Orthopedic Specialties: Hip

R.I.C.E. (Rest, Ice, Compression, Elevation)

• Rest – Limited activity is recommended immediately after an injury or demanding activity, to allow your body time to heal. Try to avoid using or putting weight on the injured area for up to 48 hours after the injury, as these might worsen injury or delay recovery.
• Ice – An icepack, wrapped in a light towel to protect your skin from frostbite, helps reduce pain and swelling when applied to the injured area. Ice should be applied in cycles of ten minutes on, ten minutes off, as often as possible for 48 hours after injury.
• Compression – Wrapping the injured area snugly with an elastic medical bandage helps prevent further swelling. Avoid wrapping too tightly, which can cut off blood flow.
• Elevation – Keeping your injured body part raised above the level of your heart can help reduce pain, throbbing sensations, and bruising.

Physical Therapy

The use of exercise therapy, manual therapy, massage and other techniques to promote mobility and function in patients, and to facilitate recovery and rehabilitation from orthopedic injuries and conditions that limit a person’s abilities to perform activities in daily life. Physical therapists also establish fitness and wellness plans to prevent future loss of mobility.

Medication

• Nonsteroidal anti-inflammatory drugs (NSAIDs) – NSAIDs are commonly known drugs, many of which are available over the counter, such as ibuprofen and aspirin. They help relieve pain, reduce fever, and decrease inflammation by inhibiting enzymes that cause pain and swelling.
• Disease-modifying antirheumatic drugs (DMARDs) – Drugs defined by their ability to slow down the progression of rheumatoid arthritis (RA), like the commonly used methotrexate. Unlike NSAIDs and corticosteroids, DMARDs treat the underlying cause of RA rather than its symptoms of pain and swelling.

Injections

• Corticosteroid injections – Corticosteroid injections are frequently used to treat inflammatory joint and soft tissue conditions that haven’t responded to conservative management like physical therapy or NSAIDs. The body increases blood flow to an injury to help it disinfect and heal. This process is known as inflammation. Corticosteroids injected at the site of an injury decrease the blood flow to the area, thereby reducing inflammation.
• Platelet-rich plasma injections – Platelet-rich plasma (PRP) is a blood product drawn from a patient and then centrifuged to form a concentration rich in platelets, the cells that help repair damage. Once concentrated, the PRP is re-injected into specific areas of the patient’s body to accelerate or facilitate healing after conservative or operative interventions.

Dry Needling

A technique in which an appropriately certified physical therapist inserts thin, solid needles into painful knotted tissues known as “trigger points.” The needles don’t inject medication; instead they’re used to stimulate tissue, helping increase blood flow, improve pain threshold, decrease inflammation, and decrease banding – taut tissue that can’t contract or relax properly.

Hip Arthroscopy

A minimally invasive surgical procedure used to visualize, diagnose, and treat problems inside the hip joint. Small incisions are made to allow pencil-sized instruments to magnify, view and possibly repair damaged cartilage or other soft tissues surrounding the hip joint. A range of procedures can be done arthroscopically, including smoothing or repairing torn cartilage, trimming bone spurs, and removing inflamed synovial tissue.

Post-operative Treatment: Treatment varies depending on the details of your arthroscopic procedure, but in most cases, physical therapy is recommended to achieve the best recovery. Exercises specific to your specific procedure can help restore your strength and mobility.

Recovery: After surgery, you’ll typically stay in the recovery room up to two hours before being discharged. You’ll need someone to drive you home and stay with you for at least one night. You can also expect to be on crutches or a walker until you can walk safely without assistance.

Hip Fracture Repair

The internal stabilization of broken bones with a surgical procedure also known as “hip pinning,” used when the pieces of fractured bone can’t be externally aligned. After the surgeon completes one or two incisions over the hip, the broken bones are properly aligned through a process called reduction or internal fixation. The bones are then stabilized with instrumentation such as surgical screws, nails, rods or plates, which keeps them in place while the fracture heals.

Post-operative treatment: Movement is encouraged soon after surgery to help speed recovery and reduce complications. Generally, patients get out of bed with help within 48 hours of surgery. Over the next few days, our staff will help you start light exercises and begin teaching you to walk with a walking aid such as a walker, a cane, or crutches.

Recovery: Varies with each person. Through a combination of a rehabilitation program and the use of walking aids, many people can return to work or other regular activities one to four months after surgery, though full recovery may take additional time.

Hip Resurfacing

The replacement of diseased and damaged bone and cartilage in the hip socket, with a metal shell implant over the hip surface. Not as extensive as a total hip replacement, hip resurfacing is a minimally invasive procedure designed to restore function to the hip joint, with advantages that include decreased risk of hip dislocation and a more normal walking pattern.

Post-operative Treatment: You may need a walker, a cane, or crutches for the first few days or weeks after surgery until you become comfortable enough to walk without assistance. Your orthopedic surgeon will schedule regular follow-up visits, and a physical therapist will provide exercises to help maintain your range of motion and restore your strength.

Recovery: Varies with each person. You should be able to resume most light daily activity within six weeks following surgery.

Total Hip Replacement Surgery

This procedure removes the diseased or damaged parts of the hip’s ball-and-socket joint and replaces them with a prosthetic implant. The prosthesis sits within the thigh bone and the pelvis, and provides support for the new femoral head. It can be made entirely of metal, but might also include elements that are ceramic or plastic, helping to recreate the function and natural feel of the patient’s original hip.

As part of our commitment to innovation, Ortho Rhode Island also offers total hip replacement with robotic-assisted technology. This 3-D visualization system with a robotic arm helps guide surgeons during hip replacement procedures, allowing greater precision.

Post-operative Treatment: Because total hip replacement is more invasive than other hip surgeries, and you will probably spend two to three nights in the hospital. Aided by a walker and a physical therapist, many total hip replacement patients begin standing and walking the day after surgery. Your orthopedic surgeon will schedule regular follow-up visits, and a physical therapist will provide exercises for home care to help maintain your range of motion and restore your strength.

Recovery: Varies with each person. You should be able to resume most light activities of daily living three to six weeks following surgery. Some discomfort during activity and at night is common for several weeks. Complete recovery can take about three to six months.