Conditions & Treatments

Hip Replacement

With recent advancements in hip replacement surgery, Orange County Orthopedic Surgeons Dr. Lance Montgomery and Dr. Larry Gersten offer patients state-of-the-art treatments for hip joint pain with disability, regardless of age. Our doctors are fellowship trained joint replacement surgeons.

The most recent advances in surgical technology include new implant materials that offer more durable and longer- lasting implants which increases the durability and duration of hip replacements. Rapid Recovery pathways for pain management, before, during and after surgery are designed to speed recovery from surgery, minimize pain and allow for faster rehabilitation.

At South County Orthopedic Specialists (SCOS), we employ these advancements for joint replacement patients, to tailor the surgery for each patient’s individual needs, and to recreate natural hip movement. We are committed to ensuring that a patient’s surgery and recovery are successful. Our goal is improved quality of care, stellar outcomes and our patient’s satisfaction.

What is a Hip Replacement?

It is a surgical procedure to remove the diseased hip joint and replace it with artificial, anatomically-correct parts called prosthesis. The purpose is to dramatically reduce or eliminate pain and improve function which improves the quality of life for patients suffering from hip arthritis, hip pain, decreased mobility, and poor quality of life. Hip replacement surgery is one of the most successful operations in all of medicine.

Hip Anatomy

The hip joint is a ball and socket joint. The upper end of the thigh bone (femur) is called the femoral head, it is the ball that fits into the socket (the acetabulum) in the pelvis. The acetabulum is lined with cartilage that allows the joint to glide easily and offers a wide range of motion. Hip replacement surgery replaces the damaged ends of both bones.

Who should consider hip replacement surgery?

People with advanced hip arthritis who suffer from hip joint pain and damage that hinders daily activities, and for which other treatments have been exhausted, should consider hip replacement surgery.  Osteoarthritis of the hip is called “wear and tear” arthritis and commonly develops in weight bearing joints, usually in people 50 and older. However, today a patient’s overall health and activities are more important than age when predicting the success of hip replacement surgery.

Non-Surgical Alternatives to Hip Replacement Surgery

Before considering total hip replacement surgery, the orthopedic surgeons at South County Orthopedic Specialists in Orange County, California, may recommend an exercise program, walking aids, and oral and topical medications for pain.  These can improve muscle strength and support to relieve some of the pain and allow a patient to avoid or delay surgery. When these efforts fail to relieve pain and improve joint function, a common alternative is osteotomy.

Hip Replacement Surgical Options

  • Osteotomy is a surgical procedure that is less complex than hip replacement. It is designed to preserve the hip joint, by reshaping either the socket or the ball when the hip socket is not in the correct position or the joint is the wrong shape. The objective is to decrease cartilage wear and tear and delay the need for hip replacement.
  • Arthroscopy is designed to repair torn cartilage and remove bone spurs that happen in the earliest stages of arthritis.
  • Revision surgery is performed to replace a prosthesis that no longer functions well due to deterioration of the implant or the bone in which the implant is placed.

Standard Hip Replacement Surgery compared to Minimally Invasive Total Hip Replacement

Standard hip replacement surgery requires a single, long incision to view and access the joint. In a minimally invasive procedure, one or two short incisions are used. Shorter incisions offer less pain and a speedier recovery.

In standard hip replacement damaged bone and cartilage are removed, leaving healthy parts of the joint intact. The muscles are split or detached from the hip, dislocating the hip for full view. The damaged head of the femur is removed and replaced with a metal stem, and a metal or ceramic ball to replace the damaged femoral head.  Then the surgeon removes damaged cartilage on the surface of the joint (the acetabulum) and replaces it with a metal socket lined with plastic or ceramic. The new joint components can be cemented in place, or uncemented to hold the socket in the correct position. Uncemented components are made with a porous surface which is designed to allow for biological fixation where the healthy bone grows into the pores to hold the parts in place.

In minimally invasive hip replacements the procedure is similar but there is far less cutting of the surrounding hip tissues and muscle. The same implants are used but the technique requires special surgical prowess and instruments in order to repair and replace the joint. While the muscles are split or detached, they are repaired after the implants are in place. This promotes healing, prevents hip dislocations, and offers a less painful recovery and quicker return to normal function.

Both procedures are performed under either general, spinal or epidural anesthesia. Minimally invasive surgery requires less surgical time, there is less bleeding and a shorter recovery time.

Minimally Invasive surgery is not for all patients. The hip surgeons at South County Orthopedic Specialists will custom tailor the procedure to each patient’s individual needs.


Early stages of recovery (within 4-6 weeks after surgery) involve the ability to get out of bed and leave the hospital.

  • 1-2 days after surgery, patients are expected to walk with a walker. By day 3, many can go home.
  • Reducing the need for major pain medications
  • Getting a full night’s sleep without medication
  • No longer needing a walker or other aid to move around the house without pain
  • Walking two blocks without pain or rest

Longer term recovery (up to six months after surgery) involves the healing of the surgical wounds and tissues, and daily activities.

  • When the patient feels normal again, without pain, and improved mobility
  • The new hip feels natural!

Drs. Montgomery and Gersten have over 20 years of experience and success in hip replacement surgery. For patients in Orange County, Irvine, Laguna Woods, and Fountain Valley who need hip replacement surgery, the fellowship trained experts at SCOS will provide an accurate diagnosis, a personalized treatment plan, and the ability to return to daily life activities.

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