subject: Rapid Recovery From Joint Replacement Surgery [print this page] Hip pain can often discourage people from pursuing their daily activities, as well as stop them from enjoying favorite pastimes. Fear of surgery and the unknown can also be significant deterrents to getting a needed joint replacement procedure. Surgery to treat hip pain has often been assumed to be a long, painful route for relief. Today, however, many new and innovative treatment options are available that can improve the quality of life of those suffering from hip pain while returning the patient to their desired activities much quicker than in past years.
Two of the more popular ways to perform hip replacement surgery are the less invasive "posterior" approach and the less invasive "direct anterior" approach. The type of hip replacement that is suitable for each individual may only be determined through discussion with his or her orthopedic surgeon. The good news is that regardless of the type of approach ultimately selected, thanks to available techniques and approaches, the patient will experience a more rapid recovery and faster return to normal activities.
The "direct anterior" approach to hip replacement is one of several less invasive techniques. By utilizing a state-of-the-art operating table to manipulate the leg, it is often possible to implant a hip replacement without cutting any muscles or tendons, which leads to less post-operative pain, quicker return to function, and does not require postoperative range of motion restrictions. It also allows for real time X-ray analysis of implant position during surgery and allows the surgeon to more accurately reproduce normal hip anatomy and leg length equality.
Orthopedic surgeons Steven Barnett, M.D. and Robert Gorab, M.D. have been early adopters and advocates of this approach and educate other surgeons nationwide on the technique. Both surgeons have extensive experience with this procedure, completing it successfully on over 1,300 patients during the past three years. They have recently presented peer-reviewed data at a national orthopedic meeting that supports excellent outcomes, low complication rates, and rapid recovery on their first 704 patients using this approach. When compared to patients that underwent total hip replacement surgery utilizing traditional approaches, this patient group required significantly less pain medication while in the hospital, progressed with physical therapy at a faster pace, and were discharged from the hospital in half the number of days on average, with some being discharged the next day.
James Caillouette, M.D., one of the founding partners of Hoag Orthopedic Institute, has helped advance new total hip replacement techniques for more than a decade and has presented on the topic of minimally invasive hip replacement to both national and international medical forums. In addition, Dr. Caillouette believes there is more to a successful joint replacement than the surgical technique alone. Physical and emotional preparation, management of fear, education and advances in management of discomfort all lead to most patients being able to walk (with assistance) within less than 24 hours and progress quickly to normal weight bearing. This holistic approach to the complete joint replacement experience is at the core of success for his patients. In fact, Dr. Caillouette has performed many total hip replacements in the outpatient surgery center, where patients go home the next morning.
Steven Gausewitz, M.D., also a surgeon, states, "Total hip replacement is a proven, safe and effective treatment for painful hip conditions. The procedure has evolved in ways that make the recovery more rapid, resulting in a more closely aligned structure than that of a normal joint, and improved durability in such that it can be offered to younger and more active individuals." Dr. Gausewitz also believes that the soft tissues can be better preserved while accurately placing and securing the implants, with shorter incisions and less overall trauma. Anesthesia and pain control also continue to improve dramatically allowing patients to return home in less than 24 hours.
Stephen Mikulak, M.D., who has been practicing minimally invasive hip surgeries for 11 years in Newport Beach, has an opinion similar to Dr. Gausewitz in his description of the advancements in total hip replacement. "The successful combination of using a small incision, specially-designed instruments and eliminating the need to cut muscle, in combination with novel pain management protocols, allows patients to be up and walking within hours of surgery, often without assistance," states Dr. Mikulak.
