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According to the Centers for Disease Control and Prevention (CDC), hip replacements are among the most common surgical procedures in the United States; and with osteoarthritis and obesity on the rise, demand for the procedure is expected to grow.

From 1996 to 2006, the number of hip replacement surgeries performed nationally increased by 30 percent, partial hip replacements increased by 60 percent; and the number of the surgeries performed on those aged 65 years and older is more than three times that of their younger counterparts (source: CDC). At NewYork-Presbyterian Hospital/Columbia University Medical Center, the number of hip replacements has increased two-fold since 1999.

"When it hurts to get around in daily life or you can't participate in your favorite sports or hobbies and your medication and physical therapy aren't working anymore, it's time to talk to your doctor. Hip replacement surgery may be right for you," says Dr. Jeffrey A. Geller, director of minimally invasive joint replacement surgery at the Center for Hip and Knee Replacement at NewYork-Presbyterian Hospital/Columbia University Medical Center and assistant professor of orthopedic surgery at Columbia University College of Physicians and Surgeons. "After a hip replacement, most patients are in the hospital for two or three days and can get around with a walker about a week later. From there, they transition to a cane, and often return to walking on their own within two to three weeks."

Surgical Innovations

Hip replacement has seen significant advances in minimally invasive surgical techniques. For one surgical option, Dr. Geller and his colleagues use a method that reduces trauma and leads to a much quicker recovery. Traditional approaches require surgeons to split and detach large portions of the musculature; however, Dr. Geller is able to use a small front or rear incision in some cases.

Dr. Geller and his colleagues are also using robotics to improve outcomes in orthopedic surgery. "In the near future, robotic surgery may give us improved accuracy when placing the hip socket, which if it isn't in the correct position could lead to dislocation or the artificial joint wearing out earlier than it should," says Dr. Geller.

Another improvement has been seen with the replacement joints themselves. The first generation of joints had a shelf-life of about 15 years. "Today patients can get as many as 20 years out of their new hips, and with the newest generation of implants, replacement hips may last as long as 30 years," adds Dr. Geller.

Research Update

Dr. Jeffrey A. Geller and his colleagues recently published a study in the Journal of Bone and Joint Surgery addressing a rare complication of hip replacement. Even with a successful initial surgery, it is possible for patients to experience pain and weakness if the gluteus medius muscle — one of the main supporting muscles of the hip — is damaged or underperforming. Traditionally there was no satisfactory way to repair the muscle, as any grafts or sutures proved too weak to withstand the force exerted on the muscle.

The new research reports on an innovative surgical approach that reinforces the muscle graft with a piece of the Achilles tendon. "From 2003 to 2006, seven patients received the novel treatment at NewYork-Presbyterian Hospital/Columbia and the results have been very encouraging with all patients experiencing greater strength and decreased or even absent pain," says Dr. Geller.

Columbia University Medical Center

Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The Medical Center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians & Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia's College of Physicians and Surgeons was the first institution in the country to grant the M.D. degree and is now among the most selective medical schools in the country. Columbia University Medical Center is home to the largest medical research enterprise in New York City and state and one of the largest in the United States. For more information, please visit www.cumc.columbia.edu.

NewYork-Presbyterian Hospital

NewYork-Presbyterian Hospital, based in New York City, is the nation's largest not-for-profit, non-sectarian hospital, with 2,353 beds. The Hospital has nearly 2 million inpatient and outpatient visits in a year, including more than 220,000 visits to its emergency departments — more than any other area hospital. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork-Presbyterian/Morgan Stanley Children's Hospital, NewYork-Presbyterian/The Allen Hospital and NewYork-Presbyterian Hospital/Westchester Division. One of the most comprehensive health care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report. The Hospital has academic affiliations with two of the nation's leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons. For more information, visit www.nyp.org.