Dr. Lou Pack

“I had a hip replacement but it still hurts. What can I do?”

First make sure that you don’t have a complication from the surgery itself.  You may even want to get another surgical opinion.  But if that’s not the case, it’s extremely important that you understand why your hip problem really developed to begin with.

We’re told that weight and age cause arthritis.  But why do some overweight people have no joint pain?  And why would it affect one hip and not the other?  I’ve also seen twenty year olds with severe hip problems and ninety year old patients with no hip pain.  Age and weight are certainly factors but not the primary cause of arthritis.

The most common cause of arthritis of the hip and subsequent joint replacement surgery is structural problems (poor alignment).  Problems such as leg length differences cause uneven wear on our joints in the same way that poorly aligned tires causes premature, uneven tire wear.  So arthritis is preventable to some extent.

Proper foot positioning is also critically important. The foot is the foundation of our entire skeletal system and if it’s not aligned all of the weight bearing joints it supports (ankles, knees, hips and back) will also be off.  The Leaning Tower of Pisa didn’t get crooked from the top but from its base! 
Remember that replacing a knee or hip joint does nothing to fix the cause of the bad joint (such as a longer leg) any more than putting a new tire on a car fixes its bent frame.  As a matter of fact, surgery often makes your frame worse because it usually results in a longer or shorter leg than before surgery! 
 To insure that you have the very best protection available to prevent arthritis (or decrease painful symptoms after joint replacement surgery) in your hips, or knees, have your structure analyzed.  Correcting problems such as a leg length difference or flattened foot can dramatically decrease joint symptoms.  Recent studies at the famed Mayo Clinic and elsewhere have now documented the important relationship of structural alignment and arthritis.

Optimal alignment can also improve your performance in golf and other sports. If you’re a right handed golfer with a long left leg, you won’t be able to easily complete your swing because you’re swinging up hill.  Putting a lift on your shortened side will reduce joint symptoms, increase balance and your performance.

A former Clinical Instructor of Medicine at Emory, Dr. Pack practices at MCG Medical Associates, at Reynolds Plantation.   He works with patients who have arthritis and wish to decrease joint symptoms and remain active.  He also treats athletes at all levels, including Olympic gold medalists, and helps the UGA Golf Team. For further information please see his web site at "http://www.drloupack.com" www.drloupack.com, or call 706-454-0040.

Printed in the January 8, 2008 edition.