Naples Orthopedic Surgeon - Dr. Robert J. Zehr » minimally invasive hip surgery

Double hip replacement an option?

admin — Mon, 07 Jun 2010 12:01:38 +0000

I have pretty bad hip arthritis. The doctor is going to do a hip replacement on the worst side first. The other side isn’t really too good. How will I manage with one bum hip and the other one just operated on?

You may want to ask your doctor about having both hips done at the same time. If you are in good health and qualify, this may be the best option for you. Without the stiffness and pain on the nonoperative side after a single replacement, you can move along faster in rehab, too!

There’s also a cost savings. Even though you’ll be in the hospital longer than if only one hip was done at a time, the overall number of days is less when both hips are done together.

You can have bilateral hip replacements in one of three ways. First, they can both be done in the same surgery. Second, you could do one and finish rehab before having the second one done. There’s usually at least six to eight weeks between operations. Some people wait longer. Third, you could have one hip done and wait five to seven days. If your health is stable and you’re up for it then have the second one done. With this third method, you don’t leave the hospital between operations.

If you still opt for one hip replacement at a time, then a physical therapist will help you. Your home may need to be adapted to make toileting, bathing, sleeping, and household chores easier. You will likely need a family member or live-in assistant for a few days to weeks, depending on the speed of your recovery.

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.

Mini-incision hip replacement can mean shorter hospital stay

admin — Wed, 02 Jun 2010 16:37:30 +0000

I heard the new mini-surgery for hip replacement takes less time and fewer days in the hospital. How much less?

The answer to your questions really depends on the surgeon. If the mini-incision method is fairly new to the surgeon, the operation itself can take longer. If all things are equal (the doctor has done the same number of both operations: open and mini), then the time is about the same.

Length of hospital stay also varies. The hope is that the newer mini-incision method will mean a shorter hospital stay. But hospitalization may be longer if there are any complications during or after the operation. For example, fractures and dislocations may happen more often when a surgeon is learning a new technique.

A recent study from the University of Missouri reports on this. An experienced surgeon had an overall rate of 42 percent for problems after a two-incision mini-invasive hip replacement. That was compared with six percent for the single-incision method. The surgeon also reported a 25 percent rate of nerve injuries. Any of these (or other) problems can extend a patient’s stay in the hospital.

Total hip replacement invasive no matter how it’s done

admin — Tue, 25 May 2010 19:02:08 +0000

My orthopedic surgeon has explained to me that my hip replacement will be done with the new minimally invasive method. I don’t get it. How is this any less “invasive” than a regular hip replacement? They’re still going to cut me open, saw the bone in half, and take the old hip out. I understand there’s a lot of cutting, drilling, and reaming of the bone. What’s not invasive about that?

You ask a very good question. Perhaps only a surgeon can really appreciate the difference between the two operations. A total hip replacement is invasive no matter how it’s done. A better way to look at it is to say it “minimizes the invasiveness”. From a patient’s point of view, it certainly does sound invasive.

The first difference and reason why it’s called “minimally invasive” (MI) is the length of the scar. MI means the incision is about two inches long. A full incision can be up to eight or 10 inches long.

During the operation fewer muscles are cut. New tools allow the surgeon to gently move structures out of the way to get to the hip. Anything that is cut is carefully repaired and put back in place.

More and more surgeons are getting trained in this new technique. We can expect it to improve even more over the next few years.

Is hip joint replacement the answer for dysplasia?

admin — Tue, 13 Apr 2010 13:09:37 +0000

I was born with developmental hip dysplasia. Physical therapy and a hip operation at age six have kept me pain free. Now at age 46, I am having constant pain. My hip dislocates from time to time. Would a hip joint replacement help me?

Studies of hip replacement for developmental dysplasia show a wide range of results. A recent report from Japan shows the results after hip replacement for this problem. Some patients were followed for 26 years. Besides the new joint, each patient had a large bone graft used to form a deeper hip socket.

