Hip Replacement Surgery

Many patients who reach the stage of requiring a hip replacement usually will have suffered from pain and discomfort in and around the hip joint for quite some time.

Osteoarthritis – which is the most common reason people require hip replacement surgery – usually develops gradually over a number of years with hip discomfort and hip pain noticed at first, which gradually progresses in its severity and frequency.

The pain may be experienced in the groin or around the buttock area or deep within the hip joint itself.

Hip x-ray

Hip Replacement Surgery Materials And Equipment

Depending on the type of hip replacement you will receive, the equipment and instruments used will differ in terms of their exact specifications, but broadly speaking the materials consist of a stem for the femur, an artificial femoral head that affixes to the stem, an acetabular component which may also require bone screws and the acetabular liner – usually made of a special type of plastic called polyethylene.

Your procedure may or may not require the use of a fluoroscopic imaging unit and will also require special retractors that allow the surgeon to visualize the hip joint as well as trial components of the aforementioned to ensure that the appropriate size component is used at the time of implanting the definitive prosthesis.

Total Hip Replacement Components

Total Hip Replacement Components

The upper part of the femoral stem may be coated with a special porous material to allow bone ingrowth for rigid fixation. The lower end of the femoral stem is usually tapered to fit snuggly in the femoral canal.

The flutes in the lower part of the femoral component helps in letting the blood and the debris out during insertion of the implant. The prosthetic femoral stem may either be press-fitted in the femoral canal or fixed using a bone cement.

The natural head of the femur rotating inside the acetabulum at a specialĀ  angle. The prosthetic components are placed to match the natural angles of the neck and the head of the femur.

Different sizes of Femoral stems used for Primary Hip Replacement.

Hip Replacement Surgery Treatment Options

Usually when the patient has reached a stage of requiring hip replacement, they have obtained maximal benefit out of nonsurgical strategies to manage their arthritis which include using gait aids to aid with ambulation, analgesics such as nonsteroidal anti-inflammatory drugs or Tylenol, and courses of physical therapy, massage therapy and even in some cases, injections.

In the event that these strategies are no longer of any benefit to the patient then a hip replacement surgery is usually required.

Many different techniques can be used to perform hip replacement surgery including the use of robotic surgical assistance and different surgical approaches, which will all have different advantages and disadvantages. Your surgeon will discuss these with you in detail and help you reach a decision as to the most appropriate technique for your needs.

Who Is A Good Candidate For Hip Replacement Surgery?

Hip replacement surgery is usually reserved for more elderly patients, although with advances in implant technology and refinements of existing surgical techniques, we are able to offer the surgery in younger patients that absolutely require it.

As previously mentioned, the patient should have maximized their benefit from nonsurgical management strategies before pursuing surgery as a treatment option.

Hip Replacement Surgery Procedure

While every surgeon has slightly different preferences as to how the procedure is performed, broadly speaking the procedure involves gaining surgical access to the hip joint (which can be done via different surgical approaches) and then removing the arthritic femoral head, the arthritis from within the socket, and then replacing both of these with an appropriate size of hip replacement implant, ensuring that the position and orientation of the implant is such that the hip has appropriate stability and the patient’s leg length is as close to the contralateral side as is reasonably achievable.

Following the steps, the surgical exposure is carefully closed to ensure maximal recovery and the surgical wound is dressed and the patient is taken to the recovery room where the recovery process begins.

Total Hip Replacement

Total Hip Replacement

Hip Replacement Surgery Success Rate

Hip replacement is consistently shown in a broad range of literature to be the most successful procedure across all surgical specialties. Most high quality studies show success rates upward of 95%, with vast majority being in the region of 97 to 98% successful. Ultimately, success is defined by the patient’s pain being improved, their ability to achieve the same level of activity, or an improved level of activity as compared to their presurgery levels, and their overall quality of life.

