How You Approach Hip Replacement Surgery Makes A Big Difference
IN THE NEWS
Hip Replacement Surgery
December, 2019 By Michael Messieh, Orthopedic Surgeon
Did you know that most surgeons who use robotics for hip replacement surgery cut through muscle. This may lengthen the recovery and need special precautions when you sit.
The hip is the largest joint in the body. Our hips allow us to move freely, sit, stand, climb, walk and run
and enjoy all types of sports. The most common cause of our hips wearing out is damage from osteoarthritis. When arthritis affects
the hip joint, the cartilage cushioning the bones softens and wears away causing the bones to rub against one another.
This bone-on-bone contact causes pain and stiffness that can increase over time. This disease process damages our hips and
we experience pain and stiffness when we walk.
For some people, lifestyle changes, medications,and walking aids are effective to alleviate the
pain. For others, hip replacement surgery,may be the only long-term solution. While hip replacement surgery has been present for a long time,
new techniques have developed. The anterior approach to total hip replacement may be the best option when replacing the hip.
Dr. Michael Messieh, Board Certified Orthopedic Surgeon, offers the latest hip replacement procedure known as the anterior hip approach.
What are the advantages of the anterior approach to hip replacement? The anterior approach allows the hip to be replaced without detaching any muscle. The patient is allowed full motion after surgery and generally experiences a quicker recovery. X-ray is used during surgery to position the implants to ensure a more accurate result. Only 20% of orthopaedic surgeons nationwide are using the anterior approach to hip surgery due to the steep learning curve of this technique.
Faster Recovery. Patients get up walking full weight bearing on their operative hip the same day of surgery and may use a cane. While it may take patients many months to fully recover following conventional hip replacement surgery, the anterior approach technique enables patients often to recover and return to activities such as golf, tennis, biking and of course distance walking in as short as four weeks.
Minimally Invasive. The anterior approach to hip replacement is the most minimally invasive choice for hip replacement surgery. Some muscles in the front of the hip are temporarily pushed apart to allow work on the bones of the hip joint but are left uninjured and completely functional in this approach. This, of course, results is far less pain than is typical in other approaches to the hip.
Less Restrictive. After conventional hip replacement surgery, patients must limit flexing of the hip to no more than 90 degrees, which complicates normal activities like sitting in a chair, on a toilet seat, putting on shoes or getting into a car. Following the anterior approach surgical procedure, patients are instructed to use their hip normally without cumbersome restrictions and are sent home from the hospital often the next day. Patients can immediately bend their hip freely and bear full weight when comfortable, resulting in a rapid return to normal function.
More Accurate. The use of a specialized X-ray machine known as a fluoroscope allows the surgeon to see the placement of the component parts of the hip prosthesis in real time and to make adjustments immediately. This is necessary to give the patient the most accurately placed hip prosthesis and to assure equal leg lengths before leaving the operating room.
Michael Messieh, MD | 352-243-6899 | Offices in Clermont and The Villages
Testimonials
Polk doctors explain outpatient hip replacement options, what questions to ask
By Robin Williams Adams, Your Health correspondent
Posted at 2:41 PM March 2020
By Robin Williams Adams, Your Health correspondent
Posted at 2:41 PM
Patients who otherwise are fairly healthy and have a good support system are good candidates for outpatient total hip replacement surgery, but Polk patients who are considering it need to ask some questions, experts say.
Patients getting a total hip replacement because of degenerative joint damage from arthritis can expect to be out of bed and on a walker within hours of their THR surgery.
Those who are healthy and have THR on an elective basis are likely to be released from the hospital in fewer than 48 hours.
Total hip replacement is the surgical replacement of the ball and socket of the hip joint with artificial parts.
With results like that, it’s probably not surprising Centers for Medicare and Medicaid Services on Jan. 1 removed total hip replacement from its list of procedures that must be done as “inpatient” surgery.
That paves the way for those procedures to be done on an outpatient basis, which Dr. Samuel Messieh, medical director of Winter Haven Hospital’s joint replacement program, said already is the case for a majority done in Polk County.
Patients who otherwise are fairly healthy and have a good support system are good candidates for outpatient THR surgery, said Dr. Michael S. Messieh, who does total joint replacements at AdventHealth Heart of Florida.
Michael Messieh and Samuel Messieh are strong proponents of the anterior approach to joint replacement, which is how both do their hip replacements.
That’s entering from the front and working between the muscles.
It provides patients with less pain and quicker rehabilitation, they said.
There are medications given before surgery to block pain receptors and prevent nausea, as well as choices in anesthesia, he said.
Doctors have been successful at reducing use of opiods for pain relief. Eliminating pain caused by a damaged hip also reduces need for opiods, Samuel Messieh said.
Robin Williams Adams can be reached at [email protected]
Your bandage after hip or shoulder replacement surgery;
At 1 week after surgery, the outer white bandage is removed carefully and the deeper transparent sticky strip is kept in place for an additional week. The skin glue on the transparent strip is important . Keep the sticky strip dry for 2 weeks so that the skin will heal well and avoid the risk of infection. You may shower at 2 weeks. No lotions, creams or moisturizers are to be used for at least 4 weeks on the incision. No tub baths or swimming in a pool for 3 weeks.
At 1 week after surgery, the outer white bandage is removed carefully and the deeper transparent sticky strip is kept in place for an additional week. The skin glue on the transparent strip is important . Keep the sticky strip dry for 2 weeks so that the skin will heal well and avoid the risk of infection. You may shower at 2 weeks. No lotions, creams or moisturizers are to be used for at least 4 weeks on the incision. No tub baths or swimming in a pool for 3 weeks.
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All surgical procedures are performed at The Advanced Surgery Center of Orlando
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