Download Hip Replacement: Cutting Edge Treatment for the Relief of

Anterior Approach Total Hip
Replacement: Cutting Edge
Treatment for the Relief of Hip
Pain
Vahan Cepkinian, M.D.
Orthopaedic Surgery
Introduction
• Hip arthritis affects hundreds of
thousands of people each year
• Many people suffering from arthritis
alter their lives to deal with pain.
Introduction
• Non-surgical treatment
– Medications
– Physical Therapy
– Assistive Devices
If these do not work then hip
replacement may be the solution
Total Hip Replacement
• The goal is to reduce
•
hip pain and improve
the motion in your
hip.
More than 345,000
people in the United
States annually
undergo hip
replacement surgery.
Anatomy of the Hip
• Ball and socket
joint
• Femoral head or
ball is at the end of
thighbone or
femur.
• Socket or
acetabulum holds
the ball.
Anatomy of the Hip
• The arthritic hip
has worn down
cartilage and rough
bone which cause
pain
Total Hip Replacement
• Involves surgically
removing the arthritic
parts of the joint
(cartilage and bone),
and replacing the ball
and socket part of the
joint with artificial
components
Total Hip Replacement
• Acetabular
component consists of two
components
– Cup - usually made
of titanium
– Liner - can be
medical grade
plastic, metal or
ceramic
Total Hip Replacement
• The femoral
•
•
component (stem and
neck portion), is
made of metal.
Femoral head is made
either of metal or
ceramic.
Stem is shaped to fit
into the bone and
support the new joint.
Total Hip Replacement
• One of the most successful adult
reconstructive procedures performed in
orthopaedics
• With newer materials, hip replacements
can last up to (and sometimes beyond)
20 years!
Total Hip Replacement
• The Traditional approach
– The hip is approached from the back
– Disrupts the tissue and muscles important
for the stability of the hip
– Involves detachment of muscles from bone
– Large incision (12-18 inches)
Total Hip Replacement Traditional
Approach
• Disrupts the
tissue and
muscles
important for
the stability
of the hip
Total Hip Replacement Traditional
Approach
• There is the risk of hip dislocation
• Limitations on hip motion and positions
• There is the risk of a persistent limp
• Greater reliance on assistive devices
(walker, cane) post-operatively
– Over 6 weeks
• Greater need for pain medication
Total Hip Replacement Traditional
Approach
• All of these factors make people hesitant
to proceed with a hip replacement…..and
they continue to live in pain!
Total Hip Replacement Anterior
Approach
• The Anterior Approach
– Approach the hip from the front
– NO DISRUPTION of MUSCLE
– MINIMAL TRAUMA to the TISSUES
– MUSCLE SPARING APPROACH
– MUCH SMALLER INCISION (4-5 inches)
Total Hip Replacement Anterior
Approach
• The hip is
•
exposed by
going in between
the muscles
WITHOUT
DISRUPTING
THEM
Muscle Sparing
Total Hip Replacement Anterior
Approach
• Compare the depth of
muscle and tissue one
has to go through
Total Hip Replacement Anterior
Approach
• This approach is made possible with the use of a
special orthopaedic table called the HANA table
which is found at Glendale Memorial Hospital
Total Hip Replacement Anterior
Approach
• A small amount of X-ray
•
is also used during the
surgery to get an exact
picture of the position of
the implants
This ensures that all of
the hip components are
in the perfect place and
that the leg lengths are
equal
Total Hip Replacement Anterior
Approach
• Essentially NO risk of dislocation
• NO limitation of hip range of motion and
positions
• Less Reliance on Assistive Devices
– Usually 2 weeks
• Less pain!
• FASTER RECOVERY!
Total Hip Replacement Anterior
Approach
• These advantages when compared to the
traditional approach can eliminate
apprehension
• QUICKER RECOVERY TO AN IMPROVED
QUALITY OF LIFE !
THANK YOU