Dr. Kelton Vasileff reviews images of a damaged hip with a patient. (Courtesy: Wexner Medical Center)
Hip replacement surgery has come a long way in the past couple of decades, with faster recovery times and lower risk of complications. It’s also become a lot more common, particularly for younger patients.
But a new procedure may make some of those operations unnecessary.
It involves a technique that’s been used in place of some knee replacements for the past couple of years.
A few orthopedic surgeons are now beginning to utilize a procedure that uses a compound to fill voids in damaged hip joints, rather than swapping out that joint for an artificial one.
The procedure, called Subchondroplasty, can’t be used for everyone needing a hip replacement.
However, allowing some patients to avoid a full replacement could mean a shorter recovery time, less invasive surgery, and fewer people needing multiple hip replacements. In particular, that’s likely to be the case for younger patients.
If arthritis has progressed too far, it may simply not be possible to save the joint and replacement may still be necessary, said Dr. Kelton Vasileff, an orthopedic surgeon at The Ohio State Wexner Medical Center.
But if there’s just edema bruising the bone underneath the cartilage, or cysts forming in the bone as a reaction to damage to the joint, the new procedure could be an easier, faster option.
“It’s not necessarily an either-or or instead-of question,” Vasileff told Healthline.
He compared whether to go with the new procedure or a traditional knee replacement to the decision of whether to repair or replace a car tire.
“If the tread of the tire is bald, then just patching the tire isn’t going to fix it,” he said, “but if there’s a small hole in it, just fixing it can work.”
Vasileff said he first began performing the Subchondroplasty procedure around six months ago.
He estimates he’s done close to 10 procedures since then.
He’s the only surgeon doing the procedure at Ohio State and one of only a handful across the country.
How the procedure works
In the new approach, a surgeon injects a bone substitute into the hip joint.
The compound hardens in the recesses that have formed in the weakened bone. Gradually, the bone is able to regenerate and replace the compound with new bone.
It’s still surgery, said Vasileff. But injecting a compound versus cutting out and inserting a 3- to 5-pound piece of machinery is a lot simpler.
In a traditional hip replacement, patients typically remain in the hospital for a couple of days. Then they spend at least several weeks at home resting and using a walker or crutches to get around.
Subchondroplasty patients can often return home the same day as the operation and spend one to two weeks on crutches.
It also helps avoid some of the clotting and infection complications that can come with hip replacement.
The procedure is still new, so little information is available about its long-term success for now.
Vasileff said that all his patients are entered into a long-term outcomes database, in order to help doctors better determine who the best candidates for the new procedure are.