Understanding Anterior Supine Hip Procedure.

Mid Florida Ortho

Understanding hip arthritis and the options you have for overcoming pain.

Hip Arthritis

Hips are a prime target for arthritis. The first sign may be an occasional ache, but, over time, the pain may become too much to ignore. Millions of Americans have more than 100 different types of arthritis, and osteoarthritis, the most common type, is a leading cause of hip pain. Joints like the hips are simply places where bones meet and join together. Those meeting places are cushioned by cartilage, so the bones don’t rub right up against each other. But when the cartilage is worn away—which is actually the definition of osteoarthritis—the result is a bone-on-bone grind. That grinding hurts. You can feel it walking, sitting, or even lying down trying to sleep.

Other causes of hip pain include rheumatoid arthritis, osteonecrosis (death of bone caused by insufficient blood supply), injury, and bone tumors.

In a healthy hip, cartilage provides a cushion between the hip ball and socket.

In an arthritic hip, the cartilage has thinned and deteriorated, allowing bone to rub against bone, causing pain.

Anterior Supine Hip Procedure

The Zimmer® Anterior Supine Hip Procedure combines the benefits of Zimmer Minimally Invasive Solutions™ (MIS) procedures with the advantages of an anterior approach. In this case, the word “anterior” refers to the front of the hip. With this procedure, your surgeon utilizes a smaller incision than with traditional hip replacement surgery and has the ability to work between the leg muscles without detaching them from the thigh bones.

You may be a candidate for the Anterior Supine approach to surgery. This means you could experience the benefits associated with Zimmer Minimally Invasive Solutions (MIS) procedures and the Anterior Supine approach that are explained here. If you haven’t already, talk to your doctor to find out if this procedure is right for you because not everyone is a candidate.

Zimmer MIS Anterior Supine Hip Procedure

Traditional surgery involves an 8-12 inch incision on the side or back of your leg. The Anterior Supine procedure uses a 3-6 inch incision on the front of your leg. This allows your surgeon to have an optimized view of your hip joint during surgery.

This procedure also allows your surgeon to preserve the tissue that keeps your joint tight, which reduces the risk of dislocation after surgery. Dislocation is when your hip comes out of the socket.

Benefits of the Zimmer MIS Anterior Supine Hip Procedure

While every patient’s experience may differ, the Anterior Supine Hip Procedure is designed to provide a number of benefits:

• Accelerated recovery time and reduced pain, due to the minimal trauma to muscles, tendons and nerves
• Reduced scarring from the use of a smaller incision than with traditional total hip replacement
• More rapid stability of the hip, because the muscles are not disrupted during the procedure
• Possible accelerated recovery time because key muscles are not detached during the operation

In addition, because the Zimmer MIS Anterior Supine Hip Procedure is a muscle-sparing procedure, patients may experience reduced rehabilitation time following surgery, as compared with the 6-8 weeks of rehab that is typical with traditional hip replacement procedures.

What Is It Like To Have Total Hip Replacement Surgery?

Before Surgery

If you and your surgeon decide that total hip replacement is right for you, a date will be scheduled for your surgery. Several things may be necessary to prepare for surgery. For example, your surgeon might ask you to have a physical examination by your primary care physician.

You should also finish any dental work that may be under way to prevent germs in your mouth from entering the bloodstream and infecting the new joint. If you prefer, or if your surgeon feels it is needed, you may want to donate your own blood ahead of time to reduce the risk of your body reacting to the blood transfusion.

During Surgery

On the day of surgery, an intravenous tube will be inserted into your arm to administer necessary medications and fluids during surgery. You will then be taken to the operating room and given anesthesia.

The surgery usually takes 2 to 4 hours, although this is dependent upon the severity of the arthritis in your hip. In the operating room, a urinary catheter will be inserted and left in place for 1 or 2 days. Compression stockings and pneumatic sleeves will be put on both legs.

The procedure is performed through an incision in the area of the hip. The ball-end of the thighbone (femur) is cut and replaced with the new ball and stem components. The stem may be stabilized with or without cement. The damaged surface of the socket is smoothed in preparation for the insertion of the new socket. The ball and socket are then joined. When the surgeon is satisfied with the fit and function, the incision will be closed and covered with dressings. You will also find small drainage tubes coming out of the hip to drain fluid from the wound.

Recovery

You will be sent to the recovery room, and as the anesthesia wears off you will slowly regain consciousness. A nurse will be with you, and may encourage you to cough or breathe deeply to help clear your lungs. You will also be given pain medication and will find a foam wedge or pillows placed between your legs to help hold your joint in place. When you are fully conscious, you will be taken back to your hospital room.

What Can I Expect After Surgery?

When you are back in your hospital room, you will begin a gentle rehabilitation program to help strengthen the muscles around your new hip and regain your range of motion. On the day of surgery you may be asked to sit on the edge of the bed and dangle your feet. You will also learn how to protect your new hip while doing daily activities.

As soon as possible, usually within the next 24 hours, your physical therapist will help you start walking a few steps at a time. As you heal you will progress from walker or crutches to a cane. Before you are dismissed from the hospital, an occupational therapist will also show you how to perform daily tasks at home with your new hip. For example, he or she will instruct you on how to go to the bathroom, how to dress yourself, how to sit or stand, how to pick up objects, and many other tasks.

After about 2 to 4 days, or when your surgeon determines that you have recovered sufficiently, you will be discharged. You may be transferred to a nursing facility for a few more days, as determined by your surgeon.

Upon returning to your home, you will need to continue taking your regular medications and continue exercising as directed by your surgeon or physical therapist. Walking, remaining active, and practicing the required exercises are the quickest ways to full recovery. Within 6 weeks, you will revisit your surgeon at the hospital to check up on the progress of your recovery.

In most cases, successful total hip replacement will relieve your pain and stiffness, and allow you to resume many of your normal daily activities. But even after you have fully recovered from your surgery, you will still have some restrictions. Normal daily activities do not include contact sports or activities that put excessive strain on your hips. Although your artificial hip can be replaced, a second replacement may not be as effective, and your activities would likely be even more restricted. Talk with your surgeon about your specific situation.

Risks of the Zimmer MIS Anterior Supine Hip Procedure

Every surgical procedure has risks and benefits. Your individual results will depend on your personal circumstances, and recovery takes time. How long a hip replacement will last varies from patient to patient. It depends on many factors, such as the patient’s physical condition and activity level, body weight, and the surgical technique.