Category Archives: Surgical Approach

Surgical Approch information

More Infection With Direct Anterior Hip Cases?

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Read Full Article Here:  https://ryortho.com/breaking/more-infection-with-direct-anterior-hip-cases/

By: Elizabeth Hofheinz, M.P.H., M.Ed. • Fri, July 12th, 2019

New work from NYU Hospital for Joint Diseases and NYU Langone Medical Center has examined the impact of using the direct anterior (DA) versus other total hip arthroplasty (THA) approaches on the risk of prosthetic joint infection (PJI)…

…“Practically speaking, we tell our patients the following based on this work and the work of several others that concur (some out of the Mayo Clinic and out of Anderson Clinic) that with the anterior approach there is a higher risk of superficial wound infection after THA. Specifically, with our obese patients of BMI > 40 we recommend against anterior approach surgery citing higher deep PJI rates in this group likely due to larger overhanging pannus. Patients should know that there are risks and benefits to everything including approaches regardless of the marketing and significant hype regarding …

Anterior, Lateral and Posterior Approach to Surgery by Talking with Docs – Dr. Zalzal and Dr. Weening

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Talking With Docs Published on July 24, 2018 – Dr. Paul Zalzal and Dr. Brad Weening discuss different surgical approaches to hip replacement surgery. There has been a lot of interest in the anterior hip approach recently. This video compares anterior approach to lateral and posterior approaches.

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The general information provided on the Video is for informational purposes only and is not professional medical advice, diagnosis, treatment, or care, nor is it intended to be a substitute therefore. Always seek the advice of your physician or other qualified health provider …

Anterior Hip Replacement Surgery Approach Increasing

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Scott Zellner: An American Association of Hip and Knee Surgeons survey from November 2016 shows 34 percent of surgeons are doing the Anterior Approach, which is quite remarkable. Since 2004 we have partnered with Dr. Joel Matta, a pioneer in the space to conduct surgeon education about the Anterior Approach and back then, 1 to 2 percent of surgeons were doing it. To see this climb to 34 percent nationally is really remarkable. We are seeing numbers higher than the industry average, however, with upwards of 40 percent of DePuy Synthes users performing the Anterior Approach.

Becker’s Hospital Review is the original producer/publisher of the content…

Similar Outcomes with Mini-incision Posterior vs Two-incision Approach for THR

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Read Complete Abstract Here

October 5, 2017  –  Investigators found there were no differences in midterm outcomes in patients who underwent total hip arthroplasty with a mini-incision posterior approach and patients who underwent total hip arthroplasty with a two-incision approach, according to Craig J. Della Valle, MD, study co-author.…

Dorothy Discusses Bilateral THR with Posterior Approach and one with Anterior Approach

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Published on Nov 14, 2011  Dorothy, a dental assistant, started having trouble with her hips about ten years ago. The pain on one side progressed over the years and she went for an X-ray. It was clear she needed a hip replacement. Many friends recommended Dartmouth-Hitchcock for her care. “I was very comfortable with the hospital,” Dorothy said. “They were very thorough. That gave me a lot of confidence. The doctor was just amazing – he described the surgery and I could really sense, ‘This is what this man does every day! There’s nothing to it.'” The surgery was successful and she had limited mobility for six weeks, as well as post-surgery pain medication. Knowing her other hip would need to be replaced soon, she didn’t wait until the pain became unbearable. She went back to Dr. Stephen Kantor, who had performed her previous surgery. He told her that the
…

Anterior Approach Hip Replacement – Pros and Cons by Dr. North 2017

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Published on Aug 21, 2017  There’s the anterior approach, posterior approach, direct superior approach, anterolateral approach, direct lateral approach, among others. They’ve all come in and out of favor at some point with orthopedic surgeons. The most important thing when deciding your joint replacement approach is the relationship you have with your surgeon. If you go to somebody that does a posterior approach and not an anterior, but you really like them, this could be a great option for your hip or knee replacement. Some benefits with the anterior hip surgery are: reduction in postoperative pain and closer to a normal gait in the first six weeks after surgery (after six weeks, the other approaches catch-up and are pretty similar). Some downsides with the anterior approach hip replacement: A longer procedure time; potential for increased blood loss; less common surgical method so not as many expert surgeons available to perform
…

Muscle Sparing Total Hip Replacement Less Pain and Faster Recovery by Dr. Powers

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Written by Mark J. Powers, MD, F.A.C.S., F.A.A.O.S.

There are many underlying causes of hip pain with the most common being arthritis. Careful clinical evaluation which consists of a history, physical exam and x–rays leads to a diagnosis of the correct pathology in most individuals. Occasionally further diagnostic testing (MRI, CT scan, bone scan, blood test) and repeated examination may be required.

The treatment rendered depends upon the diagnosis as well as the individual’s needs. The majority of hip complaints can be treated with conservative measures consisting of observation, medication, physical therapy, and occasional injections. However, if the disease has progressed to the extent that conservative modalities yield little benefit, surgical intervention may be warranted.

Hip arthritis progressively limits a person’s activities of daily living as well as quality of life. It is a major cause of disability world wide. The advent of modern total hip arthroplasty offers a patient …

Muscle Sparing Hip Replacement -Florida Orthopaedic Specialists

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At Florida Orthopaedic Specialists we offer the latest technological treatments for total hip replacement, the Muscle Sparring method. This procedure requires NO muscle or tendon detachment, and the incision length is approximately 3-4 ½ inches instead of the usual 12-15 inches with a traditional hip replacement surgery. The result is a majority of patients require a shorter hospital stay, have minimal pain and are able to walk with a cane in 24 hours.…

AAOS to CMS: Decision for outpatient TKA should remain patient-surgeon choice

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AAOS New’s Release September 06, 2017
Original Press Release Here

Washington, DC–On August 30, 2017, the American Association of Orthopaedic Surgeons (AAOS) submitted comments to the Centers for Medicare and Medicaid Services (CMS) on its “Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems” proposed rule. The comments highlight a number of concerns, including those related to computed/digital radiography changes, social risk factors and risk stratification, physician-owned hospitals, and needed health care system flexibilities. On the radiography changes, AAOS commented that the reduction in payments for services utilizing computed radiography technology is unreasonable; “providers who offer in-office services to improve access and convenience to patients should not be penalized for using this time-tested technology.” AAOS also called for further hardship exceptions in reporting requirements, electronic health records improvements, and increased access to Medicare claims data.

In addition, CMS in this rule proposed removing total knee arthroplasty from the …

Benefit of Direct Posterior Approach for THR by Dr. Anthony K. Hedley

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Published on Jul 17, 2015 Dr. Hedley of Hedley Orthopaedic Institute talks about the direct anterior approach versus the direct posterior approach to hip replacement.

“I think I can honestly say that I have done every approach to the hip there is, and I’ve settled on the approach that I use for–what I consider–a number of very good reasons,” says Dr. Hedley, founder of Hedley Orthopaedic Institute (Phoenix, Mesa and Tempe, AZ). http://www.hedleyortho.com/hedley/

“I’ve now done over 10,000 joints in this hospital, and I’d like to think we’ve provided a good service. And if I can improve the outcome in the patient in any way, I’m going to do that. It’s what I’m here for.”

Benefits of Direct Posterior Approach
– Much gentler surgical approach
– Blood loss is less
– Analgesia is less
– Complications are less
– “My patients are leaving the hospital the next day,” says Dr. …