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A Lifetime Hip Replacement?
Joint implants last longer than you may think – and research is helping further enhance their durability
Peter F. Sharkey, MD, is a joint specialist with the Rothman Institute at Thomas Jefferson University Hospital and professor
of Orthopedic Surgery at Thomas Jefferson University. As such, he has extensive experience in treating patients with hip problems.
And he’s nothing short of passionate about the life-changing results patients can experience through hip replacement.
Keep In Touch spoke with Dr. Sharkey to get his perspective on the benefits of this procedure – and the advantages of choosing a surgeon
from the Rothman Institute at Jefferson.
Keep In Touch: In this issue, we’ve talked about two other types of procedures for hip resurfacing and hip preservation . Is traditional hip replacement still an option for many patients?
Dr. Sharkey: Absolutely. Quite simply, hip replacement is considered the best operation ever developed by physicians to restore quality
of life. You see, when you have arthritis, if you use your joint, it hurts. If you don’t use it, you feel better. So patients
with arthritis sit around and feel better – and the more they sit, the better they feel.
Eventually, they sit around so much that it’s no longer compatible with a good quality of life. That’s when they seek help
from someone like me. A patient will come to me and say, “My quality of life has deteriorated,” and I can say with confidence,
“There’s a 98 percent chance I can restore or greatly improve your quality of life with a hip replacement.”
Keep In Touch: With those kinds of odds, it seems like a hip replacement would be the way to go. Do patients understand the benefits of
the surgery?
Dr. Sharkey: When I tell patients I can restore their quality of life, their next question is usually, “For how long?” We now anticipate
that hip and knee replacements will support good quality of life for 20 to 30 years. At that point, a patient may have to
undergo another procedure to restore the quality of life.
And yet, out of 100 patients who walk through my door, 95 truly believe a replaced joint will last only 10 years or less.
It’s an extremely common misperception among the general public. In fact, many people in their 50s will say, “I really wanted
to wait until I was 60 to get this operation.” They have a perception that after the operation, they’ll have only one good
decade, and that’s just not the case. If anything, patients should seek help to restore their quality of life while they’re
younger and able to live life more fully.
What has me really excited is the possibility of a hip replacement that can surpass 20 or 30 years. I believe we’re getting
closer and closer to a hip replacement that can last 50 years. There’s work underway here at Jefferson to make that a reality.
Keep In Touch: You said about 98 percent of hip replacements are successful. What are some of the reasons why that other two percent fail?
Dr. Sharkey: Failure of a hip implant can be caused by biologic factors or mechanical factors – or both.
When the plastic starts to wear, there can be a biologic response to the plastics. The plastic emits tiny particles that are
about the size of bacteria, and the body attacks them as if they were bacteria.
Another cause of failure is infections, and that’s something my colleague, Dr. Javad Parvizi, is studying. In time, joint
implants may be coated with antibiotics, and there would be a mechanism to alert the implant to trigger the release of those
antibiotics. So even if you had a hip replaced and developed an infection many years later, the implant would start clearing
it up for you.
Mechanical failures can include wear and breakage, and researchers at Jefferson are working to understand how we can further
reduce the incidence of those types of failure.
Keep In Touch: It sounds like the Rothman Institute at Jefferson is involved in some impressive research about hip replacements. How does
that benefit patients today?
Sharkey: We offer patients an incredible combination of clinical experience and leading-edge research. We have physicians doing research
at the cellular level to study how the body reacts to implants, and we have a team of engineers studying implant failures
to understand why they occurred and how we can avoid that in the future.
I have access to these and other tremendous resources, and that’s a real benefit for my patients. Just as one example, if
there’s a defective product out there, our researchers may be the people who discover the problem and let us know about it
months before a formal recall is issued. As a surgeon who wants to do the best thing for my patients, that real-time input
is invaluable.
For an appointment, call 1-800-JEFF-NOW
To make an appointment with a Jefferson physician, call 1-800-JEFF-NOW. We’ll help you choose the doctor that’s right for you, based on types of medical insurance accepted, location, and any other
factors that are important to you.