Hip Replacement Surgery Risks

Although a highly successful surgery, hip replacement is a major surgery, and is associated with a number of risks. These include heart attack, blood clots, stroke, infection, neurovascular injury, dislocation/instability, leg length discrepancy and persistent postoperative pain.

Although many of these can be avoided in the vast majority of patients with existing strategies to minimize these risks, we are unfortunately not able to make the risks of these complications absolutely zero. There are certain patient factors that will increase the risks of developing some of these complications and these include morbid obesity, smoking and poorly controlled diabetes.

Hip Replacement Surgery Recovery And Timeframe

The vast majority of hip replacement patients achieve almost complete recovery by three months post surgery. There is literature to suggest the recovery from a hip replacement is quicker in patients who receive the hip replacement through a direct anterior approach, although ultimately beyond 3 months the success of the procedure is equivalent and has not been demonstrated to be superior thereafter.

The vast majority of the recovery happens in the first 6 weeks, with the first 2 weeks seeing the gradual subsiding of the postsurgical pain; the subsequent month is spent regaining mobility and strength in the muscles surrounding the hip joint.

The patient may require the use of a gait aid during their recovery phase and this is completely normal and entirely acceptable. Returning to work following hip replacement surgery is ultimately determined by the level of strenuous physical activity required in each patient’s job.

Those with a more sedentary occupation can typically return to work within a few weeks, those who are faced with higher physical demands as part of their job will usually take between 6 weeks and 3 months to return to work fully. It should also be mentioned that patients who have the option to modify their duties at work to accommodate limits of their physical activity would be able to return to work sooner than this.

Hip Replacement Surgery Exercises

Although your physical therapist will advise you specifically on the exercises that you are required to do the most in order to achieve the best result in the recovery, these will ultimately be determined by the surgical approach that was used during the surgery.

Typically, strengthening exercises such as straight leg raises, clamshell raises, and even wall squats are typically included in most patients recovery exercise regimen. Gradually improving strengths and numbers of reps in each of these exercises, in addition to any other exercises that your physical therapist has advised you to perform, will give you the best chance at having an uneventful and speedy recovery.

Hip Replacement Surgery Exercises To Avoid

This will also depend on the surgical approach used to replace your hip, and there may be no major restrictions in terms of specific movements immediately following a surgery, however, there may be restrictions on your movement depending on the surgical approach that was used for your surgery.

Your surgeon will advise you of these, and they can include no adduction and external rotation of the operative legs for lateral approach patients, or no abduction and internal rotation of the operative leg in posterior approach patients.

Hip Replacement Surgery Cost

The cost of the surgery will vary significantly depending on the equipment required to complete it. For example, an anterior approach surgery, the use of fluoroscopic imaging guidance is typically required and this does increase the case costings for the case, it may also require special type of table, which may also increase the case costings. Implant cost is also a factor and for the vast majority of patients with arthritis requiring hip replacement surgery, these will be the same.

However, if you have unique anatomy or specific conditions that require special types of implants, these may also increase the cast costings as well. For a full breakdown of the cost of your surgery to your insurance provider and to the patient, please schedule an appointment to discuss your treatment options with one of our specialist orthopedic surgeons who will be happy to provide you with all the information necessary to make an informed decision about the appropriate hip replacement technique and implants for you.

