I’m so grateful to Dr. Ehmer for resolving my hip pain, making it possible to enjoy my retirement, play tennis again (every day) and return to the things I love in life. ~Theresa Lane
As an avid recreational tennis player, Theresa developed progressive hip pain over the years. Being a professional nurse with osteoarthritis, she knew that a hip replacement was inevitable. She also was well versed about the latest surgical techniques and benefits of the “anterior approach.” After extensive research, she found Dr. Ehmer was the local expert. In June, Theresa had a total hip replacement to resolve her disabling bone-on-bone pain.
According to Theresa, “The best part is that I was walking immediately after surgery and discharged from the hospital the very next day. After three days, I was walking unassisted and off all pain medications within five days. After just two weeks, I was playing tennis and given permission to dance.
What is ‘the anterior approach’ to hip surgery?
Total hip replacement surgery has been utilized by surgeons for decades – generally as a way to treat hip trauma and late stage arthritis of the hip. Overall, long term outcomes have been observed as excellent in the majority of patients. Pioneered in the 1960s, advances made in this surgical procedure have gradually improved outcomes and patient satisfaction. Case studies have demonstrated that 90 percent or greater are still functioning well after 20 years, and after 30 years the rate decreases only slightly, to about 70 percent.
In traditional total hip replacement surgery, an incision is made around the hip joint and the muscles, tendons, and joint capsule are moved away from the joint to expose the head of the femur and hip socket (acetabulum). Next, the head and neck of the femur are removed and the acetabulum is cleaned out in preparation for the replacement component. The channel inside the femur is then prepared so the femoral stem can be fitted into position and a carefully fitted “ball” is secured to the end of the femoral stem. Finally, the hip joint is rejoined and all surrounding tissues are repaired back to the normal position
Over the years, doctors have improved this procedure making it less invasive, reducing the size of the incisions while improving the safety and effectiveness of the technique. These improvements have helped to diminish trauma, limit adverse reactions to anesthesia and decrease time spent in the hospital.
The anterior approach to total hip replacement is now being looked upon by many surgeons as a viable alternative to the more common posterior approach. Although it is a surgical technique that has been in use since the 1980s, recent breakthroughs in instrumentation makes it possible to perform the anterior approach using smaller incisions. In this procedure the surgeon makes a four-inch incision through the front of the leg, rather than the back. Accessing the hip from this direction makes it possible to reach the joint by separating, rather than cutting, important muscles. Anterior hip replacement surgery very frequently results in a swifter recovery and shorter hospital stay for patients, likely due to reduced muscular damage.
Nevertheless, every surgical approach has risks and benefits. The overall performance of a hip replacement depends on factors such as; the patient’s age, weight and level of activity. There are potential risks to any surgical procedure, and recovery always takes time.
Nathan R. Ehmer, D.O.
At Santa Rosa Orthopaedics, Dr. Ehmer is part of a collaborative team of multi-specialist orthopedic surgeons and highly skilled physical and occupational therapists. In its efforts to bring the best outcomes to patients, SRO offers patients in-house diagnostic imaging, rehabilitation, sports injury prevention, as well as advanced surgical treatments in joint replacement, sports medicine, trauma care, hand, foot, ankle, and general orthopedic surgery. For more information and to schedule an appointment call 707-546-1922.