Anyone who has arthritis of the hip knows how painful even walking can be. Osteoarthritis, otherwise known as degenerative arthritis, develops over time in response to the everyday wear and tear on our joints, as well as from injuries. Treatment can be as simple as weight loss and exercise, to over the counter or prescription medication, to joint replacement surgery if there is enough damage. There are a number of things that can accelerate the development and severity of arthritis including being overweight, long-term repetitive movements like marching or sawing, high impact activities or playing sports, and previous injuries. Some other diseases can also make you more susceptible to developing osteoarthritis. Diabetes, especially type 2 diabetes, has been linked to osteoarthritis in some recent studies. While this may be, in part, due to being overweight which often leads to Type 2 diabetes, some researchers believe there is a more direct link. But if I’m diabetic and develop osteoarthritis that is severe enough to require surgery, can I have hip replacement surgery? The answer to this question is “yes”. So, if you are a diabetic who is suffering from the pain of hip arthritis that is not improving with other treatments, don’t hesitate to seek the advice of an orthopedic surgeon who will address your specific needs in the event that hip replacement surgery is right for you.
What is Hip Arthritis?
The most common cause of hip arthritis is osteoarthritis. The hip joint is a ball-and-socket joint, consisting of the round head of the long bone of the thigh (femur) which sits in the socket of the hip bone (acetabulum) and is secured by strong ligaments and muscles and protected by cartilage and lubricating fluid (synovial fluid). Over time, or with injury, the cartilage breaks down and fluids diminish, causing damage to the cartilage and bones in the joint. As the arthritis worsens, pain and inflammation increases, causing disability and a poorer quality of life. In fact, osteoarthritis is one of the most common causes of disability in adults. If left untreated, the pain and decreased mobility caused by hip arthritis can lead to or worsen other health problems including weight gain, diabetes, high blood pressure and depression.
What is Hip Replacement Surgery?
Hip replacement surgery is generally done during a brief overnight hospital stay, although outpatient surgery is becoming more common. While the patient is under anesthesia, the orthopedic surgeon will make an incision to access the hip. The ball at the top of the thigh bone is removed and replaced with an artificial ball made of metal or ceramic that is supported by a small support (called stem) within the thigh bone. Then the damaged cartilage and bone in the hip socket is removed, the surface is prepared, and the new socket joint is attached to the inside of the old hip socket. Within the new socket a smooth polymer gliding surface is also placed. Finally, the new ball is placed into the new socket and the wound is closed. Hip replacement surgery is one of the most successful orthopedic procedures performed today and can lead to a greatly improved quality of life.
What do I Need to Know as a Diabetic?
As a diabetic, you can have all the benefits that hip replacement surgery has to offer. However, there are some specific things you should be aware of to help with a successful recovery. First of all, having good control of your blood sugars before, during and after surgery will help promote healing and prevent complications. Glucose control will also minimize any diabetic complications such as circulation problems or kidney problems, which could otherwise interfere with healing. Finally, type 2 diabetes, just like osteoarthritis, is often associated with being overweight, so working with your healthcare partners to achieve your optimal weight before surgery will not only help with your glucose control, but also help minimize stress on your new hip joint.
Managing Your Glucose Control Before, During and After Surgery
Before hip replacement surgery, you should be working with your primary healthcare provider to achieve a hemoglobin A1C of less than 7 or 7.5%, the lower the better. This would indicate that your blood sugars have been in good control for the last 3 months. Taking your medications as directed, monitoring your blood sugars as prescribed, following a diabetic diet and getting routine exercise will help you achieve this goal. By keeping you blood sugar controlled prior to surgery, you are preparing your body physically for the stress of surgery.
Your surgical team will give you instructions on what insulin or medicine to take the day of surgery. Do not be surprised if you stay overnight in the hospital, that your insulin dose may change, or that you will receive insulin even if you usually take pills to control your diabetes. This doesn’t mean that your diabetes is getting worse. It just means that the stress of surgery will change your insulin needs initially. Most likely, you will return to your old routine after surgery.
Once on the road to rehabilitation and recovery, it will be very important to control your sugar level. Elevated blood sugar can increase the risk of infection. Controlled blood sugars will promote healing. So, as with the rest of your rehabilitation, you will be in control by following the recommendations of your orthopedic surgeon and the rest of your healthcare team.
Don’t let diabetes keep you from achieving your highest quality of life. Hip replacement surgery is available to you if you need it. If you have any more questions about hip replacement surgery, our friendly team is here to answer them. To seek the expert advice of Dr. Brett Gilbert in Raleigh, Durham, Apex or Cary, who will address your unique concerns, contact us today by calling us at (919) 788-8797 or you can request an appointment with Dr. Gilbert using our appointment request form, or you can self-schedule your appointment here.
