Newsletter Fall 2003

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Ceramic-on-Ceramic Hip Replacement
Cancer Care Center
Barbara Fountain's Cancer Treatment Story
Welcome Physicians and Clinicians

Ceramic-on-Ceramic: The New Hip Replacement

Golf legend Jack Nicklaus is busy talking to the media these days, though his message is not about golf, as you might expect. Four years ago Nicklaus underwent hip replacement surgery. The results were so successful that he decided to become spokesman for a patient education campaign for Stryker, the company that designed and manufactured the hip prostheses.

Nicklaus suffered chronic hip pain from an old golf injury and more than 40 years of competitive golf. “Joint pain affected my everyday activities,” he says on his website, “from playing with my grandchildren or helping my wife, to working with my sons or enjoying the outdoors. It wasn’t until I made the choice to get a total hip replacement that I could again live my life on my own terms, free of hip pain.”

Moses Lake Orthopedic Surgeon John Wheaton understands the pain Nicklaus is talking about. “I have degenerative arthritis of the hips,” says Dr. Wheaton. “My father had arthritis of the hips, my brother’s had one hip replacement and is going to have another. It runs in the family.”

For Wheaton, it wasn’t just one hip that was causing him problems, but both hips. “The pain made it hard to stand at the operating table, hard to sit for a long period of time. We have horses, and I couldn’t ride anymore. It got to the point where I was waking up at night, where I was needing to take pain medicines.”

For anyone facing hip replacement surgery, there are many decisions to be made. For Wheaton, the decision was clear. As an orthopedic surgeon who performs hip replacement surgery himself, he was accustomed to presenting the choices to his patients.

“The first decision that should be made when you’re doing a hip replacement in a younger person,” says Wheaton, “-- by that I mean someone under 65 -- is whether you’re going to choose a cemented hip replacement or an uncemented hip replacement. How are you going to fix the prostheses to the bone?”

Cemented prostheses have been the standard since hip replacements became common in the 1960’s. Research has proven the effectiveness of cemented prostheses to reduce pain and increase joint mobility. These results usually are noticeable immediately after surgery. Cemented replacements are more frequently used for older, less active people and people with weak bones, such as those who have osteoporosis.

Uncemented prostheses were developed about 20 years ago to try to avoid the possibility of loosening parts and the breaking off of cement particles, which sometimes happen in the cemented replacement. Younger, more active people might choose uncemented. However, people who choose uncemented prosthesis have a longer recovery period than cemented, because it takes a long time for the natural bone to grow and attach to the prosthesis. Activities must be limited for up to 3 months to protect the hip joint. The process of natural bone growth also can cause thigh pain for several months after the surgery.

The next important choice you must make is selecting the type of artificial hip. Until recently, the standard artificial hip included a metal ball that fit inside a hard plastic (polyethylene) cup liner within a metal shell. Unfortunately, over time the metal ball grinds away the plastic cup, wearing out in 10 to 15 years, or even shorter for younger, more active people. And when the plastic wears out, it sometimes results in a destructive reaction causing bone loss around the joint. The metal and plastic<