Rapid Recovery From Joint Replacement Surgery
Hip pain can often discourage people from pursuing their daily activities,
as well as stop them from enjoying favorite pastimes.
Fear of surgery and the unknown can also be significant deterrents to getting
a needed joint replacement procedure. Surgery to treat hip pain has often
been assumed to be a long, painful route for relief. Today, however, many
new and innovative treatment options are available that can improve the
quality of life of those suffering from hip pain while returning the patient
to their desired activities much quicker than in past years.
Surgeons practicing at
Hoag Orthopedic Institute have extensive experience in several less invasive approaches to hip replacement
surgery that allow for a more rapid surgical recovery. Two of the more
popular ways to perform hip replacement surgery are the less invasive
“posterior” approach and the less invasive “direct anterior”
approach. The type of hip replacement that is suitable for each individual
may only be determined through discussion with his or her orthopedic surgeon.
The good news is that regardless of the type of approach ultimately selected,
thanks to available techniques and approaches, the patient will experience
a more rapid recovery and faster return to normal activities.
The “direct anterior” approach to hip replacement is one of
several less invasive techniques. By utilizing a state-of-the-art operating
table to manipulate the leg, it is often possible to implant a hip replacement
without cutting any muscles or tendons, which leads to less post-operative
pain, quicker return to function, and does not require postoperative range
of motion restrictions. It also allows for real time X-ray analysis of
implant position during surgery and allows the surgeon to more accurately
reproduce normal hip anatomy and leg length equality.
Hoag Orthopedic Institute-affiliated orthopedic surgeons
Steven Barnett, M.D. and
Robert Gorab, M.D. have been early adopters and advocates of this approach and educate other
surgeons nationwide on the technique. Both surgeons have extensive experience
with this procedure, completing it successfully on over 1,300 patients
during the past three years. They have recently presented peer-reviewed
data at a national orthopedic meeting that supports excellent outcomes,
low complication rates, and rapid recovery on their first 704 patients
using this approach. When compared to patients that underwent total hip
replacement surgery utilizing traditional approaches, this patient group
required significantly less pain medication while in the hospital, progressed
with physical therapy at a faster pace, and were discharged from the hospital
in half the number of days on average, with some being discharged the next day.
James Caillouette, M.D., one of the founding partners of Hoag Orthopedic Institute, has helped
advance new total hip replacement techniques for more than a decade and
has presented on the topic of minimally invasive hip replacement to both
national and international medical forums. In addition, Dr. Caillouette
believes there is more to a successful joint replacement than the surgical
technique alone. Physical and emotional preparation, management of fear,
education and advances in management of discomfort all lead to most patients
being able to walk (with assistance) within less than 24 hours and progress
quickly to normal weight bearing.
This holistic approach to the complete joint replacement experience is
at the core of success for his patients. In fact, Dr. Caillouette has
performed many total hip replacements in the outpatient surgery center,
where patients go home the next morning.
Steven Gausewitz, M.D., also a Hoag Orthopedic Institute surgeon and partner at Newport Orthopedic
Institute, states, “Total hip replacement is a proven, safe and
effective treatment for painful hip conditions. The procedure has evolved
in ways that make the recovery more rapid, resulting in a more closely
aligned structure than that of a normal joint, and improved durability
in such that it can be offered to younger and more active individuals.”
Dr. Gausewitz also believes that the soft tissues can be better preserved
while accurately placing and securing the implants, with shorter incisions
and less overall trauma.
“Anesthesia and pain control also continue to improve dramatically
allowing patients to return home in less than 24 hours.”
Stephen Mikulak, M.D., who has been practicing minimally invasive hip surgeries for 11 years
in Newport Beach, has an opinion similar to Dr. Gausewitz in his description
of the advancements in total hip replacement. “The successful combination
of using a small incision, specially-designed instruments and eliminating
the need to cut muscle, in combination with novel pain management protocols,
allows patients to be up and walking within hours of surgery, often without
assistance,” states Dr. Mikulak.
Successful hip replacement puts trainer back on the field
Bill Cunerty, previously the head football coach at Saddleback College
and now a trainer and evaluator for potential NFL football players participating
in the Combine, decided his hip was causing him enough pain that he needed
to see a doctor or else he may have to quit his career and favorite hobby—golf.
After researching different types of hip replacements, Bill met with a
Hoag Orthopedic Institute surgeon and after discussing his options, decided
on the direct anterior approach surgery for hip replacement. The result
was an outstanding experience and successful surgery. “I felt no
pain following surgery, and did not have to take any pain medication so
I was able to return quickly to my daily activities,” shares Bill.
“This surgery has drastically improved my life because my hip pain
Hoag anesthesiologist for outpatient total hip replacement
Lionel Powell, M.D., an anesthesiologist who works with Hoag Orthopedic
Institute and Hoag Hospital, sees quite a few hip surgeries in his work.
After realizing that he personally needed a hip replacement, he met with
his orthopedic surgeon to discuss the options. Given his otherwise good
health, he and his surgeon determined that his total hip replacement could
take place at the Orthopedic Surgery Center of Orange County. Within hours
after surgery, Dr. Powell was walking with a walker and was discharged
in less than 24 hours. “I was pleasantly surprised that I could
bend to tie my shoes, walk up and down stairs and comfortably return to
work within just a couple of weeks,” states Dr. Powell.
He attributes the success of his experience not only to the talent of his
surgeon but also to the team approach–from his surgeon to the surgery
staff and rehabilitation professionals—who all provided him streamlined,
superior care. “It is important for the surgeon and patient to collaboratively
determine which venue is most appropriate for surgery,” adds Dr.
Powell. “In my case, my health status and post-surgical needs all
came into play in the decision for a total hip replacement.”
Successful outcome for football referee and runner
NFL referee Laird Hayes had been a long distance runner for many years,
but the deterioration of cartilage and resulting bone on bone pain in
his hip was preventing him from moving comfortably around the football
field. After completing his own research and having in-depth conversations
with the orthopedic surgeon he has trusted for previous surgeries, Laird
decided to move ahead with a minimally invasive total hip replacement.
His procedure utilized a small, posterior incision complimented by an
approach to the joint, which spared trauma to the surrounding muscles.
Laird happily recounts that he was walking with a walker less than 24
hours after surgery, and went home in less than 48 hours and felt no appreciable
pain. “The strong relationship and trust I have with my surgeon
is a large part of my successful outcome,” shares Laird. He also
points out that diligent compliance with his physical therapy program
got him back to work on the football field sooner than he expected.
For more information on total hip replacement, including podcasts on joint
replacement, visit the
Hoag Orthopedic Institute website Patient Resource Center, or call 888-635-1685.