When to Replace or Not Replace Your Hip

Barbara Bukousky was born with hip dysplasia, a congenital hip disorder affecting 1 out of every 1,000 babies born.  This deformity occurs when the hip fails to form normally.

Barbara was unaware that she had this disorder until her early 30’s. That’s when she took a fall and shortly thereafter started to experience severe groin pain.“In 1988 I began visiting every doctor I could find in Southwest Florida and around the state, and no one could tell me what was wrong.” Some physicians even dismissed her, suggesting the pain was in her head.

Ameglio Orthopedics Patient

Barbara Bukousky, Patient

Finding a Solution

In 1991, she traveled to Boston to find a solution and found herself under the care of Dr. Stephen Murphy.  Barbara underwent extensive reconstruction surgery to preserve her hip joint, the result of the hip dysplasia. Since total hip replacements typically last from 10-30+ years, this surgery was designed to delay the need for a total hip replacement – which Dr. Murphy informed Barbarba she eventually would need.

When that time came little did Barbara know Dr. Murphy, co-inventor of SuperPATH® total hip replacement, would be the surgeon who personally introduced Dr. Ameglio to this cutting-edge technique.


Although developed in 2003, Dr. Ameglio is the pioneer of this procedure in SW Florida and is the most experienced SuperPATH surgeon in our area.

With a traditional hip replacement, even after the hip heals the potential exists for it to dislocate during normal activities. Therefore, patients are sent home with a list of movement precautions that they must adhere to for 2 months. SuperPATH carries none of these restrictions. This is the only hip replacement where both the hip is never dislocated, and no muscles or tendons are cut.

According to Dr. Ameglio, “The SuperPATH approach is less traumatic. It’s easier on the patient physically, they experience less pain, and the recovery time is shortened significantly. It just makes sense and anatomical studies confirm it.”

Hip Replacement

It made sense to Bukousky as well. Over the summer she had her right hip replaced by Dr. Ameglio via SuperPATH and was driving two weeks after the surgery. “I experienced little to no pain,” she marvels.

Her hip was back in working order however, about 4 months later Bukousky began experiencing back and groin pain on the opposite side. “I would be up for two weeks and in bed for three, and thought it was time for a hip replacement on the left side,” she recalls.

Dr. Ameglio began to investigate the cause of her pain. Although Barbara’s X-ray clearly indicated arthritis in her hip, this time her symptoms were slightly different from the right side.  This raised the suspicion that Barbara may be suffering from sacroiliac joint dysfunction.  “The symptoms of hip arthritis and SI dysfunction many times overlap making it challenging to diagnose the source of a patient’s pain.”

SI Joint

The sacroiliac joint functions as a shock absorber, supporting the entire spine. It dissipates the shock to the sacrum and pelvis; however, with age, it’s less able to absorb shocks and becomes less mobile.  SI dysfunction can also present itself after an accident, fall, childbirth, or simply picking up a suitcase.

Problems with the SI joint can result in pain in the buttocks, thigh, groin, and can radiate down the leg. SI dysfunction is not identifiable on X-rays or any imaging study, adding to the complexity of the diagnosis. “This is why understanding the difference is critical in avoiding an unnecessary hip replacement or revision hip replacement surgery”, adds Dr. Ameglio.

Dr Ameglio is the only Orthopedic Joint Surgeon in SW Florida treating both the hip and the SI Joint.  This gives him a unique perspective in understanding the source of patients’ pain.

“15-30% of people with low back pain have sacroiliitis and in patients who have a lumbar spine fusion, up to 45% have sacroiliitis,” says the surgeon. “It’s a sizable number and it is critical to consider this diagnosis.”

Resolving Pain

Dr. Ameglio performed an SI fusion on Barbara’s left side in November.  Barbara is now living pain-free for the first time in decades.

“30 years is a long time to live the way I lived,” says Bukousky. “To be able to get up and walk and not be in a wheelchair is amazing AND I’m not in pain.” Convinced by the success of her surgeries performed by Dr. Ameglio, her husband has scheduled SuperPATH hip replacement with the surgeon.

“There’s not too many doctors I trust anymore because of what I’ve gone through,” says Bukousky. “I love Dr. Ameglio, I believe in him, and most importantly, I trust him.”

Dr. Peter Ameglio

Ameglio Orthopedics


6160 Winkler Road, Fort Myers, FL 33919