If you constantly have pain in the side of your knee, you are probably suffering from iliotibial band syndrome, also known as ITB. This is a common and often persistent knee injury, causing pain mainly on the outer side of the knee. If you have pain in the hip or the thigh, it is not ITB. Mostly iliotibial band syndrome is a relatively simple condition, usually treated by resting from physical activities until the pain subsides. However, if you cannot get rid of it just by resting, the condition could be more serious than you think, and permanent damage might occur in the long term.

When medication, therapy, injections and the use of walking supports fail to provide pain relief and restore function, total hip-replacement surgery is an alternative. Technically called an arthroplasty, the procedure generally reduces discomfort and improves patients’ range of motion. The operation has a high success rate, due to improvements since the first hip replacement in 1960. Each year, U.S. surgeons perform more than 285,000 such procedures. Arthroplasty entails extracting damaged bone and cartilage, then implanting prosthetics. The surgeon removes the head of the femur and replaces it with a metal stem that extends into the femur’s hollow center. The stem is pressed into place; sometimes a surgeon may wedge the metal implant into the thigh bone, and sometimes cement is used to hold the implant in place. A metal or ceramic ball is affixed to the top of the stem as a substitute for the femoral head. The next step is replacing damaged cartilage on the surface of the hip socket with a metal socket. In some cases, it is necessary to use screws or cement to secure the device. The surgeon installs a spacer (made of plastic, ceramic or metal) between the prosthetic ball and socket to reduce friction. Metal on metal implants (which are no longer used), use a metal ball and metal cup with no intervening plastic. Most patients receive general anesthesia before the operation. Some are administered spinal, epidural or regional nerve blocks that numb their lower bodies. Anesthesiologists determine which method is best for individual patients. Factors that doctors and orthopedic surgeons consider in recommending total hip replacements include patients’ pain levels and degrees of disability. Most people who undergo the procedure are between 50 and 80 years old. However, arthroplasty has been proven effective for patients of various ages, from young people suffering from juvenile arthritis to elderly victims of degenerative arthritis. Symptoms that qualify patients for hip-replacement surgery include: 1. Pain in the hip that impedes walking and other activities, especially groin pain 2. Pain that persists even without moving the hip 3. Stiffness that makes it hard to raise or move a leg 4. Failure to get relief from conventional treatments 5. Inability to navigate stairs with a reciprocating gait 6. Significant limitation in walking distance In determining whether hip replacement is appropriate, surgeons consider patients’ medical histories, the amount of pain they are experiencing, tissue damage and deformity, and the extent to which patients are able to perform everyday activities. Doctors use diagnostic imaging equipment like x-rays and MRIs to assess hip strength, mobility and alignment. Following surgery, patients are advised to refrain from sports and other strenuous activities that place excessive strain on the hip. Such exertion wears down the prosthetic materials, shortening the time it takes for them to become loose and cause pain. Even normal activities like walking can eventually erode the material between the socket and femoral head. However, when not overly stressed, hip replacements generally last for many years. To prevent injury, and to promote healing, postoperative patients often install handrails along stairways and in bathrooms in their homes. Sitting with the knees lower than the hips, while keeping the back straight, enhances recovery. Other recommendations include a raised toilet seat, a chair in the shower, a sponge or shower hose with a long handle, a long stick to aid in putting on socks and other clothing, and a grabber (or reacher). The objective is to avoid bending the newly repaired hip too far or too often. If you have been told that you need a hip replacement or want to inquire about the procedure, schedule an appointment with our top notch and nationally recognized sports medicine specialists at Orthopedic Surgery San Diego.