“I have no pain, and I’m so grateful to Dr. King. I can finally play with my grandchildren again.”
Hip replacement surgery may seem like an unusual birthday gift, but that’s exactly what Maria Rivera, a resident of Iselin, decided to give herself when she turned 60 in July 2022. A mother, grandmother and human resources associate at a Perth Amboy supermarket, Maria had had enough after years of chronic hip pain.
“I couldn’t sleep, and it was difficult to walk,” she recalls. “When you’re in constant pain, it’s hard to think about anything else.”
Like many who suffer from joint pain, Maria had osteoarthritis.
“Osteoarthritis is a very common form of arthritis—it’s the general wear and tear on joints brought about by genetics, weight and joint trauma that occurs over the years,” says orthopedic surgeon John King, DO, a staff physician with Robert Wood Johnson University Hospital (RWJUH) Rahway.
Maria first sought treatment from Dr. King several years prior for arthritis pain in her knees. Once chronic pain starts impacting daily activities and having an adverse effect on your quality of life, Dr. King advises that it’s time to consult an orthopedist.
To facilitate movement and reduce pain, Maria received viscosupplementation treatment, in which a gel-like hyaluronic acid is injected into the joint. When Maria began experiencing hip pain, she tried oral medications, but they only offered temporary relief.
“Over several years, Maria had progressed to end-stage disease in her hip,” says Dr. King. “She was experiencing severe limitations of range of motion and had bone rubbing on bone.”
Although Dr. King recommended total hip replacement surgery, two things were holding Maria back.
“My job isn’t physical, and I’m a very strong person,” says Maria. “I didn’t want to miss out on work.”
Maria also weighed 240 pounds, and her elevated body mass index would make surgery challenging. “I tried so many diets,” she says. “But when you’re in pain, it’s hard to exercise, and you become frustrated.”
After Maria made several unsuccessful attempts to lose weight on her own, Dr. King referred her to Anish Nihalani, MD, Medical Director of the Surgical Weight Loss Program at RWJUH Rahway, for bariatric surgery. After surgery, Maria shed over 80 pounds. Almost a year and a half later, on July 27, 2022, she was ready for a total hip replacement—the same day as her 60th birthday.
A Life-Changing Procedure
Maria was not alone; more than 450,000 total hip replacements are performed each year in the United States. There are several surgical options for total hip replacement. It can be done from the front (anterior), side (lateral) or back (posterior), and patients often wonder whether one offers a greater benefit. Research presented by the American Academy of Orthopaedic Surgeons (AAOS) shows no difference in patient outcomes with each option six months after surgery.
“There are benefits and risks with any approach,” says Dr. King. “It’s critical for patients to see a doctor who’s highly experienced in their technique to avoid any complications.”
Dr. King used a lateral incision for Maria’s surgery to come into the anterior aspect of her hip to remove the damaged section of the hip joint and cartilage. A metal stem was placed into the hollow center of the femur (thigh bone). The ball of the hip socket was replaced with a metal ball coated in a polyethylene shell. Dr. King uses imageless computer navigation to map the hip’s rotation and patient leg length to precisely fit the prosthetic. The damaged surface of the socket (acetabulum) is removed and replaced with a metal socket. The poly coating on the metal ball creates a smooth glide between the new ball and socket and offers extended longevity for the prosthetics.
Dr. King prefers to bring his joint replacement patients, like Maria, to RWJUH Rahway.
“The Joint Replacement Center has private rooms for patient recovery, and one of its biggest draws is the rehabilitation program,” says Dr. King. “In some hospitals, patients aren’t ready to be discharged because they haven’t received enough physical and occupational therapy, but RWJUH Rahway, offers extensive rehab for quicker recovery.”
Today, Maria is making big strides (literally and figuratively) and continues weekly physical therapy at RWJUH Rahway.
“I have no pain, and I’m so grateful to Dr. King,” says Maria. “I can finally play with my grandchildren again.”
Although Maria faced daunting hurdles, she was able to meet them head-on with support from her RWJUH Rahway physicians and therapists. Now she’s back at work, keeping pace with her 4-year-old grandson, Julian, and is thankful that her 60th birthday gift—a total hip replacement—has helped her get back to the life she loves.
For more information about the Joint Replacement Center, call Robert Wood Johnson University Hospital Rahway's Rehabilitation Services at 732-499-6346.