Back to Basketball after Anterior Total Hip ReplacementJuly 14, 2017

We had the pleasure of taking care of a man in his mid-50s who presented to us with debilitating pain in his left hip. He had undergone a prior successful right hip replacement a number of years of ago but was having increasing pain in the left hip. One of his passions in life was playing basketball and one of the primary goals of doing surgery was to get him back to this as quickly as possible. This particular patient sought to have his hip replaced through an anterior approach due to its muscle sparing nature and relatively quick functional recovery. After we mutually decided to proceed with an anterior total hip replacement, we utilized his pre-operative x-rays to develop a plan for surgery.

His surgical plan was executed successfully and he made an uneventful early recovery. His post-operative x-rays are demonstrated here and very closely mirror our pre-operative template.

He recently sent us this video of him playing basketball pain free at just 2.5 months post-operatively. He has truly made a remarkably quick functional recovery. This case demonstrates the potential of anterior total hip replacement in fit and motivated patients. We could not be more pleased that he has gotten back to the active lifestyle he desires.

Preparing for SurgeryFebruary 28, 2017

Our goal is to provide the safest and most effective surgical care for our patients. While much of the outcome depends on our surgical team, there are at least four important steps patients can take before surgery to improve the chances of achieving the best possible result. The importance of these steps has been repeatedly demonstrated by published research.

Get strong: Pre-surgical physical therapy

  • Build muscle in the operative limb
  • Learn exercises before surgery that will be necessary after surgery – build muscle memory
  • Practice using a walker or crutches to speed early post-operative mobilization

Get trim:  Gradual Weight Loss if Applicable

  • Less body weight on your joints
  • Allows for less inflammation and faster healing
  • Lowers risk of wound healing complications
  • Lowers risk of component instability
  • Lowers risk of fracture
  • Lowers risk of falling

Get aerobic: Moving and Exercising

  • Walking, water exercises, swimming, stationary cycling and rowing may be well tolerated even with an arthritic joint.
  • Getting your heart rate up for 15 to 30 minutes each day will improve your fitness for surgery.

Get rid of bad habits: Importance of Quitting Smoking

  • If you quit smoking three months pre-op it can lower the risk of infection
  • Quitting promotes wound, bone and tendon healing and decreases risk of surgical infection

Bottom line: getting in the best possible shape before surgery will help you achieve the best and safest result from your surgery.

If you have questions or would like to schedule an appointment, let us know. 

Smoking Increases Surgical RiskFebruary 28, 2017

A recent study performed and published by Dr. Matsen Ko and her colleagues in a leading orthopedic journal, The Journal of Bone and Joint Surgery, demonstrated the potential adverse effects that smoking can have on the outcome of elective joint replacement surgery.  In their conclusions, the authors noted that:

"current smokers have a significantly increased risk of reoperation for infection and that packs per decade, regardless of current smoking status, is associated with unplanned nonoperative readmission"

To read the findings of their study, click on the following link (here).

Our goal is to counsel patients on the risks of elective surgery and to do our best to mitigate them.  That is why we strongly encourage patients to stop smoking prior to elective joint surgery.  Smoking remains one of the most preventable causes of death and disease.  In additional to improving a patients overall health, it can substantially lower the risk of readmission and reoperation.

Happy Sailing after Anterior Total Hip Arthroplasty for ArthritisJuly 13, 2016

We recently had the pleasure of seeing a patient back in the office 3 months after undergoing an anterior total hip arthroplasty for arthritis of the hip. The patient's pre-operative and post-operative x-rays are shown below. He is doing wonderfully and back to enjoying the things he loves, namely sailing.

We received this great note from him the other day:

"Just a short note to thank you for giving me my life back. Prior to hip replacement surgery, many of the basic life activities were either not possible or extremely painful. I was unable to place a sock on my left foot without the help of my wife, unable to tie the shoe lace on my left foot, unable to walk without pain, unable to stand from a sitting position without a grab bar of some type, to name a few things I couldn't accomplish. Since the surgery in March, I have no limitations and I am pain free. The relief was immediate.Thanks again - my wife thanks you too! I highly recommend that anyone with severe hip pain consider the replacement option sooner rather than later"

We wish our patient happy sailing on his new hip!  For more information on our approach to anterior total hip arthroplasty, visit our website here.

Anterior Total Hip Replacement for AVNJanuary 5, 2016

At times total hip replacements are not done for osteoarthritis. We had a young patient recently who had sustained a right pelvic fracture in a motor vehicle accident. He was having excruciating pain in his hip. His pelvic fracture had healed great but he had lost the blood supply to his femoral head and had developed Avascular Necrosis. As the name implies, this means that due to loss of blood supply, the femoral head actually starts to die. As you know, our bones are alive and require a steady source of blood to allow bone turnover and nutrients. If this is lost, the bone will not be viable. This is extremely painful for the patient.

If the diagnosis is in question, an MRI can be obtained of the hip. As you can see in this image, the femur is gray but the top of the femur has actually turned dark, consistent with loss of blood supply.

Although this patient was quite young, once the avascular necrosis gets to the point of changing the shape of the femoral head, the main surgical option is to do a total hip replacement.

We saw him back recently and he is able to do stairs without pain and is weaning off his walker for the first time in years. He is hoping to be able to start working again soon.