Title: Anterior Approach Total Hip Replacement: Cutting Edge Treatment for the Relief of Hip Pain
1Anterior Approach Total Hip Replacement Cutting
Edge Treatment for the Relief of Hip Pain
- Vahan Cepkinian, M.D.
- Orthopaedic Surgery
2Introduction
- Hip arthritis affects hundreds of thousands of
people each year - Many people suffering from arthritis alter their
lives to deal with pain.
3Introduction
- Non-surgical treatment
- Medications
- Physical Therapy
- Assistive Devices
- If these do not work then hip replacement may be
the solution
4Total 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.
5Anatomy 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.
6Anatomy of the Hip
- The arthritic hip has worn down cartilage and
rough bone which cause pain
7Total 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
8Total Hip Replacement
- Acetabular component - consists of two components
- Cup - usually made of titanium
- Liner - can be medical grade plastic, metal or
ceramic
9Total 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.
10Total 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!
11Total 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)
12Total Hip Replacement Traditional Approach
- Disrupts the tissue and muscles important for the
stability of the hip
13Total 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
14Total Hip Replacement Traditional Approach
- All of these factors make people hesitant to
proceed with a hip replacement..and they
continue to live in pain!
15Total 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)
16Total Hip Replacement Anterior Approach
- The hip is exposed by going in between the
muscles WITHOUT DISRUPTING THEM - Muscle Sparing
17Total Hip Replacement Anterior Approach
- Compare the depth of muscle and tissue one has to
go through
18Total 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
19Total 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
20Total 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!
21Total Hip Replacement Anterior Approach
- These advantages when compared to the traditional
approach can eliminate apprehension - QUICKER RECOVERY TO AN IMPROVED QUALITY OF LIFE !
22THANK YOU