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5.0
Based on 107 reviews
Dr. Nakul Karkare is awesome! And patriotic! Thank you, Dr. Karkare for displaying the American Flag in your waiting room, honoring and mourning our military personnel, this Memorial Day, who died while serving in the United States Armed Forces.
Dave
00:52 30 May 23
Excellent and skilled orthopedic practice specializing in joint replacements. Dr Karkare was trained at the Hospital for Special Surgery and has excellent results, as do his associates!! Would gladly refer family members to the practice!!
Eclectic54
00:24 30 May 23
I had such a wonderful experience with Complete Orthopedics in Stony Brook. Not only did Dr. Kuo fix my broken wrist with such kindness and care, but the office staff, including Billing, Reception and the X-Ray Technician, was always so helpful, going out of their way to ensure that each patient felt welcome, answering any questions with a smile, and ensuring any issues with insurance/billing were handled with the utmost professionalism. I highly recommend their practice!
Victoria DeMatteo
19:49 10 May 23
I'm very happy St. Catherine's sent me to this office for treatment after I broke my collar bone! Unfortunately the break was too severe to repair on its own and I had to have it rebuilt a week after the injury. Dr. Vaksha did a great job fixing it. I'm three months out, and I have full use of the arm and shoulder. The whole office staff is very professional, accommodating, and welcoming. I hope to not need orthopedic services again, but Dr. Vaksha will be my number one choice if I or anyone in family suffers such am injury.
Tina Rivera
20:42 08 May 23
No one likes going to the doctor. But these people make it painless. I go for knees, hips and shoulders. At almost 70 Complete Orthopedics keeps my active life style running smoothly. Whether chasing my Grandson and even surfing again, I highly recommend them!!
Thomas Slavin
15:02 02 Mar 23
Dr. Kuo knowledgeable and competent surgeon- very good experience and more importantly great result.
Joseph McCoy
21:23 25 Feb 23
Dr Vaksha was so kind and helpful. He took extra time with us and explained things so thoroughly. Highly recommend. Office very clean.
Susan Bosinius
20:20 19 Feb 23
Dr Vaksha, is a great doctor very professional knows what he talking about. Treat patient with upmost respect. Thank You
Troy Spencer
16:46 19 Jan 23
Dr. Karkare is an amazing doctor, very caring and attentive, the girl at the front desk is very kind and helpful. .elizabeth .thank you so much .
blanca ventura
21:32 26 Oct 22
Been going to this place before my accident and after I had my knee surgery. So happy how I been treated and how well I am getting. Thank you all and specially Dr. VAKSHA for everything and getting back on track.
Ita Opico
19:01 25 Oct 22
Love this place From the minute I called I was treated kindly. When I arrived The Dr saw me right away he was compassionate and ordered the appropriate tests for me. I came back in for my follow up and had the same great experience.
Christine Rostock
21:28 23 May 22
Dr Vaksha and Dr karkare are 2 of the best orthopedic doctors around my wife Susan had a very serious broken ankle in March of 2019 she didn't think she was going to walk again Dr vaksha did an excellent surgery on her ankle he said it was his toughest he ever did he put a lot of hardware in her ankle and told her she would be alright she made remarkable recovery thanks to his surgery as of now she regained 100 percent use of her ankle she would highly recommend him to anyone. My own experience with Dr karkare has been wonderful he takes his time with you listens to what you have to say and prescribes various treatments and is very caring I would highly recommend him to anyone I would give both doctors a 10 plus rating we are very happy with them the best.
Harry Jones
23:31 19 May 22
Complete orthopedics is a wonderful place to go when you hurt or injured a great staff and wonderful doctors very knowledgeable and helpful I would recommend this place to all of my family and friends that is in me of orthopedic care I give them 10 thumbs up
Wayne Pemberton
17:39 18 May 22
The staff is very professional and helpful. Dr. Vaksha is excellent. He takes time to listen and offer suggestions to help you get better. I’m very thankful and happy to be a patient here at Complete Orthopedics.
Phoenix Rising
19:54 16 May 22
Dr.Karkare is the best. He listens to everything and explains everything I recommend him to everyone. I am so happy he is my doctor.
Myrna James
00:48 13 May 22
