Total hip replacement is becoming increasingly more common, with the underlying factors for the procedure diagnosed at an increasingly younger age, said Dr. Maximillian Lincoln, a Bassett Healthcare Network surgeon who specializes in this procedure.
Bassett Healthcare Network currently employs 10 orthopedic surgeons.
“The improvements in technique and longevity of the implants have also resulted in increased ability to provide for patients with severe arthritic change,” he said.
About 700,000 total hip replacements are done per year in the United States. The Bone and Joint Center in Albany performs 100 of these procedures per week, said Brianne Kuchera, total joint coordinator for the Bone and Joint Center. This number includes the work of nine hip surgeons in five locations, from the Saratoga Hospital to Albany Medical Center, and three other surgical centers in Malta and the Capital Region.
In the last two years, the Bone and Joint Center has expanded to five facilities for total hip replacements to accommodate the demand. Patients are required to attend a pre-operation informational joint replacement class prior to surgery. These are offered in person and via Zoom.
Dr. Godwin Njoku, a local physician in private practice who specializes in family medicine, treats many patients older than 50.
“Arthritis is very common. It comes with age,” he said. “It is physical wear and tear of the joint.” Arthritis also can affect athletes as early as 30 to 40 years old, he said.
Doing professional gymnastics can lead to early arthritis. Fractures from motor vehicle accidents also can become arthritic, he said.
“Prior to surgery, there are many helpful modalities to improve arthritic pain in the hip,” Lincoln said. “Weight loss, physical therapy, aerobic exercise, use of oral analgesics including Tylenol, anti-inflammatory or NSAIDs, and lidocaine patches or muscle relaxer medications can be helpful.”
X-rays of the hip can help the doctor determine how severe the presence of arthritis is. An MRI may be required to see more soft tissue images. Sometimes, there is arthritis in the spine as well that contributes to patients’ discomfort or even causes numbness in the leg or legs, said Dr. Donald Cally, a back, neck and spine medical doctor at the Bone and Joint Center in Albany.
Cortisone injections into the hip also can be performed to relieve hip pain temporarily doctors report.
“Biologic treatments including platelet rich plasma have been tried along with hyaluronic acid,” Lincoln said, “although these are not always covered by insurance.”
Resources for seniors
The Otsego County Office for the Aging offers senior citizens a free class called Tai Chi for Arthritis. An application and prior approval is required. The Gathering Place in Oneonta offers this county-sponsored beginner’s tai chi class, as well as a continuation class for those that have completed the six-week introductory course.
One of several chronic disease self-management education programs offered by the Office for the Aging is an arthritis self-management program. Two trained leaders, who often have health conditions themselves, lead the 2.5-hour workshop, held each week for six weeks in community settings.
The Gathering Place also held a resource fair for its members with more than 30 local vendors offering information about their services, including the Office for the Aging. The mission of The Gathering Place, according to its website, is “to provide healthy and active lifestyles for people who are 50 plus.”
The Oneonta Gathering Place, located at 5506 State Highway 7 in Oneonta, opened in September 2023 following the success of the Cobleskill Gathering Place, located at 127 Kenyon Road in Cobleskill, which opened in June 2021.
Chair Pilates, gentle yoga and several Silver Sneakers movement classes are also available weekly at The Gathering Place. Some are free to members, who pay a $65 fee per year. Other classes ask for a nominal fee.
Physical therapy
Physical therapy before and after hip surgery is also recommended. Butterfly movements, bicycle movement, leg lifts and heal stretches are some of the exercises suggested to increase a patient’s mobility. Gentle yoga can also be effective.
Dean Roberts, 86, of Schenevus, is a strong advocate of healthy living and physical therapy. He is the former owner of the Green Earth Health Market in Oneonta. He elected to have knee replacement surgery in January 2025.
“I used to bicycle everywhere,” he said. “I was in good shape.”
“Diligently do the exercises they give you after the operation,” he said. “If you sit on the couch after your operation and do not do the exercises, you will not benefit from the flexibility possible after a joint replacement,” he said.
The decision to have surgery and when to have surgery is a personal one.
“When the arthritis is affecting the quality of your life or you do not trust your joint, it is a good idea to have surgery,” Njoku said.
Prior to surgery, clearance must be provided by a primary care physician. An EKG, blood work and a physical are required within 30 to 90 days before surgery depending on the location of the surgery.
Melissa Manikas, a State Farm agent in Cooperstown, 70, had both of her hips replaced 15 years ago by a Bassett surgeon named Dr. Jonathan Rich, who is now retired. She had the first hip replaced in 2011 and the other side in 2012.
She said both of her hip bones were dying. “The doctor called it avascular necrosis,” she said. “I was in so much pain going into surgery,” she said.
“A couple days later I could walk again,” she said. “I had posterior or lateral hip replacement,” she said.
R. Mark Barnwell, 66, of Cooperstown, had an anterior total hip replacement about three years ago.
“They had me up and walking with a walker shortly after surgery,” he said. “Pain was minimal.”
“If you have the opportunity to choose anterior replacement rather than posterior replacement, choose anterior,” Barnwell added. “The recovery time is much shorter.”
Lincoln said the risks associated with hip replacement include deep or superficial infection, dislocation, limb length inequality, fracture either during or around the time of surgery, nerve and blood vessel damage, blood clots, and exacerbation or worsening of medical conditions.
“The infection percent risk tends to vary with each surgeon,” Lincoln said.
Dr. Dionisio Ortiz, a hip surgeon with the Bone and Joint Center, estimated a 1% chance of risk of infection.
“A national benchmark is a rate of less than 1% for any deep infection,” Lincoln said, “although generally infection rates are less than this.”
Due to the risk of infection, no dental work is allowed one month prior to the hip replacement and within three months after the surgery.
Instructions from the Bone and Joint Center state, “For two years post-operatively, you will be required to take antibiotics before all dental appointments, including cleanings, fillings and oral surgeries.”
To prevent infection, The Bone and Joint Center requires the patient to administer an ointment called Mupirocin into the nostril daily for five days and to use chlorohexidine wipes daily for three days post shower.