Mercy Memorial Hospital System (MMHS) has launched the newest in minimally invasive surgery with the direct anterior approach to hip replacement.
This surgery is separated from others by the fact that there is no muscle division when replacing the hip.
“When muscle is divided, this is what inhibits patients and their recovery,” said Kenneth McNamee, M.D., orthopedic surgeon and Vice Chief of the Medical Staff at MMHS. “There are no precautions after surgery and patients are able to walk and bend over without the fear of dislocation. Using the traditional method, a lot of time was spent in the OR repairing the muscle after it was cut.”
McNamee said one of the major worries of the traditional hip surgery was the fear of dislocation in addition to the time off of work and lifestyle changes that had to be met.
“Patients are about 1000 times less likely to dislocate with the anterior hip replace than with the former approach,” McNamee said.
Currently patients are staying in the hospital after surgery for approximately 24 to 48 hours, but McNamee said he expects that the surgery will be same-day/outpatient next year. Previously many patients had to transfer to a rehabilitation or skilled nursing facility before going home.
“It’s like magic,” he said. “This procedure has exceeded my expectations. Patients are able to ambulate with no aids and no medication.”
The anterior hip approach has been around for a few years, but the training and significant investment in the special table needed for the procedures is why many are reluctant to make the investment.
“This procedure takes a partnership with the physicians and hospital to do it,” McNamee said. “Patients were previously having surgery on their side, now they are on their back (supine position). Additionally x-rays are done during the surgery to insure a perfect fit. Leg lengths are virtually perfect and there are no issues with that or dislocations which can be common using the former way.”
“Mercy Memorial is very excited about the anterior hip procedure,” said Annette Phillips, FACHE, president and CEO. “The investment in the technology is relatively small compared to the time commitment made by Dr. McNamee to develop his expertise in the procedure. The patient outcomes are truly remarkable. This is a tremendous benefit for the community to have access to state of the art procedures close to home. I am very proud of the partnership with Dr. McNamee and the MMHS clinical team.”
MMHS invested $100,000 for the specialized table for this procedure, while McNamee spent the better part of a year training to perform the surgery.
“It took a long time to study, travel and watch experts and learn how to do the surgery myself,” McNamee said, who spent more than a year investing in the education and training for the surgery. After all that, the patients, immediately postoperatively have exceeded my expectations and they are up and walking, pain-free. They are back to work and their normal life quicker than before.”
Monroe resident Tennery Wilson was walking in high heeled wedges a month after her surgery – which many are shocked to see, she said.
“I don’t have any pain when I walk, but there is some tiredness for sitting or walking for long periods of time right now,” Wilson said. Wilson is just two months post surgery.
Wilson began having problems with her hip in 2011 after she fell off her front porch and landed on her right side.
“Of course, before I did anything I looked around and to see if anyone was watching,” Wilson laughed. “I was sore, went to my regular doctor and didn’t see any fractures, so I lived with it and it just got worse and I was in more pain. After three years my doctor finally said I would have to do something, so I scheduled my appointment with Dr. McNamee.”
Wilson heavily researched the anterior hip approach and was determined to have Dr. McNamee perform the surgery.
“Nobody wants to sit around for six weeks or more recuperating with the old approach,” she said. “I was standing completely on it and walking within the day. There’s not enough I can say about it, it is really wonderful. It used to be when you broke your hip it meant death. This new surgery means hope.”
Wilson said she was walking and tackling stairs two days after surgery.
“I was afraid to get up off my couch, so I finally stood up, with no more cane, pain or limp. I never used any kind of assistive materials,” she said.
Passion and the desire to help others get past the fear of the surgery is what drives Wilson.
“I want to help other people by telling them about and showing how great this surgery this is. I have friends putting it off, and I know they are now looking into it.”
Prior to surgery, Wilson said she was essentially homebound and didn’t want anyone to see her limping because of her hip pain. She also lost more than 80 pounds prior to surgery.
“I can have a life now – I didn’t have a life before,” she said.
Traditional hip replacement techniques involve operating from the side (lateral) or the back (posterior) of the hip, which requires a significant disturbance of the joint and connecting tissues and an incision approximately 8 to 12 inches long. In comparison, the direct anterior approach requires an incision that is only 3 to 4 inches in length and located at the front of the hip. In this position, the surgeon does not need to detach any of the muscles or tendons.
The benefits of the anterior approach may include:
- Decreased hospital stay and quicker rehabilitation
- Smaller incision and reduced muscle disruption may allow patients a shorter recovery time and less scarring
- Potential for less blood loss, less time in surgery, and reduced post-operative pain
- Risk of dislocation may be reduced
- May allow for a more natural return to normal function and activity
For more information regarding the anterior approach of minimally invasive hip replacement, go to www.mercymemorial.org or call our physician referral service at (734) 240-4565.
