By Anthony M. Bevilacqua, DO
Many patients who would benefit from a total hip replacement are still unaware of how much the surgery has changed in recent years. The continuous evolution of less invasive surgical techniques and safer, more durable implants has increased the benefits of this procedure both for younger, more active patients and the traditional older population – an age range of anywhere from 40 to 90-plus years.
Other changes and improvements in the industry to note:
• While total hip replacements once required several days of hospitalization, substantial pain and a lengthy recovery process, today’s healthier patients typically spend only one night in the hospital before walking out the next day. Medications, injections used in surgery, spinal anesthetics and less invasive measures have permitted patients to go home much sooner, typically with less pain and better function than we’ve seen with prior techniques.
• Nationwide, surgeons increasingly are offering total hip procedures on an outpatient basis, a trend that certainly will continue and emerge locally as more ambulatory surgery centers add the necessary equipment. In fact, an estimated 45 to 50 percent of Medicare beneficiaries are good candidates for same-day procedures, based on current criteria. For patients who do qualify, outpatient surgery can help reduce the risks of infection and ease the recovery process even further, all at a much lower cost.
• The Direct Anterior approach to the hip joint, a tissue-sparing method sometimes referred to as “Jiffy Hip”, allows entry between muscles in the front of the thigh. Patients typically feel better sooner – particularly in the six weeks following surgery – which can boost their confidence in a new joint and speed along the physical therapy process. However, patients also should take comfort in the fact that over the long term, traditional surgical approaches are equally effective. I advise asking your surgeon about his or her experience, expertise and opinion based on your specific case, as not all patients would benefit from Direct Anterior approach.
• With “metal-on-metal” hips virtually eliminated from the market, product recalls thankfully are no longer a routine concern. Implants also are designed to grow into the bone, rather than be cemented in place, contain more durable plastics in their sockets and have parts in micro-sizes, putting less metal into the body while accomplishing the same goals.
• Many people who fall and fracture their hips now receive a total joint replacement as treatment, rather than just a replacement of the fractured part(s). While dependent on hip condition at the time of injury, this approach has improved postoperative function in many.
• Moving into the future, the greater emergence of robotically-assisted hip replacements will provide even greater accuracy in surgery and precision fit, with assistance from CT scans, detailed 3D images of each patient’s unique anatomy, and access to real-time interactive data in the operating room.
I look forward to helping more patients of all ages overcome a wide variety of hip problems and, as quickly as possible, regain their quality of life.
Anthony M. Bevilacqua is a Board-certified orthopaedic trauma surgeon at Sports Medicine & Orthopaedic Center, based in SMOC’s Suffolk and North Suffolk offices. He specializes in hip, knee and shoulder replacement and sports medicine. smoc-pt.com
