This pain is usually difficult to tolerate by those inflicted with the condition because the hip is a major weight-bearing joint in the body, constantly has to work hard, and is related to the functions of movement. In some cases, the hip joint will even hurt while the patient is doing nothing or just moving the hip gently. In addition to the hip pain, patients with this condition will start to hobble and younger people are less likely to tolerate any hindrance in their walking.

In Thailand, there are two common causes of diseases of the hip: osteonecrosis (lack of blood supply to the bone), especially from the use of steroids or pain medications; and degenerative condition, which occurs in old age. Other causes include hip problems from birth and injuries causing hip dislocations or hip fractures, as well as a few other less common causes.

Hip cancer can develop in two ways, metastatic and locally invasive, both of which will cause hip pain at all times in all positions and to a more severe extent than from osteoarthritis. Patients with hip cancer may experience low-grade fever, loss of appetite, and weight loss. Patients with hip infections will also suffer from severe pain and have high-grade fever but without any loss of appetite or weight loss.

Whether or not a hip replacement is needed depends on each individual patient and condition.

It is primarily older patients who benefit from hip replacement. In contrast, hip replacement is not recommended for younger patients because they tend to be more active and the artificial hip joint will be used for an extended period of time.

This can cause the joint to wear out before the end of their lifetime, necessitating the hip joint to be replaced several times. In most cases, one hip replacement surgery is performed in patients over 65 years of age and the artificial hip is expected to last for their entire life. However, the life expectancy of the artificial hip joint varies according to how it is used.

It can last up to 25 years if it is used only for walking, whereas engaging in more activities will shorten its life expectancy. Each patient’s health conditions are also taken into consideration when deciding on hip replacement surgery.

For example, hip replacement surgery should be performed for young patients if they have an underlying life-threatening disease because the artificial hip will help improve their quality of life and reduce their suffering from severe pain, enabling them to lead a normal active life.

There are different types of artificial hip joints, cemented and uncemented prosthesis. In an uncemented hip replacement, the surface of the implant is covered in a coating that enables it to be attached to the bone.

A cemented hip replacement on the other hand uses a special type of cement to secure the implant to the bone. Although the uncemented hip replacement is expensive, it is durable, safe and requires only simple surgery.

The type of surgery used depends on the surgeon’s expertise and patient’s age and lifestyle. Moreover, there is a special technique involving a minimally invasive procedure requiring only a 4.5 cm incision.

Patients who are not very heavy will recover quickly and can walk the next day with minimal tissue damage and pain, thereby requiring less postoperative pain medication. Patients who have this procedure can also return to work faster.

DR PRAKIT TIENBOON is an Orthopaedic Spine Surgeon and director of the Revision Spine Centre at Samitivej Srinakarin Hospital. |Call (02) 378 9000.