Jock Doc

Jock Doc: New advances in hip-replacement surgery can help in the long term

Q. I have been having hip pain that has gotten worse for several years. I saw my orthopedic surgeon, who said I had bad arthritis and needed a new hip. I have been reading online about minimally invasive hip surgery, robotic hip surgery and traditional hip surgery. Do you have any advice on what I should do?

A. Joint replacement surgery has continued to evolve over the last 30 years. Technological advances have made less invasive approaches possible for many patients.

The indication for joint replacement surgery is when you can no longer live with the pain. If non-surgical treatment options such as anti-inflammatory medication, injections and physical therapy are no longer effective, then hip replacement surgery is likely indicated. . The technology for hip replacement implants has advanced considerably, meaning there is a lower risk that a hip revision surgery would be necessary down the road.

Less invasive approaches, including an anterior approach, seem to decrease the risk of post-operative hip dislocations and allow for more rapid rehabilitation and less post-operative pain. However, the most important consideration during surgery is proper visualization to make certain the components are put in as perfect a position as possible, which will aid in longevity of the prosthesis. In some patients this may require a larger incision or more invasive approach. Some orthopedic surgeons are using a robotic approach, which is less invasive and offers more precise hip positioning. However, studies are still being done to determine if this advantage is more theoretical or truly a better approach.

I recommend you return to your orthopedic surgeon to determine what type of prosthesis and what operative approach is best for you. If you are still unsure, you may want to seek a second orthopedic opinion from an additional orthopedic hip specialist.

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Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to

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