| Anterior Approach for Hip Replacements Offers Fast Recovery, No Restrictions after Surgery
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http://www.surgistrategies.com/hotnews/anterior-hip-replacement-surgery.html#
SANTA MONICA, Calif. -Thanks to surgical techniques and technology pioneered
by Joel Matta, MD, medical director of the Hip and Pelvis Institute at the Saint
John’s Health Center in Santa Monica, Calif., increasing numbers of patients in
North America are receiving hip and pelvis surgery that protects tissue, offers
faster recovery, allows for more accurate placement of medical implants and
reduces post-operation restrictions compared to traditional hip surgery.
In the "anterior approach," the hip joint is reached from the front of the
body. This allows the surgeon to operate through a natural space between the
muscles, and eliminates the need to detach muscles from the pelvis or femur -
unlike other procedures that take a lateral (side) or posterior (back side)
approach to the hip. Since the anterior approach leaves the muscles that provide
hip function undisturbed, trauma is greatly reduced and the new hip is
immediately stable after surgery.
Anterior approach hip replacement offers patients faster recovery,
unrestricted mobility after surgery and far fewer complications such as hip
dislocation. Having performed more than 1,700 procedures since he introduced the
anterior approach to North America, Matta is the leading champion and innovator
of the anterior approach in North America and the United States.
"The anterior approach is a revolutionary improvement in hip
surgery which helps people get back on their feet faster, without restrictions," Matta said.
"It improves patient satisfaction and health, and saves money by shortening
hospitalizations and reducing the risk of future complications."
Although the anterior approach technique has been known for many years,
difficulties in reaching the femur bone have prevented surgeons from adopting it
widely. The robotic table gives surgeons better access by raising and
positioning the femur, making the anterior approach easier to perform.
If a patient needs both hips replaced, both procedures can be performed in
one visit to the operating room. Patients receiving the anterior approach
typically leave the hospital in one or two days; with other approaches, recovery
takes four weeks or longer.
There have been an increasing number of high-profile anterior hip patients.
Last fall, Matta performed anterior approach surgery on eight-time major golf
champion Tom Watson. Watson left the hospital a day after his surgery and within
three months was playing on the tournament circuit again. The success story was
featured in the March 2009 issue of Golf Digest magazine.
"I studied a variety of surgeons and techniques. I wanted to know about
complication rates, recovery time and how well the anatomy was put back
together," Watson said. "Then I sought the best surgeon. After a lot of due
diligence, I selected Matta."
All types of artificial hip prostheses can be used with the anterior
approach. What may be even more important, though, is that prosthetic hip
implants can be situated more accurately and consistently with the anterior
approach, Matta said. This ensures that both the position of the components and
leg length will be correct, which are critical to normal hip function.
In planning a hip replacement, one mistake both patients and doctors can make
is to become overly concerned with the prosthetics rather than the surgical
approach itself.
"People get too focused on what kind of parts and materials
are being used," Matta said. "That's a good discussion to have, but what's more
important is what the surgeon will do during the operation. As surgeons, we need
to ensure that the muscles around the hip aren't disturbed, the parts are fitted
and oriented properly, and that the leg length is correct. And it behooves us to
perform hip replacements that don't rely on our patients restricting their
movements for the rest of their lives."
Anterior approach patients have no restrictions on their movements. In
contrast, patients undergoing traditional surgeries have an extensive list of
movements they must avoid to prevent dislocating the new hip. Simple actions
such as crossing legs and tying shoes normally may be permanently prohibited.
Yoga is out. Even sitting on the toilet can risk dislocation.
"The lateral and posterior approaches to hip replacement
traumatize the muscles that support the hip. They destabilize the hip and
increase the risk of dislocation," Matta explained. He noted that in the U.S., an average of 4
percent of traditional hip replacement patients suffer hip dislocation,
requiring additional hospitalizations and surgeries.
In comparison, the risk of dislocation is far lower with the anterior
approach: A multicenter research study showed that only 0.6 percent of anterior
approach patients experienced hip dislocation. Matta's own patients fared even
better, at a low 0.2 percent.
"And these are patients with no restrictions," Matta added.
"It shows that anterior approach patients can do anything they want, and still
have a 20 times reduced risk of dislocation."
As word spreads about the anterior approach, patient interest is causing more
surgeons in the United States and the rest of the continent to seek out Matta
for training. He has trained hundreds of physicians and is conducting nearly a
dozen courses this year.
Source: Saint John's Health Center
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