these attach the muscles to the bones.
3. Ligaments: these surround the hip and hold it in position so it doesn’t come out of it’s joint while you move.
All these types of showed damage when the hip joint failed.
However I wonder whether the damage to these tissues goes much further back. This is an extract from my book Natural Treatment for Osteoarthritis in the Hip. It explains the hip anatomy and what happens to the tissue around the hip when you have OA.
The hip is the joint between the top of the thigh bone (the femur) and the pelvis. The femur sits in a socket called the acetabulum. It is held there with ligaments and is tremendously strong. As it is a major weight bearing joint it is prone to wear and tear so primary osteoarthritis (when the degeneration occurs for no apparent reason) is common in the hip.
What Else Happens?
In most cases the degeneration is not the only cause of pain for an osteoarthritis sufferer.
The muscles, tendons and ligaments (the soft tissue) around the joints give pain too. This happens because as the joint becomes worn it becomes dysfunctional and the soft tissue has to work harder which irritates it. This leads to inflammation in the soft tissue around the hip and in adjacent joints such in the low back, buttock and knee.
When soft tissue is inflamed and irritated it gives pain when it is used and stiffness after when it is not used. (Ask anyone who has fractured a bone how painful it is to get the soft tissue moving again after being in a cast for a while).
Chronically inflamed soft tissue becomes scarred and shortened. A joint is held in place by the soft tissue so the shortened soft tissue pulls in the joint so it becomes misaligned. This misalignment makes the joint dysfunctional.
This means is a rapidly downwards spiral as the joint gets more dysfunctional, irritating the soft tissue more, leading to increased joint dysfunction leading to more soft tissue irritation.
Which Came First- the Tissue Damage or the Hip Replacement Surgery?
If the tissue was already damaged when the hip replacement surgery was done then the tissue is going to be putting adverse stress on the implant. Like anything mechanical if there is adverse stress placed on it then it will break down.
What Can Surgeons Do To Reduce This Problem?
They can make sure the tissues are in the best possible shape BEFORE they do the surgery. Research has shown that a pre-operative hip replacement surgery exercise program improves the outcome but still this is not common practice. Exercises are only given post operatively and, let’s face it, the surgeons are not exactly gentle with the tissues. They pull the hip bone around, sawing and hammering like it is a a bit of wood.
Watch this rather long but detailed video if you don’t believe me but it is but for the squeamish!
I treat my Sunday roast more gently!
What Can You Do To Improve Your Post Operative Pain?
Do an exercise program PRIOR to going into surgery. If your surgeon won’t refer you then sign up for my Joint Control Program or buy How To Treat Osteoarthritis Naturally. Both will give you a targeted individual program to make sure your tissues are in the best possible condition before your hip replacement surgery. It will reduce the post operative pain, decrease your hospital stay and reduce your chance of the surgery failing. Read Joe’s story if you want some independent proof.