Total Hip Replacement

Traditional Approach

According to board certified orthopedic surgeon, John Conner, MD, “The first step in trying to control knee and hip pain is decreased activity, anti-inflammatory medications and injections. If patients have tried these and it hasn’t helped, they should talk to their orthopedic surgeon about whether total joint replacement surgery is the best option for them. People ask me how they’ll know it’s time, and I say, ‘When it gets painful enough, you’ll know.'”

Dr. Connor adds, “There are more options for implants and bearings than ever before. Formerly, the materials were mainly metal on plastic. Now, in an arthritic hip, the damaged ball is replaced by a metal ball and stem fitted into the femur. A plastic socket replaces the damaged one in the pelvis. The plasic materials are durable and wear-resistant. Overall, we get a better, more comfortable outcome.”

Board certified orthopedic surgeon, Edward Bell, MD, explains, “Total joint replacement surgery has really come a long way. 20 years ago, it was common for patients to stay in the hospial for as long as two weeks after surgery. Today, the average stay is three days, and patients are out of bed and working on mobility the day of surgery.”

Anterior Total Hip Replacement

Until recently, nearly all total hip replacements were performed through incisions on the side or a little toward the back of the hip. It is still a reliable and effective technique. But recent developments have made a new approach possible. Called anterior total hip replacement, the incision is made in the front of the hip.  Aniefiok Uyoe, MD, board certified, fellowship trained adult reconstructive orthopedic surgeon at Baptist Health Floyd, explains why this is such a significant and exciting option for many patients.

According to Dr. Uyoe, “The anterior, or front, approach is muscle-sparing. The surgeon can take advantage of the natural muscle planes and avoid cutting through them. That makes recovery much faster and less painful. Patients can get back to activities like driving quickly.” Recovery typically takes just two to eight weeks instead of two to four months.

“Following traditional hip replacement surgery, patients are advised not to sit on low surfaces, cross their legs or bend over,” said Dr. Uyoe. “However, when the anterior approach is used, these precautions are not needed. Patients are able and encouraged to resume normal, low impact activities.”

As Dr. Uyoe explained, “The anterior surgery is performed through a much smaller incision than the traditional procedure. But what matters most is what you’re doing to the soft tissues underneath the incision. And this procedure is truly minimally invasive in that there is very little disturbance of muscles and tendons.”Dr. Uyoe added that many surgical instruments and implants have also been reengineered to accommodate the new anterior approach. “Older replacement joints were difficult to insert from the front,” he said, “But the new implants are much easier to put in. They also allow us to conserve more of the patient’s natural bone.”