Ask Dr. Hansen: Who Gets a Partial Hip Replacement?
Dr. Hansen describes the perfect candidates for a partial hip replacement.
Hip pain can be debilitating. When conservative treatments do not effectively control pain, patients contemplate their surgical options. Currently, there are two joint replacement options: a total hip joint replacement and a partial hip replacement. How do you decide which surgery is best for you? Hip specialist Dr. Dane Hansen explains what a partial hip surgery is and describes the patients who benefit most from this treatment.
What is a partial hip replacement surgery?
“A partial hip replacement is what it sounds like: a replacement of part of the hip joint” says Dr. Hansen. “The part of the hip replaced is the ball or head of the hipbone. A partial hip surgery leaves the patient’s hip socket intact.”
The evolution of hip replacement surgery
Partial hip surgeries have been a treatment option since the initiation of joint procedures. “Early on, partial hips were used to treat a lot of different scenarios,” explains Dr. Hansen. “We used them to treat patients with avascular necrosis. Partial hips were also used for issues where the ball of the hipbone was damaged, but the hip socket still had healthy cartilage. Today, however, partial hip procedures are done far less often. That’s because the longevity and outcome of total hip replacements has improved markedly.”
“In the past,” remembers Dr. Hansen, “we’d discourage a younger patient from having a total hip replacement because we knew these implants wore out in 10 or 15 years. Instead, we’d recommend a partial hip replacement. This was the best available option even though a partial hip increased the risk of arthritis in the hip socket and eventually wore the socket down. At that point, we’d perform another surgery to give the patient a full hip replacement.”
Today, surgical recommendations have changed because the longevity of total hip replacements is so much better. “Implant technology is so good that even young, active patients can expect their total hip replacement to last for 25 to 30 years and possibly longer,” notes Dr. Hansen. “Advances in technology have transformed total hip replacement into a long-term solution. But there is still a place for partial hip replacement within a specific population of patients.”
The ideal partial hip replacement candidate
“Today, there is one narrow but significant indication for a partial hip surgery,” says Dr. Hansen. “Elderly patients who have fallen and suffered a hip fracture are ideal candidates. Hip fractures in this population are very common. Typically, the injury is characterized by a break through the neck of the femur just below the ball of the hipbone. The consequences of this break mirror the consequences of avascular necrosis: the blood supply to the head of the hipbone is compromised. Consequently, it’s almost impossible to fix the fracture and get the bones to heal together. That’s why a partial hip is the perfect solution. We remove the ball altogether and replace it with a partial hip implant.”
Benefits of a partial hip replacement
Dr. Hansen explains that a partial hip provides several advantages for elderly hip fracture patients.
- A partial hip is a less taxing surgery. “A full hip replacement is not a drastically larger surgery compared to a partial hip, but it is a larger surgery,” notes Dr. Hansen. “Technically, a total hip is also a bit more difficult and means slightly more trauma for the patient. Elderly patients are already fragile, so minimizing surgical trauma is a benefit.”
- Surgical risks are lower. Because a total hip replacement requires a larger implant and more metal in the hip, the risk of infection is slightly higher than it is with a partial hip.
- There is a lower risk of postsurgical hip dislocation. A total hip replacement for hip fracture comes with more postsurgical movement restrictions and therefore higher dislocation risks. “The challenge with treating elderly patients is their fragility and the other medical issues that they have—which often include dementia,” explains Dr. Hansen. “Dementia affects the ability to follow restrictions, and that has an impact on risks for dislocation. As much as we can, we want to minimize those risks. A partial hip helps us to do that.
- A partial hip lowers immobility complications. “One of our biggest concerns after hip fracture in an elderly patient is immobility,” says Dr. Hansen. “These patients are often not very functional and can decompensate rapidly if bedridden. With a partial hip, these patients can immediately walk and put full weight on that hip. We know that if these fractures aren’t fixed quickly so that patients can start moving again, we face higher risks of medical complications. Immobility can trigger blood clots, pneumonia, urinary infections, other severe issues, and even death.”
Surgical recommendations are always tailored to patient needs
“A partial hip is an excellent option to quickly and safely treat a hip fracture in elderly patients with limited mobility,” says Dr. Hansen. “That said, it’s still important to make surgical decisions based on a patient’s unique circumstances. Because total hip replacements are so successful, I’ll consider them for any active patient who has highly cognitive function. There is a constantly shifting line between patients who should get a partial hip replacement and those who should get a full hip replacement. If you are an actively functioning, independent 75-year-old with a life expectancy of 10-plus years, I will at least have a conversation about whether you want a partial or a total hip replacement.”
When to seek treatment for your arthritis
Arthritis doesn’t have to spell the end of an active life. If you are experiencing worrisome symptoms or persistent pain, the renowned arthritis specialists at Summit Orthopedics can help. We work with you to confirm a diagnosis and develop an appropriate conservative treatment plan. If nonsurgical treatments fail to support your lifestyle goals, highly skilled orthopedic surgeons will consult with you and discuss appropriate surgical options. Summit is home to innovative joint replacement options. Our Vadnais Heights Surgery Center is one of only two surgery centers nationally to receive The Joint Commission’s Advanced Certification for Total Hip and Total Knee Replacement.
Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Plymouth, MN, Vadnais Heights, MN, and Woodbury, MN, as well as additional community clinics throughout the metro and southern Minnesota.
More resources for you
“Arthritis patients have high expectations for their activity level. With advanced training in minimally invasive surgical techniques and quick-recovery joint replacement, I strive to help my patients return to their fully active lifestyle as quickly as possible.”
Learn how Dr. Hansen evaluates hip pain to identify hip replacement symptoms.
Summit’s arthritis specialists offer a broad range of nonsurgical treatments to manage arthritis pain.
When patients complain of hip pain, we’ll try first to treat pain with nonsurgical treatment. If conservative treatments fail to control pain, Dr. Hansen explains the available surgical options you might consider.