N09 — March 2013 — Hockey Coach Gets Hip
Intro: According to the National Center for Health Statistics, close to 330,000 hip replacements are performed each year in the U.S. Many are done to ease the pain of osteoarthritis, also called wear and tear arthritis. And most patients are over age 60. But that's' changing, as younger patients are opting for surgery so they can stay active. Experts at Mayo Clinic say an alternative approach to standard hip replacement helps stop the pain and gets many people back to their normal activities faster.
Hockey coach Robb LaChappelle [Lah-Shop-ell'] says he first noticed pain when he was out on the ice.
"It was a groin muscle, I thought. I kept nursing it like a groin muscle. Always thinking, oh, this is going to get better. Never thought it was a hip problem."
Bone on bone osteoarthritis.
"It's kind of like a toothache. It's constant, it's always there. And it just starts to get worse and worse."
The pain got so bad, Robb stopped skating.
"It got to the point where I didn't want to walk."
At age 48 Robb needed a total hip replacement. Instead of accessing the hip joint from the back by splitting the gluteus muscle, Robb had what's called a direct anterior hip replacement. Mayo Clinic Dr. Michael Taunton performed the surgery.
"In the direct anterior approach, we make an incision directly in front of the hip joint."
Using x-ray guidance and a specially designed operating table, Dr. Taunton goes through the skin to the muscles. One there he separates them and gains access to the hip joint by going between them. Then, he removes the femoral head, or ball of the joint. Next, he re-contours and replaces the socket. Finally, he replaces the ball which is attached to a metal stem that is fixed into the femur, or thigh bone. No muscles are cut during the operation.
"Patients recover a little bit quicker. Most studies are showing that the patients get out of the hospital maybe a day sooner."
Patients also have fewer restrictions on movement in the first weeks after surgery, the risk of dislocation is reduced and many patients rehabilitate faster.
"I was walking around the block after the first day or so."
At eight weeks after surgery, Robb was back on the ice.
"For me to skate again, it's just everything."
For Mayo Clinic News Network, I'm Vivien Williams.
Another advantage of the anterior approach is that the x-ray guidance allows for better accuracy in placement of the implant to be sure leg length is as it should be.
Both types of hip replacements are very successful long term. Because Robb is young, he may face a revision in the future.
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