We’ve all seen the hip replacement ads. Active happy people on TV or plastered across billboards who are so happy they had that hip replacement because it allowed them to get back to the life they had before hip arthritis. A new study, however, didn’t confirm that these ads are the reality for the average person. Let’s take a look.
My Patient Yesterday
Here’s a story to bring home what we’re about to review in terms of research. I saw a patient yesterday in the clinic who had both hips replaced. Since the surgery, she’s had severe pain in the front of the left hip (and some on the right). It’s so bad she can’t walk very far. We’re still trying to figure out where it’s coming from, as it seemed to be her psoas muscle, but that turned out not to be the case.
Hip Replacement Results: The Research Doesn’t Support the Ads
The new study consisted of 51 hip replacement patients. After hip replacement, the patients’ activity levels were monitored via accelerometers worn on the wrist for 24 hours at 2, 6, 12, and 26 weeks. Indicators measured included activity level ranging from sedentary to vigorous, frequency of activity, and sleep. Patient feedback on outcomes such as pain, stiffness, daily activity functions, recreational activities, and quality of life was also collected. What did researchers find? Before the hip replacement, the patients were sedentary and didn’t sleep well. After hip replacement? No significant improvements in activities. Poor sleep efficiency. In other words, function and sleep was just as bad after surgery as it was prior. They concluded there was no improvement in activity as far out as six months after surgery.
So based on these results, the happy hip replacements all those clever marketing ads promise don’t seem to carry through to the real world for most patients.
Unfortunately, the Ads Are Working
Despite the research showing time and time again that the hip replacement results the ads promise just aren’t panning out, the ads are working. A Blue Cross Blue Shield report recently published that hip replacements, between 2010 and 2017, increased by 33%. Another concern is that, if you notice, the ads are targeting younger adults (the seventy- and eighty-somethings of years past have turned into the fifty- and sixty-somethings today), and this marketing push, too, is working. The same report found that hip replacements for those 55-64 increased by 42%, for those 45–54 by 25%, and for those 35–44 by 14%.
The research isn’t just finding poor outcomes following hip replacement as we saw in today’s feature study, it’s also finding many complications associated with the surgery…
The Never-Ending Side Effects of Hip Replacement
Let’s first take a look at the problems with hip replacements being performed in those younger and younger patients. In addition to issues with hip replacement results, hip replacement in younger patients, unfortunately, is riddled with many complications. While these younger patients may have had less-severe hip arthritis than the older patients, after the surgery, younger patients expect a lot more from their artificial hip and for a much longer length of time. In other words, younger patients are just naturally going to be more active and live longer compared to older patients who traditionally had this surgery. Because of this, younger patients often have poorer results, such as more pain, as well as higher rates of revision when their artificial hip fails earlier. They also use more pain drugs than their elderly counterparts, likely due to the increased demand the younger patients place on the joint.
Additional issues associated with hip replacement include pseudotumors, ongoing pain (with 67% still in pain after hip replacement), hip dislocations, disruptions in hip alignment, stroke risks, and metal toxicity due to wear particles from the device.
What about those devastating falls in teh elderly? Does a hip replacement at least lower the risk of falls? One study says no as it found that 31.4% experienced falls prior to hip replacement and 30% after surgery, which didn’t equate to any clinically significant difference.
The upshot? Never trust drug or device commercials. As I’ve shown many times, especially when it comes to knee and hip replacement ads, they rarely depict reality. What’s bizarre is that the FDA has strict guidelines on marketing, but in my experience, they usually don’t enforce those regulations on knees and hips the same way they do with higher risk devices like cardiac defibrillators. So buyer beware!