They found that problems are more likely to occur in patients under age 50 with this operation. The authors suggest that other operations can be tried first before removing the joint and replacing it. Patients must be advised about the right level of activities. This will help preserve the hip before surgery.

Delaying hip surgery for elderly improves recovery

admin — Fri, 26 Mar 2010 14:00:13 +0000

My mother fell and broke her hip. The doctors say she has a better chance of recovery if we delay surgery. Why is this?

Mortality (death) rate during the first year after hip fracture repair is 55 percent in older adults when the surgery is done within the first 48 hours. The death rate goes down to 24 percent for surgery done 48 hours to one week later. Surgery done more than a week after injury is linked with only 14 percent death rate.

The reason for this? Doctors think many older patients are in poor condition when they fall. Medical treatment before surgery can make a difference. The person gets fluids and proper nutrition. Their medications are reviewed and adjusted. Those who have diabetes get their blood sugars regulated. Other health concerns can be taken care of.

All these things help improve the patient’s general condition and give them a chance for a better surgical result.

Saving money on hip replacement surgery

admin — Tue, 23 Mar 2010 21:15:18 +0000

I’m a self-insured, self-employed plumber. I desperately need a hip replacement to keep doing my job. I just can’t get in and out of tight spots anymore. What’s the fastest, least expensive way to get this done?

If you’re a good candidate, your doctor may consider you for the minimally invasive operation (MIO). Only a small incision is made. If you do well, you can be discharged and go home the same day.

A recent study comparing inpatient versus outpatient total hip replacements showed the outpatient method saved up to $4,000 per patient. That’s a big chunk of change if you’re paying out of pocket. Not all surgeons are set up to replace joints using the MIO method.

Once you find one who is, then ask about the kinds of patients who are allowed to have this surgery. Usually you have to be in stable health without heart, lung, or other major problems. If you have diabetes, a heart condition, or seizures, you may have to be in the hospital.

Follow all of the instructions the nurses and therapists give you both before and after the operation. This will help ensure a better result with fewer problems.

Full disclosure important when facing total hip replacement surgery

admin — Thu, 14 Jan 2010 14:44:50 +0000

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.

Compare these two total hip replacement surgeries

admin — Thu, 31 Dec 2009 20:49:20 +0000

I’ve had two total hip replacements. The first was a full incision and took me six months to get back on my feet and up to speed. The second one was three weeks ago with two tiny cuts. I’m already walking without a walker for up to 30 minutes. I still have a little trouble with stairs but that seems to be coming. Is a smaller incision really all that makes the difference?

The operation you had is called a minimally invasive total hip replacement (THR). Two small incisions are made: one in the front of the hip and one to the side. Besides the small cuts, there are other important differences from the standard THR.

No muscles or tendons are cut in a minimally invasive THR. The joint capsule is cut, but not removed. The joint itself is removed in several pieces. No cement is used to hold the new implant in place.

Overall, less trauma to the soft tissues and joint mean less pain and a faster recovery time. Patients can stop taking pain killers and get back to normal function faster. In fact most patients are able to put weight on the operated leg the same day as the surgery. Many go home in the first 24 hours.

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. For more information on this subject, visit www.zehrcenter.com.

How can I control the pain after hip replacement surgery?

admin — Thu, 01 Oct 2009 17:52:14 +0000

I had a total hip replacement last year. The first few days after the operation were very painful. I don’t like using drugs. Is there any other way to control the pain?

Pain control is one of the biggest challenges after surgery of any kind. Some doctors are using a much smaller incision to do some hip replacements. It depends on the type of hip implant being used. With a small incision there’s less damage to the muscles and less pain. Ask your doctor if you might be a candidate for this mini-incision operation.

Other methods of pain control are used such as acupuncture, electrical stimulation, hypnosis, and patient controlled analgesia (PCA). A recent study from Japan suggests using constant cold therapy for the first four days. A cooling pad is placed over the surgical site. A computer keeps it at a constant temperature.

More than half the patients were pain free by the end of the third day. This reduced painful days by at least two full days. Tell your doctor about your concerns. Find out what’s available at your hospital or surgery site.