Dr. Anthony Anderson of Durango Orthopedics gave a presentation about hip pain to a packed audience last week at the Durango Public Library.

By all appearances, most people in the crowd had become eligible for AARP membership long ago. And at points, the presentation felt as though the conspicuously youthful Anderson – who warned the crowd that his pregnant wife might go into labor any minute – was putting on a one-man talent show for the benefit of adoring grandparents.

But, far from indulging Anderson, the audience appeared riveted throughout his careful discussion of ailments and treatments that loom large in one’s later years as bone and cartilage grow weak: osteoporosis, arthritis and arthroscopy.

The big finale – Anderson’s ode to anterior hip replacement surgery – might have garnered a standing ovation were it less painful for so many people in attendance to stand up.

Anderson even joked: “It’s unbelievable how many people in small-town Durango are here to talk about hip pain!”

Anderson said 43 million people suffer from some form of arthritis, and the symptoms of osteoarthritis – which affects the hips, knees and spine – can develop “suddenly or slowly.”

“Typically, it comes in waves, where over a period of time, your good days get worse than your bad days used to be, and it gets worse as we get older,” he said.

The pain and stiffness can get so bad from osteoarthritis in the hip that “the hip doesn’t even move anymore. It’s the body’s way of giving up, and saying, ‘You’re so bad, I’m not even going to let you move anymore.’” he said.

When pain from arthritis and joint generation becomes so acute that putting on shoes is excruciating, there are lots of potential treatments, Anderson said.

They include: medications, physical therapy, bracing, steroid and fluid injections in the joint, arthroscopy (which will make the popping, clicking sound go away, but not the pain), partial hip replacement and total joint replacement.

Unfortunately, he said, the nonoperative treatments are “not the greatest.”

Anderson said taking glucosamine sulfate “to me is like eating a bunch of hair and expecting it to end up on your head; but a lot of people take it and say it’s great, so I’m not here to say stop.”

He said people suffering hip pain should avoid weight-bearing exercises like marathon running.

While Anderson had nice things to say about vitamins and diets rich in fish oil, fruit and vegetables, he was considerably more skeptical about alternative treatments, like biofeedback, hypnosis, relaxation, yoga, tai chi, acupuncture, magnets, various dietary supplements and vegetarian diets, saying, “be careful because sometimes the pocket books are the only things they have an affect on.”

Anderson gave support aids – including canes and walkers – a ringing endorsement.

“When I suggest a cane, most people get really upset,” he said. “It is not a positive conversation. But using a cane can reduce force by 50 percent. And if you don’t want hip surgery, a cane is probably the best thing you can do.”

Then Anderson came to anterior hip replacement – a surgery in which he specializes, saying it is often the best treatment option “when pain is severe and interferes with daily activities and what you need to do, like walking with friends or getting on the floor with your grandkids.”

Anterior hip replacement is a relatively novel procedure first described in America in the 1970s, by which the surgeon cuts through the front of the hip, as opposed to the side of the hip or the buttocks, allowing doctors to access the hip socket while bypassing major muscle clusters.

The Lancet, the British medical journal, dubbed the technique “the operation of the century,” Anderson said.

The technique leads to fewer complications, shorter recovery time and better long-term results than standard hip replacements.

Anderson said anterior hip replacement “lengthens people’s lives,” reducing risk of coronary surgeries later on.

He said studies had shown the procedure “results in significant restoration of function and reduction of pain in 90 to 95 percent of patients.”

A projector blasted images of inordinately happy, active women who had apparently undergone anterior hip surgery.

“Here, she loves her new hip!” Anderson said.

cmcallister@durangoherald.com