a new innovative approach to hip replacement

So, you have always been moderately active, you play golf or tennis one to two times a week, walk or jog daily, but recently you have started to experience joint pain … particularly in your hip. Your fairly regular exercise regime is falling short on your list of daily, even weekly, activities due to increasing hip pain. In your mind, you think, “I am too young to have hip pain and way too young and busy to be a candidate for hip replacement surgery.” Well, until a proper evaluation is done by an orthopedic surgeon, you can’t know, but if you do undergo a proper assessment and it is determined that you are a candidate for total hip replacement surgery, you have a new and amazing option that allows for a quicker and more viable recovery: the Direct Superior Approach Total Hip Replacement.

Total Joint Replacement Surgery is constantly evolving, and new technologies are making total hip replacement surgery a safe, viable option for patients seeking relief from hip pain. A little over a year ago, I was excited to offer patients a new and exciting option: The Direct Superior Approach-Hip (DSA-H). This procedure incorporates state-of-the-art technology and minimally invasive surgical techniques resulting in remarkably high record of successful outcomes. Since March of 2015, I have performed over 200 procedures, and the results have been exceptional.

You may ask, “What makes the DSA-H different?” Easily answered. It is a muscle and bone sparing procedure. For the procedure, I make a single incision on the outside of the hip in the buttock region, which will allow adequate exposure to perform the surgery accurately and with very little soft tissue damage. I work through the small incision and diligently work to preserve the muscles around the hip joint, in order to place the hip implant with the least amount of soft tissue trauma as possible. After securely placing the implant, I will repair the hip capsule and skin to facilitate proper healing and prevent dislocation of the hip. The surgery will take me about 50-90 minutes, and patients will typically be up walking two to three hours following their surgery. The majority of my patients will go home the morning following surgery and resume an exercise and walking program at home.

This has resulted in much shorter recovery times. As a result, instead of being in the hospital for four to five days, most of my patients are in the hospital for 24-36 hours, spending one night and being discharged the morning following their surgery. Instead of being able to drive in a month, they’re usually able to drive in half the time. Instead of being off of work for three months, they are able to return in much less time. The short recovery time makes the surgery accessible for more patients who might not be able to take three months off work. Additionally, most DSA patients do not have to assume an outpatient physical therapy program, but can immediately begin a walking program to increase strength and improve gait. Many people who would benefit from hip or knee replacement surgery never get the operation and instead live with the pain and reduced function because they fear a long recovery time. The Direct Superior Approach-Hip replacement patients typically have a much more rapid recovery. Most of my patients are back to golfing, yoga and other activities within two to three weeks.

The Direct Superior Approach-Hip offers numerous benefits:

· Reduced post-procedural occurrence of hip dislocation · Earlier ambulation minimizes complications commonly seen with traditional hip replacement (i.e., blood clots and muscle fatigue) · No hip precautions after surgery;many patients resume normal activities much earlier than expected, and the whole recovery process is much faster and less painful than with traditional techniques · Requires only one small incision in the hip, leaving muscles and tendons undamaged and preserving the hip’s natural alignment

· Less leg manipulation and less soft tissue damage allows for earlier return of function, less pain and greater stability after hip replacement · Accurate implant positioning is achieved, which allows for longevity of the hip replacement · Surgery may be performed on an outpatient basis (or a one-night hospital stay) · More comfortable recovery period, with minimized pain medication requirements · Minimization of blood loss (compared to traditional hip replacement techniques) · Fewer incidences of complications during and after surgery.

There currently are a handful of orthopedic surgeons in the country utilizing the DSA-H technique. Currently, I am Stryker educator/consultant for the DSA-H and am working on the technology to utilize this approach using MAKOplasty, making the surgery even more precise and less invasive. I have had the privilege to teach this technique to orthopedic total joint replacement fellows around the country, as well as introduce several practicing orthopedic surgeons from around the globe to this amazing procedure.

If you suffer from hip or knee pain, I encourage you to talk to your family physician or be evaluated by an orthopedic surgeon. The strides in joint replacement surgery are vast and all geared toward getting you back to a healthy, active lifestyle more quickly and safely.

Steven Atchison, MD is an orthopedic surgeon specializing in disorders of the knee and hip.