Thursday, February 11, 2010

Less-Invasive Hip Surgery That Speeds Recovery -

Hip replacement is one of the most successful operations in all of medicine, which prompts many orthopedic surgeons to think, as one leader in the field put it, "Why change something that doesn't need fixing?"

But that leader, Dr. Robert Berghoff; his colleagues at Arizona Orthopedic Associates in Phoenix; and other orthopedic surgeons around the country believed that improvements were possible, especially with regard to reducing complications and speeding recovery.

The technique these surgeons use is called anterior hip replacement, one of several minimally invasive operations that are associated with a shorter hospital stay, smaller incision, less trauma to muscles, less pain and blood loss, reduced risk of dislocation after surgery, faster healing and a quicker return to normal activities.

"The morning after surgery I was able to walk without a walker or even a cane and could put my full weight on the operated side," Jack White, a 71-year-old personal trainer from Paradise Valley, Ariz., said in an interview. "The next day I walked 50 yards without a limp and was able to go home, where I did physical therapy five days a week for two weeks. On Day 5, I walked a mile and a half, and in Week 4, I taught my aerobics class and played 18 holes of golf with no pain and no problem."

The operation was introduced in the United States more than two decades ago by Dr. Joel M. Matta of the St. John's Health Center in Santa Monica, Calif., who also helped design a special operating table to simplify the procedure.

Another minimally invasive form of hip replacement, the PATH technique, was developed by a Los Angeles orthopedist, Dr. Brad L. Penenberg.

Dr. Patrick Meere of New York University Langone Medical Center and the Hospital for Joint Diseases in New York tells me this method has the same advantages as the anterior approach, results in no activity limitations and also offers a safety net: If anything goes wrong during the procedure, the problem can be repaired without having to do a more extensive operation.

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