Total Hip Arthroplasty

Description

Dr Lawrence Menendez talks about Total Hip Arthroplasty using the anterior approach.

Transcript
A Total Hip Arthroplasty is a surgical procedure in which the normal hip that consists of a ball and socket is replaced with an artificial ball and socket. It is a technique utilized for patients that have incapacitating pain from osteoarthritis or rheumatoid arthritis, who have been treated medically over a period of time, but no longer are able to pursue activities of daily living because of this severe pain. The anterior approach to hip replacement is a method utilized to insert a total hip prosthesis. It's a way of doing it in which we approach the hip from the front rather than from the side or the back. The technique requires removal of a portion of the thighbone and replacement with a metal implant that has a circular head on it. The cup of the implant is actually placed into the bone, the pelvic bone of the patient that's prepared in a particular way. So when the patient is done with the hip replacement, there is an artificial cup and an artificial head that articulates. This eliminates the arthritic pain and allows the patient to ambulate and mobilize without difficulty. One of the advantages of the anterior approach is that no muscles are cut. This can greatly facilitate their rehabilitation, but can also be helpful if they ever need surgery in the future, because their anatomy is not distorted. Patients in the past were told to avoid having a total hip arthroplasty until they were old and were less likely to wear out their implant. With the newer implants that are available, the life expectancy of the implants is much greater. Also, patients now are less likely to want to wait another ten years or 15 years to get a hip replacement done, when they know they're going to be in agony for those 10 or 15 years. Patients that need total hip replacements have pathology in the hip joint. The more severe the pathology, for example, if they have severe deformity or have had previous surgery or have an implant already in place, these factors would make the surgery much more difficult and would add to the length of the procedure. But for someone who has not had surgery has a fairly straightforward case of osteoarthritis of the hip for example, it would take about an hour to an hour-and-a-half. Traditionally, the rehab would take six weeks or longer. With the anterior approach, the rehabilitation is much more facilitated. Most patients are relatively pain-free after surgery. That means they don't require a lot of narcotic medication. That means that they're much more able to get up and out of bed either the same day or the next day and begin rehabilitation. Most patients can discard their walking aids within two weeks. So essentially, after total hip arthroplasty through an anterior approach, we just tell the patients to use their hip as they normally would, and this facilitates the job of the physical therapist very much, and often obviates the need for extended care and a nursing facility or rehab facility. We hope that you've enjoined and benefited from this episode and we look forward to hosting episodes in the future. If you would like a referral to one of our many physicians, please call 1-800 GS Cares. 1-800 GS Cares. Hope to see you next time. Thank you.
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