Dr.Kuo is amazing very attentive,caring,and passionate and staff is awsome too.Thank you for everything Dr.kuo.
Erick Murillo
23:17 12 May 22
I was in a car accident November 1 I was referred to Dr. Vaksha For shoulder surgery . I he was amazing he made me feel very comfortable and explained everything that was going to happen from surgery all the way through my physical therapy highly recommend Dr. Vaksha
Yolanda Ojeda
19:37 09 May 22
My appointment with Dr. Vaksha was amazing. Dr. Vaksha was very thorough and kind. I would refer this office to anyone who needs a great orthopedic doctor.
John Senechal
19:54 05 May 22
Scheduling my appointment was quick and easy. The staff was super friendly and down to earth. I was seen on time. The appropriate test, ā€œx-raysā€ were taken before the conversation with doctor, something I really liked, test for analysis and conversation was done upfront. Dr. V had a great personality and was no BS, straight forward diagnosis and a play on next steps. I am happy I found them and would refer them to friends and family.
Sam
00:46 03 May 22
I have seen Dr. Kuo two times already and he's awesome along with his staff. Very friendly office and I'm glad to be a patient here.
Camaris A
20:01 28 Apr 22
Amazing team!! Very caring, profesional, and friendly!! Dr. Kevin Kuo, you are the best, very passionate, caring, and helping thank you for getting me better and being so kind to me! Elizabeth you the best thank you for you help always and you big smile and positive actitud❤️🙏🏼
breidy valerio
19:01 22 Apr 22
The staff is truly exceptional, they make you feel comfortable and welcomed. The doctors are amazing,always professional, compassionate and great listeners.
Elizabeth Collado
03:25 09 Apr 22
What a great place! The place is clean and organized.The staff is wonderful. Setting up physical therapy is right there as well.I'm so glad I found this place.
Donna Anne
22:45 05 Apr 22
This was my 1st time breaking something in my 27 years on this planet. I was recommended here by a friend Dr. Vashka helped me from day 1 and still continues to check in on me and my healing ankle. Would highly recommend
tyron davis
16:06 01 Apr 22
Brand new office, same great doctors! Rooms are clean, plenty of parking, physical therapy attached, Dr. Karkare and his staff are awesome. Thank you!
Emily B
02:49 24 Mar 22
Dr.VAksha is the best, I love the way he treats me as his patient, he is caring,understanding and very attentive to my needs
Mirna Caballero
14:53 03 Mar 22
Great staff. Dr. Vaksha is awesome and takes the time to listen to his patients. He is very compassionate. I would highly recommend this office.
Bebe Doyle
01:24 23 Feb 22
After suffering from a severe ankle injury Dr. V was able to help me heal and return back to work completely to a job where I stand for 12 hours a day. The office is very clean and I appreciated the reminders of my appointments via phone call and through text. The patient portal made it easy for me to access all my documents including work notes. The office staff is wonderful and Rebecca was able to schedule me with a busy schedule and awesome at answering all of my questions including referring me to a great physical therapy office. I highly recommend this office to anyone who’s looking for knowledgeable and kind orthopedic office.
Elizabeth Birchwell
21:31 28 Jan 21
The staff here are great, I was seen at the time of my appointment and was well taken care of!
Shaun Berry
18:14 07 Jan 21
They are an excellent practice. The front and back office people are amazing and so helpful. Rebecca is such a kind and understanding person. I had an issue with paperwork and she cleared it right up. Dr. Karkare is very knowledgeable, helpful, and caring.
Matt S.
19:31 18 Nov 20
Rebecca K. - What a true burst of sunshine. Very friendly and definitely an asset to the practice!
Laura Aston
18:17 17 Nov 20
Great experience, the Doctor is nice but the staff is incredible. I worked with Linda, who was profession and assisted me beyond what any person has done at other practices. Complete Ortho should be complimented for having such a person on their staff.I highly recommend this place!!!
Joe Allen
17:26 17 Nov 20
Linda and Becca they are so good ever time I come they are very nice I would tell everyone I no to come to this office..
Barbara Victor
16:45 17 Nov 20
