A New Hip for a New Life
At age 34, Joan Bunyan developed a rare and severe arthritic condition that led to the deterioration of both of her hip joints. Her arthritis was the result of a medication given to her two years earlier. Doctors tried many pain medicines and treatments to help her weakening hips, but nothing worked. Her pain was so excruciating and constant that she could no longer walk, dress herself unaided or go to work. Joan’s life had deteriorated along with her hips. After two years of living in pain resulting in a collapsed and fractured hip, joint replacement surgery would turn her life around.
Joan was one of the 300,000 Americans annually who return to active lives because of hip replacement surgery.1 She spent only five days in the hospital after the surgery, and with the help of physical therapy, she was able to stand within 24 hours of her surgery. The day after Joan’s surgery her hip pain was gone. Three days later, she was able to walk up a flight of stairs. One year later, Joan walked down the aisle at her wedding and danced with her husband.
The Burden of Osteoarthritis
Approximately 16 million Americans, mostly over the age of 65, suffer from osteoarthritis. America’s growing obesity epidemic is adding to the number of young and old people with osteoarthritis.2
Osteoarthritis: #1 Cause of DisabilityNumber of Americans with osteoarthritis | 16 million
1 in 3 over age 602 |
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| Disability | #1 cause of disability: 8 million people with daily limitations3 |
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| Annual number of outpatient visits | 36 million3 |
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| Annual number of hospital days | 4 million3 |
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| Annual cost of osteoarthritis | $86 billion4: $51 billion in medical costs, $35 billion in indirect costs |
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| Annual number of hip replacements | 300,000 (25% younger than age 65; 75% older than age 65)1 |
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| % of Medicare patients discharged to their home after hip replacement surgery | 72%5 |
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In severe cases of osteoarthritis, such as Joan’s, hip replacement surgery is the only remedy to fix the problem. Total hip replacement surgery involves replacing the head of the thigh bone and the hip socket with a durable artificial hip made of a strong metal or ceramic. The artificial joint may be cemented in position or held securely in the bone without cement.1
The first total hip replacement was performed in 1960 by implanting a metal stem and ball with a plastic shell using cement, similar to the cement used by dentists, to hold the devices in place.6 Over the past 40 years there have been significant advancements made in hip replacement technology. Hip replacement surgery today is less invasive, has a shorter recovery time and improved patient outcomes. Hip implants have become lighter, more durable and increasingly resistant to corrosion, which means that they are able to keep their shape for a longer period of time, preventing further bone destruction. In addition, scientists have also developed hip implants that are designed to attach directly to bone without the use of cement. These designs also have a surface that is conducive to new bone growth and actually allow the bone to grow into the surface of the implant.
Remarkable Advances in Total Joint Replacement7 | 1973 | 1993 | 2002 |
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Incision size | 8"–10" | 6"–10" | 4"– 6" |
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Length of hospital stay | 12.5 days | 5.5 days | 4 days |
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OR time | 140 minutes | 65 minutes | 45 minutes |
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Recovery time | Several weeks in the hospital | 10 days | 3-4 days, minimally invasive outpatient procedure |
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Featured improvements | Cement used for implants, not as durable and led to cracks. Ten-year implant life. | Increased use of non-cemented implants that encouraged bone growth into the implant. | Ceramic, metal on metal and improved polyethylene implants improved durability and implant life to 15 years or more. |
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Since Joan’s surgery, she has completed her degree in occupational therapy and is working with patients in their homes. Not only does she now enjoy activities she never thought possible, such as horseback riding, belly dancing and walking on the beach, Joan can now complete her daily activities without assistance. “I only wish I would have had the surgery sooner,” said Joan.