Throughout the last two centuries, the treatment of hip arthritis and problems necessitating hipreplacement surgery has evolved from rudimentary surgical techniques to the minimally invasive methods available today. Now patients who undergo a hip replacement procedure are more active than ever, thanks to technological improvements and innovative techniques that have made artificial joints more stable and durable (some of these techniques and implants have been pioneered by Los Angeles surgeon Dr. Allison himself.) But that evolution took decades to refine.
The Evolution Of Hip Replacements
For sure you’ve had your share of stories from your grandparents about how they or their friends would either slip or fall, break their hip, and how hip replacement surgery in their time was a “major” procedure that wouldn’t even guarantee a full recovery. Some were even too scared to undergo the procedure. But to better understand how hip replacements have become one of the most reliable and successful interventions in medicine, here’s a quick history lesson on the history of total hip replacement.
- When the hip joint is exposed to injury or arthritis, the layer of protective cartilage that lines it becomes damaged, causing extreme pain.
- Over a century ago, the search to help alleviate joint pain led surgeons to do extensive research on the exploration of hip replacements.
- 1821 – Anthony White of the Westminster Hospital in London performed the first arthroplasty which involved the replacement of the arthritic or joint surface. While the procedure helped with pain and mobility, it failed in stability.
- 1826 – John Rhea Bartonii performed the first osteotomy, a procedure that involves cutting the bone to shorten, lengthen, or alter its alignment. This procedure, however, achieved unpredictable results.
- Other options considered included removing calcium deposits and damaged cartilage.
- 1891 – Professor Themistocles Glück developed hip implant fixation wherein he produced an ivory ball and socket joint that he attached to the bone using nickel plated screws.
- Glück‘s research on hip replacements included the proposition of implementing joints from cadavers and amputated limbs, as well as the idea of biocompatibility, which suggests how a foreign material placed in the patient’s body should be well tolerated by the body.
- 1925 – American Surgeon Marius Nygaard Smith-Petersen molded a piece of glass into the shape of a hollow hemisphere which could fit over the ball of the hip joint and provide a smooth surface for mobility. Unfortunately, it failed as the glass shattered from the stress of walking. Smith-Peterson then continued his research and explored other materials including plastic and stainless steel.
- 1936 – Scientists manufactured a cobalt-chromium alloy that was exceptionally strong and resistant to corrosion. While the new metal was a success, the resurfacing technique was inadequate.
- 1938 – Dr. Jean Judet and his brother, Dr. Robert Judet of Paris, used an acrylic material to replace arthritic hip surfaces. This material, however, tended to fall loose.
- It became clear at this time that artificial joint material had to be biocompatible, as well as have the ability to withstand the stresses of the body.
- 1950s – Frederick R. Thompson and Austin T. Moore separately developed replacements for the entire ball of the hip. Their type of hip replacement replaced the arthritic femoral head (ball), but failed to replace the acetabulum (hip socket).
- 1958 – John Charnley from England proposed the idea of replacing the eroded arthritic socket using a Teflon component. When this failed, he used a polyethylene polymer to construct the socket.
- Polymethylmethacrylate was used as a bone cement.
- 1961 – Charnley continues performing surgeries with great results, having pioneered the modern frictionless total hip arthroplasty.
Dr. Allison’s Hip Replacement Technique
Hip replacements have come a long way in the last several decades. The procedures available today are safe and effective in relieving pain, increasing motion, and helping you get back to your normal everyday activities with minimal invasiveness – especially when performed by a top-rated expert. Practicing in Los Angeles, CA Dr. Allison is a highly trained and esteemed orthopedic reconstructive specialist who is dedicated to making his patient’s lives better.
For any patient with hip degeneration or osteoarthritis, Dr. Allison regards surgery as a last resort; before proceeding with any surgery for hip degeneration / arthritis, he first suggests these alternatives to a hip replacement:
- Physical therapy to improve hip joint motion, strength, and overall condition
- Activity adjustment (decrease high impact activity)
- Weight optimization
- Non-steroidal anti-inflammatory (NSAID) medications
- Hip joint injection
- Corticosteroid (steroid)
- Hyaluronic acid (AKA “gel”)
- Possible biologic agents (PRP, stem cells, amniotic solution)
If surgical total hip replacement does become an option, such as after progression of degenerative arthritis, an injury, or severe inflammatory arthritis, Dr. Allison will work with you to restore full mobility and stability while relieving pain through his refined and perfected surgical technique. Total hip arthroplasty (total hip replacement) is the procedure that replaces the diseased bone and entire cartilage surfaces with metal and plastic counterparts (a new ball and socket joint). Dr. Allison is one of a handful of surgeons who performs the direct anterior method, using a standard operating table (avoiding problems associated with traction tables). His method minimizes trauma and damage to the soft tissues around the hip, optimizing recovery and overall function. Dr. Allison developed a patented retractor system to facilitate the anterior approach, as well as a popular femoral stem implant which facilitates minimally invasive surgery. Some additional information about hip replacement can be found at niams.nih.gov
Revision Hip Replacement
Revision hip replacement could address a surgery failure (often indicated by swelling or bruising around the hip, pain around the hip, or the inability to bear weight on the affected leg), or serve as a salvage treatment for severe, destructive disorders of the hip joint or a fracture near the implanted device (e.g., trauma, degeneration, or inflammatory arthritis). And since joint revision surgery is often complex with significant bone and soft tissue compromise, Dr. Allison’s significant experience in tumor surgery as well as his gives him a significant advantage when addressing these complex problems. Dr. Allison is one of the designers of a state-of-the-art revision hip replacement implant which is currently in development.
Trust the Hip Replacement Expert
Because of the extent and complexity of the conditions involved, Orthopedic oncology + advanced reconstruction is a unique field with very few specialists, and Dr. Daniel C. Allison has become one of the most sought-after experts in the United States. His training and experience in the treatment of complex pelvic and extremity disorders have made him exceptionally skilled at handling non-oncologic bone and joint conditions such as osteoarthritis, trauma, degenerative joint disease, congenital deformity, and revision joint replacement. And with a treatment philosophy that puts patient care above everything else, Dr. Allison is committed to providing world-class comprehensive care in Los Angeles.