I was rear ended in an auto accident , Dr Vashka was recommended by a friend of mine .I was experiencing Back , neck , and shoulder pain . After a thorough examination and given exercises to do at home , I am feeling much better , and I ended up avoiding surgery . The staff at Complete Ortho is extremely attentive and show great care when making an appointment and are very friendly and i never waited more than 5 minutes for my appointment . So I would strongly recommend Complete Orthopedics for any aches and pains that one might be experiencing.....
Bill Becht
04:44 17 Nov 20
It was the afternoon of Friday Sept. 24. We were in Pt. Jefferson and my wife, Mary Ann, broke her hip. We went to Mather Hospital and it was determined that she would have to have an operation to have it repaired. This would be her third time under the knife in the past year. It just so happened that we were very fortunate enough to have Dr. Karkare, who was on standby, perform the surgery. He put in a rod and two screws in her hip. She spent a few days in the hospital and then went to Gurwin rehabilitee for another few weeks.It has now been almost six weeks and we both worked the election the other day. If it wasn’t for Dr. Karkare’s expertise she never would have been able to work. She is able to walk with a walker and is doing physical therapy three times a week.We can not thank the doctor enough for the compassion and dedication that he puts into his work. It allows Mary Ann do the things that she likes to do, even on a limited basis for a while. I know that with her will, perseverance and the great work that the surgeon performed she will be back on her feet in no time.Sincerely:John V. PlumpEast Northport, NY 11731
Jack Harris
14:36 06 Nov 20
In the year of 2018 I was referred to Dr. Karkare because I was experiencing severe knee joint pain. After exhausting physical therapy and trying to labor through the pain, I had to make a quality of life decision. Total knee replacement was the only viable option. Dr. Karkare made my decision easy as he walked me through the whole process from surgery to recovery.On 12/13/19 ( Friday the 13th) I enter Lenox Hill Hospital in great hands. From the time I entered Dr. Karkare’s office for the first time until now, his staff has been amazing. Andrea the medical coordinator walked me through all the paper work and necessary preparations for the surgery. Courtesy and kind would be an understatement. Dr. Karkare went over and beyond from the wellness checks and phone calls all to assure me that I was important to him. This was the right decision no pain and no limp. Complete Orthopedics should be your choice!
Kenneth Randolph
22:18 25 Sep 20
Dr. Vadshka has a great bedside manner. He really takes his time and explains treatment options.
T Lee
12:33 09 Sep 20
I suffered with pain in both knees for years. My orthopedic doctor kept recommending knee replacement . I fought it for years, as I was just afraid. When I had no choice and could barely walk , it was recommended I see Dr. Karkare. We set up a consultation and my wife and I left his office feeling totally confident and comfortable with moving ahead with the surgery. He explained everything to us, and the office staff set everything up for us and made the process easy. So about one month after our initial meeting I had the first knee done. I was up walking mere hours after the surgery, and on the workout machines the next morning. I went home two days after the surgery, and yes walked my daughter down the aisle at her wedding only one week after the surgery without even a cane! Three months later I had the other knee done and went home the very next day. Dr. Karkare put my fears to rest . I would highly recommend him. His expertise gave me my life back. Thank you Dr. Karkare.SincerelyVito Congro
Ethel Congo
23:58 12 Aug 20
Dr Rhodin really cares for his patients. When I see him he makes sure to review my progress in detail.
Micki Cahill
15:03 08 Feb 20
My mom had a total hip replacement by dr karkare. He is the BEST orthopedic doctor.Her incision is almost invisable.She is going back for her other hip next week. The office staff is the best, love Andrea.You wont find a better doctor.
Ryan Brigandi
21:06 13 Jul 18
There is no better Orthopedic doctor you will find. Broke my ankle three places on a Saturday. Called Dr. Karkare. He had is team ready at the hospital and operated on me within 6 hours after my injury. Now After 3 months of great care by him and his staff, I am walking to normalcy.
Spacecom Tel
04:13 23 Mar 18
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I am fellowship trained in joint replacement surgery, metabolic bone disorders, sports medicine and trauma. I specialize in total hip and knee replacements, and I have personally written most of the content on this page.

You can see my full CV at my profile page.