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Anterior Approach Total Hip Replacement: Cutting Edge Treatment for the Relief of Hip Pain Vahan Cepkinian, M.D. Orthopaedic Surgery.

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Presentation on theme: "Anterior Approach Total Hip Replacement: Cutting Edge Treatment for the Relief of Hip Pain Vahan Cepkinian, M.D. Orthopaedic Surgery."— Presentation transcript:

1 Anterior Approach Total Hip Replacement: Cutting Edge Treatment for the Relief of Hip Pain Vahan Cepkinian, M.D. Orthopaedic Surgery

2 Introduction Hip arthritis affects hundreds of thousands of people each year Hip arthritis affects hundreds of thousands of people each year Many people suffering from arthritis alter their lives to deal with pain. Many people suffering from arthritis alter their lives to deal with pain.

3 Introduction Non-surgical treatment Non-surgical treatment –Medications –Physical Therapy –Assistive Devices If these do not work then hip replacement may be the solution

4 Total Hip Replacement The goal is to reduce hip pain and improve the motion in your hip. 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. More than 345,000 people in the United States annually undergo hip replacement surgery.

5 Anatomy of the Hip Ball and socket joint Ball and socket joint Femoral head or ball is at the end of thighbone or femur. Femoral head or ball is at the end of thighbone or femur. Socket or acetabulum holds the ball. Socket or acetabulum holds the ball.

6 Anatomy of the Hip The arthritic hip has worn down cartilage and rough bone which cause pain The arthritic hip has worn down cartilage and rough bone which cause pain

7 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 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

8 Total Hip Replacement Acetabular component - consists of two components Acetabular component - consists of two components – Cup - usually made of titanium – Liner - can be medical grade plastic, metal or ceramic

9 Total Hip Replacement The femoral component (stem and neck portion), is made of metal. The femoral component (stem and neck portion), is made of metal. Femoral head is made either of metal or ceramic. Femoral head is made either of metal or ceramic. Stem is shaped to fit into the bone and support the new joint. Stem is shaped to fit into the bone and support the new joint.

10 Total Hip Replacement One of the most successful adult reconstructive procedures performed in orthopaedics 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! With newer materials, hip replacements can last up to (and sometimes beyond) 20 years!

11 Total Hip Replacement The Traditional approach 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)

12 Total Hip Replacement Traditional Approach Disrupts the tissue and muscles important for the stability of the hip Disrupts the tissue and muscles important for the stability of the hip

13 Total Hip Replacement Traditional Approach There is the risk of hip dislocation There is the risk of hip dislocation Limitations on hip motion and positions Limitations on hip motion and positions There is the risk of a persistent limp There is the risk of a persistent limp Greater reliance on assistive devices (walker, cane) post-operatively Greater reliance on assistive devices (walker, cane) post-operatively –Over 6 weeks Greater need for pain medication Greater need for pain medication

14 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! All of these factors make people hesitant to proceed with a hip replacement…..and they continue to live in pain!

15 Total Hip Replacement Anterior Approach The 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)

16 Total Hip Replacement Anterior Approach The hip is exposed by going in between the muscles WITHOUT DISRUPTING THEM The hip is exposed by going in between the muscles WITHOUT DISRUPTING THEM Muscle Sparing Muscle Sparing

17 Total Hip Replacement Anterior Approach Compare the depth of muscle and tissue one has to go through Compare the depth of muscle and tissue one has to go through

18 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 This approach is made possible with the use of a special orthopaedic table called the HANA table which is found at Glendale Memorial Hospital

19 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 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 This ensures that all of the hip components are in the perfect place and that the leg lengths are equal

20 Total Hip Replacement Anterior Approach Essentially NO risk of dislocation Essentially NO risk of dislocation NO limitation of hip range of motion and positions NO limitation of hip range of motion and positions Less Reliance on Assistive Devices Less Reliance on Assistive Devices –Usually 2 weeks Less pain! Less pain! FASTER RECOVERY! FASTER RECOVERY!

21 Total Hip Replacement Anterior Approach These advantages when compared to the traditional approach can eliminate apprehension These advantages when compared to the traditional approach can eliminate apprehension QUICKER RECOVERY TO AN IMPROVED QUALITY OF LIFE ! QUICKER RECOVERY TO AN IMPROVED QUALITY OF LIFE !

22 THANK YOU


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