TMH Living Well: Is it time to consider hip replacement surgery?
July 10, 2015
So you've had pain in your hip for some time. You've tried everything from medicines to physical therapy to walkers, but it's still interfering with your everyday movement and causing you to give up your favorite activities. It's time to consider total hip replacement surgery. This surgery is designed to reduce pain by replacing injured cartilage and bone on the two parts of the hip joint, the socket (or acetabulum) and the femur.
Approaches in hip replacement surgery
Most people who undergo a total hip replacement will have a dramatic reduction of hip pain and a significant improvement in their ability to perform the common activities of daily living. More than 285,000 total hip replacements are now performed each year in the United States. Even with the success of this procedure in its traditional form, surgeons strive to make it safer with an even quicker recovery.
Did you know there are many different approaches to hip replacement surgery? Maybe you've heard of the common posterior and direct anterior approaches.
The posterior approach is considered the traditional method for hip replacement, and is most commonly used. The surgery is performed through the back half of the joint, which requires cutting the capsule and muscle. This surgery is in most cases safely and reliably performed. However, due to the nature of the soft tissue damage, there is a higher risk of hip dislocation after surgery. To prevent this, many surgeons will restrict the hip range of motion.
With the direct anterior approach, the incision is made at the front of the hip. This approach utilizes an interval between muscles that allows the surgeon to avoid damage, which may contribute to a faster recovery in the first 6 weeks when compared to the posterior approach. However, the anterior approach does have some limitations, including difficulties preparing the femur, femur fractures, wound complications and injury to the sensory nerve on the front of the thigh.
A third approach to hip replacement surgery that's quickly gaining attention is called the superior approach, which is being popularized by the SuperPath technique. Only a handful of physicians in Colorado are trained in the SuperPath technique and Dr. Kevin Borchard, orthopaedic surgeon joining The Memorial Hospital, is one of them. He is just now finishing up his training with Dr. Stephen Murphy in Boston, who championed the approach.
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"Of the current hip approaches being used in hip replacement surgery, I feel the SuperPath technique is the least invasive," Borchard said.
With most hip replacement approaches, completing the surgery requires dislocating the femoral head from the socket or placing the leg in positions the hip normally wouldn't allow, which can further damage muscle and tendons. With the SuperPath technique, this isn't necessary.
"With the SuperPath technique, no muscles are cut and the least amount of soft tissue is damaged," Borchard said. "The overall complication risk is lower and recovery is much quicker than the traditional approach. It's common for many patients to walk out of the hospital the next day."
With traditional posterior surgery, patients can expect to spend two to three days in the hospital and four to six weeks getting back to walking a few blocks without pain. Recovery time after an anterior approach is somewhat faster during the first six weeks.
With the SuperPath technique, the recovery can be much quicker. Since no muscles are cut and minimal tissue is damaged, pain is less, and people are back on their feet much sooner.
"Many patients are walking just a few hours after surgery, and the recovery can take half the time of a traditional approach," Borchard said.
The Memorial Hospital is pleased to bring Dr. Kevin Borchard's advanced training and skills in orthopaedic surgery to the region. TMH and Pioneers Medical Center are teaming up to open the Northwest Colorado Orthopaedic & Total Joint Center at both locations.
Dr. Borchard starts taking appointments Aug. 12; call 970-826-2400 for an appointment or visit http://www.thememorialhospital.com and select "orthopaedics" under "services" for more information.
This weekly article with tips on living well is sponsored by The Memorial Hospital at Craig – improving the quality of life for the communities we serve through patient-centered healthcare and service excellence.