Do Hip Implants Cause Long term Functional Leg Movement Restrictions?

Q: Dr. Eppley, I am a plastic surgeon from Beijing, China. I read with great interest your article published in ASJ on hip augmentation with implants (Evolving Clinical Experiences in Aesthetic Hip Implant Body Contouring) and truly admire your design of the prosthesis. I am also considering performing hip augmentation surgery with implants for my transgender patients.

I have a question and would like to seek your advice: Beyond the mid to long-term postoperative period (i.e., beyond 3 to 6 months after surgery), can patients perform movements such as deep squats, cycling, or yoga? Will they experience discomfort or even compromised stability of the implants? I suspect that when hip flexion exceeds 90 degrees, the deformation of soft tissues around the implant area may exert significant pressure on the prosthesis. I would appreciate your insights on this matter. 

A:Thank you for your thoughtful inquiry. In terms of long-term outcomes from hip implants I have no concerns that the patient will experience discomfort or compromised stability of the implants in any type of physical maneuver. However what is more pertinent is that in some movements such as signifincat hip flexion it may be possible in thin patients to see some of the outline of the implant as the soft tissues change or stretch over the implant in different leg positions. This is, of course, an aesthetic concern and not a functional one. But it is important to point out preoperatively that this will likely occur and is not a rare or unexpected outcome. It is just the nature of putting an implant in an area where the  soft tissue cover will change with dynamic motion while the implant form will remain the same.

Dr. Barry Eppley

World-Renowned Plastic Surgeon