/ May 1, 2018

The SuperPath Hip Replacement

We now have a better way to treat hip arthritis, the SuperPath hip replacement.  This article reviews why we do hip replacements, the evolution of hip replacements, and what can be expected from this relatively new, more advanced, and less invasive hip replacement surgery.

Joint replacements are done for joint pain and loss of joint function.  Some of the major causes of joint pain are osteoarthritis (degenerative arthritis), inflammatory arthritis (such as rheumatoid and gout), trauma, avascular necrosis (loss of blood flow to the bone) and cancer.  All these conditions can have the same end result with mechanical destruction of the joint which results in pain and loss of function.

Initial treatments are non-operative.  We can start with lifestyle changes such as decreased alcohol consumption, weight loss, increasing flexibility, and low impact strength training.  Secondary treatments include anti-inflammatory medications.  From there we consider injections. Many people think joint injections are very painful and dangerous, but done by a trained provider, these injections take about 3 seconds and are very easy with minimal pain.  Injections can potential give relief for months to years, and can be regularly repeated.  If these things do not provide adequate relief, we consider joint replacement surgery.

There have be millions of hip replacement surgeries done all over the world.  Just in the United States, there are hundreds of thousands of hip replacements done every year.  With hip replacement surgery, the surgeon replaces the worn out body parts with metal and plastic type parts. These have been extremely successful with excellent pain relief and return of function.  Over the last 100 years, the actual joint implants really have not changed that dramatically.  However, how we put them in has changed dramatically and that has really improved patient satisfaction and outcomes. Hip replacement surgery has gotten so much easier for the patient that we have gone from patients staying in the hospital after surgery for 2 weeks, to many patients routinely just staying in the hospital overnight and in the near future going home the same day.

Traditional hip replacements started with what we called a posterior approach to the hip.  This involved going in to the back side of the hip joint through about a 10-15 inch incision and cutting multiple muscles off the bone to get in the hip.  Patients typically had a lot of pain and were very weak for months waiting for all the muscles to heal.  There was also a higher risk of complications such as the hip joint popping backwards out of the hip joint because all the tissues were weak from cutting them to get in to the hip.

Next, surgeons tried the mini-posterior hip replacement.  With this, surgeons tried to make the surgery less invasive by doing it through a smaller incision about 6 inches, but really that is all that was changed.  All the tissues still got cut off the bone and there was no significant improvement in pain, function, or complications.

The next improvement was the anterior hip replacement.  This involved going into the front of the hip joint through about a 5 inch incision.  The good side of this approach was that surgeons could get into the hip without cutting through any muscles or taking any muscle off bone. The surgeon just went in between muscles, and patients hurt less and functioned better sooner.  The bad side of this approach was that it was harder to learn and harder to get in the hip joint and see well, especially in larger patients.  In turn, there was a higher risk of thigh bone fractures, and increased risk of the hip popping out of place through the front.

This brings us to one of the most recent improvements, the SuperPath hip replacement.  This approach involves going down through the top of the hip joint.  It can be done through a 3 inch incision. There is no cutting or detachment of muscles.  Because of this, patients hurt less and function better sooner.  There is less risk of breaking the thigh bone.  There is less risk of the hip popping out of place through the front or the back.  With the decreased risk of the hip popping out, patients have less restrictions after surgery and can get back to normal living much faster.  Currently, this approach is only being done in the Tennessee and Arkansas area by Dr. Ron Schechter at NEA Baptist Hospital in Jonesboro, Arkansas.  Quit hurting and call today!

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