I’m getting a new hip joint. The incision will be along the back of the hip. Why don’t they go in from the front?

My surgeon described the way she is going to cut me open and install a new hip joint. The incision is going to be along the back of my hip (maybe slightly between the back and the side). I guess that’s okay but why don’t they just go in from the front (or even the side) instead of cutting through my butt muscles?

It is possible to perform a total hip replacement from an anterior (front) approach as well as from the side lateral or posterolateral (halfway between the back and side). But over the years, studies have shown the best results and easiest access is from the posteriolateral direction.Some of the success with this incision location is the fact that it gives the surgeon access to the entire joint. It also makes it possible to put the implant in its best location for optimal motion and function. Even a degree or two off in one direction or the other can cause long-term problems. To avoid that, the surgeon likes an open enough incision and open wound site to see what he or she is doing.The posterior approach also makes it possible for the surgeon to size up the bone and choose the best size of implant for the patient. Getting a just the right size implant on the femoral side and placing it in the optimal location is key to full, pain-free motion. Newer techniques are being developed all the time. One surgeon has already mastered a minimally invasive technique for hip joint resurfacing.Using a three and three quarters- to four-inch length incision, the head of the femur can be accessed and cut off all inside the body. There’s no need to pull the head of the femur out of the open wound site to gain access to the arthritic component. Muscles are split in two rather than cutting them off and moving them out of the way. The joint capsule still has to be cut through to get to the joint, but these other refinements in surgical technique certainly reduce the overall trauma.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Full disclosure important when facing total hip replacement surgery

I’m filling out a form for my doctor before having a total hip replacement. It asks me to list all drugs (prescription and over-the-counter). Do I need to report vitamins and herbal supplements too? There’s no place on the form for that, but it seems important.

You’re right. Vitamins and herbal supplements can have dangerous interactions with prescribed drugs. They must be reported. Sometimes these products are called nutraceuticals. Nutraceuticals refers to any food, supplement, or dietary substance that improves health or offers medical benefit.

This can include herbs like ginkgo biloba, ginseng, Echinacea, and St. John’s wort. Antioxidants such as lycopene, Vitamins E, A, and C, and supplements like calcium are also included.

Anyone planning surgery of any kind should go over their complete list of drugs and nutraceuticals with the doctor. This is important because some over-the-counter products can cause bleeding or decrease the effect of the prescribed drug.

For example you may have heard that grapefruit juice shouldn’t be taken with cholesterol lowering drugs, calcium channel blockers for high blood pressure, and some migraine medications. The juice keeps the body from using and getting rid of these drugs from the body.

Vitamin K should not be taken by anyone who is also taking Coumadin (warfarin) to prevent blood clots. Warfarin works by stopping vitamin K factors needed to make blood clots. Too much vitamin K can keep the warfarin from doing its job.

These are just a few examples of drug-herb interactions. Your doctor will be able to see if you’re taking anything that could be a problem.

Considering a total hip replacement? Choose an experienced surgeon. Dr. Zehr is one of the few surgeons in Southwest Florida using the minimally invasive anterior approach. In fact, it is estomated that fewer than 5% of the orthopedic surgeons in the United States employ this approach.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.