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Taking a New Approach to Hip Replacement: January 26, 2013

“This is your original joint where you’ve worn down the cartilage and worn down the socket,” says Dr. Ed Humbert, orthopedic surgeon on Lee Memorial Health System’s medical staff.

The fundamentals of a hip replacement haven’t changed much.

“Hip replacement is removing the damaged cartilage and bone,” says Dr. Humbert.

But in recent years more and more doctors are taking a different approach.

“Hip replacement is the one procedure in orthopedics that the approach can vary based on the surgeon you choose. You can come through the posterior buttock region or you can come from the direct front of the hip joint or you can come in through the side of the hip joint,” says Dr. Humbert.

The most common way is to access the joint is through the backside, which comes with some resistance.

“The posterior approach does go through the biggest muscle in the body which is the gluteus maximus muscle. So you split that muscle, you have to actually remove some of the short external rotator muscles of the hip joint and hip capsule to get to the hip,” says Dr. Humbert.

Jennifer Inskeep labored over the idea of a hip replacement for years.

“I’m an active person and I was very tired of hurting every time I did something,” says Jennifer Inskeep. Anterior hip patient.
The newer, anterior or frontal approach helped change her mind.

“This procedure is easier, shorter healing time because they don’t cut the buttocks muscle. That’s one less thing that has to heal,” says Inskeep.
“You literally don’t move any muscles or tendons off the bone. So you’re basically separating and pushing the muscles apart as opposed to cutting them and splitting them. That procedure done correctly is a dramatic improvement as far as pain control and recovery times,” says Dr. Humbert.

A primary concern with hip replacement are dislocations, which are more common if the muscles have been cut. Using the anterior approach, or going through the front of the body, cuts down on that complication.

“Right, you maintain the soft tissue, you maintain the hip capsule and the short external rotator muscles, which are very protective,” says Dr. Humbert.

The change in attitude sat well with Inskeep.

“I was on a horse five weeks after surgery,” says Inskeep.