Hip, Hip, Hurray

When it comes to replacing parts, we boomers want the Jiffy Lube treatment: You're in, you're out, you're fine.

And so it was with my friend Sandra Hughes, 52, whose osteoarthritis was making it increasingly difficult for her to walk without pain. She needed to replace her right hip but didn't want to be stuck in the body shop for months, hobbling along with loaner canes and walkers.

Sandra's an active mother of two, a lawyer looking to change careers and a swimmer. She had things to do, no time for long recoveries, no interest in a long hospital stay or, worse, a week or two in a rehab facility.

"I want to have a perfect hip after this," she told me before her surgery. So, like any respectable boomer, Sandra did some research on her options.

Here are the vehicles she found on the lot.

The Cadillac Kick the tires all you want, the most traditional hip replacement surgery is a big, time-tested and generally predictable operation. Using a 10- to 12-inch incision, the surgeon has room to work and can see what he's doing. And what he's doing, when you stop to think about it, is pretty amazing. (I can understand this best while daydreaming about eating a chicken thigh, but, please, feel free to use your own mental image.)

Put simply, in all hip replacement operations, the surgeon: 1) separates the thighbone, or femur, from the socket; 2) removes the damaged top of the thighbone with a saw; 3) removes the damaged bone and cartilage from the socket using a tool called a "reamer"; 4) puts in an artificial socket; 5) hollows out the top end of the thighbone; then 6) drives an artificial "top" -- a ball on a stick -- deep into the thighbone. Most patients spend about four days in the hospital, followed by days or weeks in a rehab facility, then weeks or months on crutches.

This surgery may be easiest for surgeons who don't do a lot of hip replacements, since it allows them to eyeball everything. It may work best for patients who are particularly large -- fat or tall. And this operation has decades of data indicating high success rates. On the downside, the big incision means big-time muscle and tissue damage, which can take months to heal.

The Camry In the past half-dozen years, many orthopedic surgeons have begun to question the need for the Caddy when a downsized vehicle might provide the same reliable ride. They've opted for a midsize surgery.

"We're doing the same operation, just through a smaller window," explained Thomas Sculco, surgeon-in-chief at the Hospital for Special Surgery in New York. Instead of a foot-long incision, Sculco makes a three- to four-inch cut, then uses tools that have been customized to work in the smaller space.