Total Hip Replacement

Total hip replacement may be an option for patients who have severe hip arthritis that interferes with their everyday lives. For these patients, nonsurgical treatments may not provide sufficient pain relief. Total hip replacement restores the natural pain-free movement of the hip joint. Patients are often able to return to their favorite activities, including running, biking, golfing, and tennis.

Dr. James Ballard has over 17 years of experience with total hip replacement. He is board certified and received fellowship training in adult reconstruction surgery. Dr. Ballard has consistently been selected as a top orthopedic surgeon in his community. He is also interested in offering new solutions to improve patient outcomes, including outpatient joint replacement surgery. In fact, Dr. Ballard was the first surgeon in the Northwestern United States to perform an outpatient hip replacement in a surgery center.

"Dr. Ballard is the best doctor ever. He replaced my hip with little discomfort, and has improved my life 1000%. Before surgery I was in excruciating pain that severely limited my activities. The pain was immediately eliminated with surgery, and I regained my strength and mobility within weeks. Dr. Ballard is very personable, listens to his patients, is easy to talk to and answers all your questions.”
-- Karen Dummer, Total Hip Replacement

Candidates for Total Hip Replacement

An in-depth exam is required to determine whether or not a patient is a candidate for total hip replacement. If you are experiencing the following symptoms, it may be beneficial to schedule an examination with a qualified surgeon like Dr. Ballard.

• Hip pain and/or stiffness that limits your mobility
• Hip pain that persists even while at rest
• Symptoms that remain severe even with nonsurgical treatments like physical therapy and anti-inflammatory medications

Total Hip Replacement Procedure

During a total hip replacement, Dr. Ballard removes the damaged portions of the hip joint and replaces them with implants designed to mimic natural hip movement. Dr. Ballard performs the vast majority of his total hip replacements in an outpatient surgical center called Oregon Surgical Institute. An outpatient setting offers several potential benefits for patients, including the ability to avoid an overnight hospital stay, reduced risk of infection, and the ability to recover in the comfort of your own home.

Learn more about Outpatient Joint Replacement with Dr. Ballard >

There are different approaches and methods that an orthopedic surgeon might use for a total hip replacement. In recent years, anterior hip replacements have become very popular among surgeons and patients. During an anterior hip replacement, an incision is made at the front of the hip to access the joint and complete the procedure. This approach has been touted as a means to decrease the risk of hip dislocation after surgery. However, it has been scientifically proven that anterior hip replacement has the same, albeit low, risk of dislocation as other hip replacement approaches. The anterior approach also has a high risk of nerve problems that can cause numbness or pain down the front of the thigh. As such, Dr. Ballard does not recommend anterior hip replacement.

Instead, Dr. Ballard uses a minimally invasive posterior approach. The posterior approach has been one of the most common hip replacement approaches over time. However, the posterior approach no longer requires the large incision that it did in the past. Dr. Ballard uses minimally invasive techniques when performing hip replacement surgery, which allow him to complete the procedure through much smaller incisions. This greatly improves the recovery process for patients and allows them to return home the day of surgery.

Recovering from Total Hip Replacement

Advances in total hip replacement, like outpatient surgery, have greatly improved the recovery process for patients. When patients have their hip replacements done in an outpatient surgical center, they avoid having to stay in a hospital with sick people, decreasing the risk of infection after surgery.

Dr. Ballard uses multimodal pain management techniques, which helps patients start walking and weightbearing as soon as possible after surgery. Advanced pain management combined with early movement allows patients to return home the day of surgery.

When Can You Drive After Hip and Knee Replacement

Upon returning home, patients will need to use an assistive device like crutches, a cane, or a walker to get around until they are able to safely walk without it. Physical therapy is an important part of the recovery process, and will help to strengthen and improve range of motion in the hip. Dr. Ballard will advise when it is safe to return to all normal activities, though most patients have no activity restrictions 6-9 months after surgery.

Hip Replacement Surgery FAQ

1. What is the difference between direct anterior & traditional hip replacement?

Total hip replacement is a highly successful surgical procedure that can greatly improve the quality of life for patients suffering from severe hip pain.

The direct anterior approach to hip replacement is a surgical technique in which the removal and replacement of a damaged or diseased hip joint is through a small incision at the front of the body. Traditional hip replacement procedures approach the hip from the side.

During total hip replacement, both the ball of the upper thighbone and socket of the pelvis are removed. Dr. Ballard will then replace the removed joint components with an artificial joint (prosthetic implant), which is composed of both metal and plastic and designed to replicate the natural movement of the hip.

2. What are the benefits of total hip replacement?

Total hip replacement restores the natural pain-free movement of the hip joint. Patients are often able to return to their favorite activities, including running, biking, golfing, and tennis.

After recovery, hip replacement patients often find that the hip joint is also stronger and more flexible than before surgery, and they are able to complete tasks that were previously difficult due to chronic hip pain.

3. When is total hip replacement recommended?

Total hip replacement surgery is recommended for patients suffering from advanced arthritis of the hip, who are no longer able to manage pain symptoms through a combination of conservative treatments. Dr. Ballard will complete an in-depth evaluation of the location and severity of joint damage in order to determine if total hip replacement will relieve pain symptoms and return joint function.

4. What are the most common forms of hip arthritis?

The most common forms of hip arthritis are osteoarthritis and rheumatoid arthritis.

Osteoarthritis is a degenerative joint disease and the leading cause of hip pain. During the early stages of osteoarthritis, the cartilage on the ends of bones inflames, resulting in stiffness after long periods of rest, as well as pain during more active periods.

As the disease progresses, the protective cartilage begins to wear away because of the chronic inflammation. This allows the ends of the hip bones to rub together during movement, causing pain, bone damage, increasing pain and stiffness, and the inability to complete simple tasks, such as walking. Patients over the age of 50, have a family history of the disease, or have had a past hip injury, have a higher risk of developing osteoarthritis.

Rheumatoid arthritis is an autoimmune disease most common in middle-aged women, patients with a family history of rheumatoid arthritis, and patients between the ages of 40 and 60. Unlike osteoarthritis, which typically only affects one joint, rheumatoid arthritis typically affects the corresponding joints on both sides of the body, such as both the left and right hip joints. Symptoms of rheumatoid arthritis include increasing pain, stiffness after periods of rest, swelling around the hip joints, and decreasing range of motion.

5. What is the recovery process for total hip replacement surgery?

Total replacement surgery can be done as an in-patient procedure, which requires patients to stay at the hospital for 1 to 3 days to maintain a successful recovery. In some cases, total hip replacement can be done as an outpatient procedure in an ambulatory surgical center, and patients can return home the same day.

Approximately 24 hours post surgery, hip replacement patients will begin working one-on-one with a physical therapist to learn how to use their new joint, begin walking, and regaining strength. Upon returning home, patients will need to continue to take pain medications, as well as use the assistance of crutches or a cane to complete daily activities.

It is crucial to the recovery process to strictly follow the exercise regimen determined by the physical therapist and Dr. Ballard.

Patient Testimonial Videos

Learn more about Hip Replacement Surgery from these patients:

Cheryl Mansfield

Peter Roessler

Total Hip Replacement in Oregon City & Tualatin, OR

Dr. James Ballard has over 17 years of experience with hip replacement surgery. He was the first surgeon in the Northwestern United States to perform a total hip replacement in an outpatient surgery center, and now primarily performs hip replacements on an outpatient basis. If you would like to schedule an appointment with Dr. Ballard, please call our office at (503) 656-0836 or fill out our Appointment Request form.