Monday, June 21, 2010
As part of the services offered through the Joint Replacement Program at Baptist Medical Center, Orthopedic Surgeon Trevor Pickering, MD, in Jackson, Miss. was the first in Mississippi to perform a new approach to hip replacement using a specially designed table at Baptist.
Dr. Pickering is with Mississippi Sports Medicine and Orthopaedic Center and performs the procedure using the hana® table housed at Baptist. The hana® table allows for positioning of the hip to an extent not possible with conventional tables. While utilizing the table, surgeons are able to reach the hip socket without detachment of the muscles or tendons from the hip or thigh bones. This unique table was designed specifically to aide orthopedic surgeons in the anterior approach to hip surgery.
“Traditionally, you had to detach muscles for hip replacements, and afterwards, the patient had to take certain precautions and avoid certain positions or movements. No deep bending. It was just a long recovery,” added Dr. Pickering. “With this direct anterior approach, you can go between the muscles and not detach any muscles. We can get to the hip directly. For most patients, depending on their health, there are no precautions afterwards. They can move how they want after surgery.”
With the anterior approach, a small 3 to 4 inch incision is made on the upper part of the thigh over the hip. Two muscles are then gently pushed aside, giving the surgeon access to the hip socket to perform the procedure. No muscles at any time during the procedure are split or detached.
“Eligible patients are typically those with arthritis or other similar, painful conditions in the hip. The cartilage in joint wears out and starts to break off leaving the patient with a painful, stiff hip,” explained Dr. Pickering. “When people get up, they feel pain in the groin or buttocks regions. This tends to get worse in different stages. They might feel significant pain in walking, but the biggest complaint is stiffness in the hip. Once it gets to the point where people can’t move, it really impacts their quality of life. That’s when we start talking about hip replacement.”
The anterior approach for total hip replacement provides definite advantages for patients, even those in need of bilateral procedures. Dr. Pickering stated that when replacing both hips, the patient usually has to come back later to do their other hip.
“With this procedure, we can easily replace both hips with one visit to the operating room,” he added.
Evaluation and treatment by a physical therapist begins the day of surgery and leads to walking and functional activities. Dislocation risk is reduced, leg length is more accurately controlled, and postoperative pain is significantly decreased. The patient is typically discharged one or two days after surgery. They can resume their normal activities as soon as they wish.
For more information on this procedure, call the Baptist Health Line at 601-948-6262 or 800-948-6262.
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