TODAY’s Al Roker is recovering from surgery to treat a bad hip that recently started sending painful reminders it was time for medical attention.
“All of a sudden, I started feeling this twinge in my hip — and then my back was acting up," Al, 65, said. "It seems like my hip went fairly quickly."
On Tuesday's show he said he knew it was time to get it taken care of. "In the last three months, my left hip has been deteriorating," Al said.
"I'm in far less pain than I was 48 hours ago," Al told his fellow hosts during a live chat. "The best thing is to just get up and move and be able to walk."
Before the surgery, Al said he had osteoarthritis, although he was not in excruciating pain. "It's not like I'm crying at night, but, you know, it hurts," he noted.
He's expecting to return to the show by the end of the month, barring any complications.
Patients who get a hip replacement are usually in their 50s, 60s or 70s, but Al’s doctor said he's operated on people in their teens and one patient as old as 102.
The number of hip replacements among baby boomers has grown because they’re more active and less tolerant of having physical limits as they go about their lives, said Dr. David Mayman, an orthopedic surgeon in New York.
“People don't want to walk down the street with a cane,” Mayman told TODAY. “They want have an option that can fix them."
Because surgical techniques and implants have improved in recent years, "we're more comfortable doing hip replacements on younger, more active people and allowing them to get back to pretty high levels of activity,” said Mayman.
Why hip replacement is needed:
The hip is a ball-and-socket joint covered by cartilage, which is smooth tissue that helps the bones glide easily across each other, according to the American Academy of Orthopaedic Surgeons.
Just like the treads on car tires, people wear away that cartilage over time.
“If you drive enough miles, eventually you wear the treads thin,” Mayman said.
That can lead to pain.
When Al mentioned his younger sister had to have operations on both of her hips, Mayman confirmed genetic factors play a role in the longevity of the “tires.” But everyone is at risk for arthritis in their joints with age.
“Eventually we're all going wear out, even the really good tires," Mayman said. "Then anatomic abnormalities, injuries, things like that, along the way, expedite the wear.”
The cartilage could be wearing out for a long time and then something happens — like rolling over in bed the wrong way — that suddenly starts an inflammatory response, he noted.
Doctors start with conservative therapies to try to help symptoms, including:
Over-the-counter pain medications, such as anti-inflammatory pain relievers containing ibuprofen and naproxen.
Physical therapy to keep the joint moving.
Cortisone injections, which work for many people, but not for everybody. Cortisone's effect is also very unpredictable in terms of how long it lasts.
“One person has a cortisone injection, it lasts for three days," Mayman noted. "Next person, it's three months. It's kind of all over the place.”
When hip replacement surgery is needed:
When those conservative approaches don’t work anymore — as was the case with Al — the fix for the mechanical problem is surgery.
When Al arrives at the hospital the morning of his total hip replacement, he'll receive an epidural anesthetic that will numb the lower part of his body. He will also be sedated so that he'll be sleeping.
The surgery itself lasts just over one hour, Mayman said. He’ll make a 4-inch incision on the side of Al’s hip that will be closed with stitches under the skin, then he'll put a glue used in surgeries on the skin and a waterproof bandage on top.
When Al wakes up in the recovery room, his legs will be numb for a couple of hours until the anesthesia wears off. A physical therapist will help him get out of bed and assess his situation. If he’s feeling OK, he’ll stand up and use a walker for support. He may take a few steps at that time.
Some patients go home the same day, but most stay in the hospital overnight, Mayman noted. Some stay for two days.
“I tell people, ‘You have to say you're comfortable,’ and the physical therapist needs to say, ‘You're safe.’ Once those two things match, you don't need to be in the hospital anymore,” he added.
After the surgery:
The average healthy person walks with a cane for about two weeks after the procedure. Walking is actually the best physical therapy, Mayman said. The initial goal is to be able to go for a 1-mile walk.
Six weeks after the surgery, most people feel about 80% recovered, he noted. It takes three months for the bone to fully grow into the implants, so high-impact exercises like running or jumping are off limits.
After that time, Mayman tells patients to stay away from long-distance running. Once people fully recover, there are very few other limitations. They can resume golfing, playing tennis, skiing, hiking, swimming and biking.
“Most people who have hip replacements kind of forget they ever had a problem with their hip," he said. "They come in a year after surgery and their hip just feels very, very normal."
CORRECTION (Sept. 18, 11:35 ET): A previous version of this story misstated Al Roker's procedure. He had a total hip replacement, not a hip resurfacing.