We see many people in our office trying to avoid hip replacement surgery. These patients have usually already tried all kinds of treatments to “preserve their hip” and avoid surgery. Often, just mentioning surgery sends people searching for an alternative. Regenerative Orthopedic options are effective hip replacement alternatives.
Hip replacement can be a successful means of improving quality of life, especially when the hip has become severely degenerated. However, there are issues to be considered before choosing a hip replacement.
Hip replacements do not last forever; they wear out. So, if the patient is younger, it is essential to keep in mind that the replacement will wear out in 15-plus years.
Also, some people have continued pain after hip replacement. The surgery doesn’t go as well as planned! But there are alternatives. And Regenerative Orthopedics is a non-surgical option.
Debris can leak from the replacement, causing an inflammatory response that further destroys the hip joint. Researchers in the journal Orthopaedic Surgery say, “Inflammatory responses to polyethylene wear debris can lead to severe bone resorption and aseptic loosening in the long-term following total hip replacement.” (1)
And I always say, “Remember, once the surgery is done, it cannot be undone.” Surgery is permanent. There is no going back!
Hip replacement is often chosen because the patient has been told they have bone-on-bone arthritis, and hip replacement is the only option. The hip replacement is chosen because the patient thinks there is no other choice. But hip replacement is not the only option for bone-on-bone arthritis. Regenerative Orthopedics is a practical option in many arthritis cases.
Bone-on-bone refers to the condition of arthritis where the smooth cartilage that lines the hip bones wears away, leaving the joint without its cushion, allowing bone to rub against bone. The bones no longer glide normally.
Bone-on-bone doesn’t happen suddenly. That bone-on-bone condition began when the soft tissue, like tendons, ligaments, and even the hip labrum, became injured, worn, and/or weakened, making the hip joint unstable. Eventually, the person with this worn-out hip will experience loss of motion. Over time, the hip instability causes further joint injury, the wearing away of the cartilage lining of the hip joint, the development of bone spurs, and the “bumping” of bones into one another. The eventual degenerative changes can be seen on an x-ray, and bone-on-bone arthritis is diagnosed.
But what’s interesting is that cartilage has no nerve endings. Where is the pain coming from if it’s not from the worn cartilage? It’s likely the ligaments! All of the abnormal motion from the unstable hip changes the balance in the hip joint and distributes forces differently, injuring other joint structures like the ligaments. Ligaments are highly innervated. They do have nerves. And when damaged, can elicit pain. The injured soft tissue needs to be addressed and repaired. What repairs joint soft tissue? Regenerative Orthopedics!
Injury to soft tissue, like the ligaments, tendons, and cartilage, causes the joint to become unstable. It is crucial to address the cause and not just the effect of the wearing-out hip. Regenerative Orthopedics, such as Dextrose Prolotherapy, Platelet Rich Plasma, and Stem Cell Prolotherapy, are all non-surgical treatment options that get to the root of the problem. They actually stimulate ligament, tendon, and cartilage repair.
Have you tried pain medications, cortisone injections, hyaluronic injections, or even massage and PT? But you still have pain? Pain medications, NSAIDs, and cortisone injections may help with the pain but not repair the joint’s soft tissue. It’s also possible that massage and physical therapy helped for a time. These treatments are great for resolving and repairing muscle issues. However, if the problem involves ligaments, tendons, and cartilage that need repair, a treatment must be sought to address these soft tissue injuries. Regenerative Orthopedics does just that!
When your hip is unstable, it destroys the supporting tissue of the hip. The ball starts to rub the socket the wrong way, and it moves abnormally. This is what’s often referred to as “wear and tear” degeneration. This abnormal motion must be fixed.
The ligaments of the hip need to be repaired to stop the degenerative effect of the injured ligaments. Surgery often cuts through ligaments, but it does not repair them! The Journal of Biomechanics says, “Laboratory data indicate the hip capsular ligaments prevent excessive range of motion, may protect the joint against adverse edge loading, and contribute to synovial fluid replenishment at the cartilage surfaces of the joint. However, their repair after joint preserving (hip arthroscopy) or arthroplasty (hip replacement) surgery is not routine.“(2)
The hip ligaments need to be repaired. Many people continue to have pain even after hip replacement. The problem may be related to the lack of repair of these soft tissue structures. You can’t save the hip without saving and repairing the hip ligaments.
Regenerative Orthopedics offers an alternative for repairing hip ligaments, which can reduce the need for hip replacement. The journal International Orthopaedics says, “Newer, regenerative approaches have the potential to effectively delay or reduce the requirement for such invasive procedures.”(3)
Regenerative Orthopedics is an effective alternative to hip replacement surgery. Researchers in the Journal of Prolotherapy demonstrated that Prolotherapy helps decrease pain and improve the quality of life of patients with chronic hip pain. Ninety-five percent of patients stated their pain was better after Prolotherapy. (4)
Another medical journal reported, “According to our study, Prolotherapy is superior to exercise. Prolotherapy could provide significant improvement for clinical outcomes in developmental dysplasia of the hip and might delay surgery.” (5)
In many cases, Prolotherapy alone is sufficient to repair the hip. But PRP and Stem Cells may be needed in cases of more advanced degeneration. At OrthoRegen®, we use the Gold Standard in Stem Cell Repair, which includes Prolotherapy, PRP, adipose stem cells, and bone marrow stem cells. This combination is highly effective for advanced cases of hip arthritis. The stem cells and PRP address the cartilage problem, and Prolotherapy addresses ligament repair, stabilizing the hip and restoring joint stability. The repair is a comprehensive treatment of the entire hip.
In the American Journal of Sports Medicine, researchers say, “Results indicated that intra-articular PRP injections offer a significant clinical improvement in patients with hip osteoarthritis without relevant side effects.”(6)
In the journal Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders, researchers show that stem cells regenerate tissue damage within the osteoarthritic joint and, when combined with Prolotherapy injections, were able to restore hip stability. (7)
Hip surgeries are going through the roof, with close to 10 million hip surgeries performed annually. If you prefer to avoid surgery, please call us to see if you are a good candidate for Regenerative Orthopedics.
Hauser RA, Orlofsky A. Regenerative injection therapy with whole bone marrow aspirate for degenerative joint disease: a case series. Clin Med Insights Arthritis Musculoskelet Disord. 2013 Sep 4;6:65-72. doi: 10.4137/CMAMD.S10951. eCollection 2013.