Total hip replacements are nothing new to medical science. In fact, “there are a quarter-million total hip replacements done in the country” every single year, said Dr. Paul Enker, Chief of the Department of Orthopedic Surgery and Director of the Total Joint Replacement Program at the Queens Long Island Medical Group (QLIMG).
Dr. Enker recently performed the first total hip replacement through the anterior approach on Long Island.
Enker has been in practice for 25 years. Anyone who has been in the business that long, he adds, “has a broad view of history…We’ve all seen ideas that sounded great but didn’t work out.” Still, upon hearing about a new approach to total hip replacement surgery, one that would cause less muscle trauma, reduce hospital stays and greatly decrease recovery time, Enker was fascinated.
The anterior approach to total hip replacement, Enker said, has been done in Europe since the late 1940s.
“In 1996, Dr. Joel Matta in Los Angeles was asked by a patient to perform a hip replacement, utilizing the same approach as his other surgeon in France,” Enker said. “[Dr. Matta] looked into it, studied it and found that recovery is much quicker compared to the conventional approach.”
Over the last few years, Matta has “worked on refining the surgical technique,” which included the creation of a specially designed operating table that “allows you to manipulate the leg.”
Two years ago, Enker took his first workshop on the surgery and soon went back for a second.
“I asked our institution to get us this surgical table…it gives you enhanced visualization of the bones and it allows you to do surgery on patients who are, say, obese and are turned down [by other places]…We’ve had experience taking care of big people with the conventional approach; with this approach, you can operate on people when they’re laying on their back,” he said.
The table also allows the doctor to view a live x-ray during the surgery. In viewing a live x-ray, and with the patient directly on their back, it minimizes the possible negative side effects of surgery, such as tissue trauma and a slightly decreased leg size.
Prior to this procedure, there were a number of precautions post-surgical patients must follow.
“They’re limited in how far they can bend over, can’t cross their legs, and have to sleep with a pillow between their legs to keep their hips spread apart,” Enker said. He continued that now “because the hip is more stable, we don’t have the same concerns of dislocation. Patients can bend and sit any which way they want; don’t need any special separation pillows for legs or toilet seat extensions because you can bend the hip past 90 degrees.”
The hospital stay for patients who undergo a total hip replacement using the anterior approach is “two to four days, compared to three to 10” and the recovery time is “two to eight weeks compared to two to four months,” said Enker.
“We’ve taken care of 15 patients in two months,” he added.
They aren’t stopping now.
