Back on Two Feet
August 05, 2019
Most people think hip replacements are just for older people. Well, they used to be, but not so much now. Today, younger people are facing hip replacement surgery more and more often.
According to the Agency for Healthcare Research and Quality, more than 300,000 hip replacements are performed each year in the United States.
Laura Fischer of Richmond, Virginia, was one of those numbers this year.
Fischer, who has always lived an active lifestyle through exercise and spending time outdoors with her family, knew a hip replacement procedure was inevitable.
Fischer's mother and sister had arthritis, and she developed the condition as she approached middle age. After living with pain for a long time, she went to see a doctor and learned she needed a total hip replacement.
As much as she wanted to be out of pain, Fischer didn't want to deal with the long recovery time associated with the procedure. Fortunately for her, because she was a younger patient, she was a good candidate for a procedure known as an anterior hip replacement.
An anterior hip replacement is a surgical procedure in which the damaged bones of the hip joint are replaced with an artificial hip.
The procedure is sometimes called minimally invasive or muscle-sparing hip arthroplasty.
This anterior approach uses a front (anterior) incision, while traditional hip surgery uses an approach from behind (posterior) or the side (lateral) of the hip.
Anterior hip replacement procedures have increased in popularity over the last few decades because they are less invasive than posterior or lateral procedures.
The anterior hip replacement is also popular because it can be performed as an outpatient procedure, like in Fischer's case; she checked in at 11 a.m. and was back home by 5:30 p.m.
After a few weeks of home-based physical therapy, Fischer was back to being active and exercising.
While the procedure sounds like a win for the patient, any surgery still has a risk of complications - no matter how many procedures are performed each year.
"Every procedure carries that potential for risk," said Dr. Faisal Jahangiri of AXIS Neuromonitoring in Richardson, Texas.
AXIS, which provides intraoperative neuromonitoring (IONM) during surgical procedures, sees the risks of surgery every day and works to lower it - even during hip replacement procedures.
During one such procedure, AXIS was providing IONM services during a hip replacement procedure for a 65-year-old female. She was six months post operative for left total hip arthroplasty. While monitoring the patient's somatosensory evoked potentials (SSEP), motor-
evoked potentials (TCeMEP), and electromyographic (EMG) feedback, an AXIS technologist noted a decrease in the lower right sensory evoked potentials when the surgeon increased the traction on the right leg.
The AXIS technologist notified the surgeon immediately, allowing for a quick response by the surgeon. After reducing the traction in the right leg, the patient's SSEPs improved.
Neuromonitoring is usually not performed routinely for hip replacement surgeries. However, the surgeon decided to use IONM for this patient because she was at higher risk due to revision surgery, with a history of right hip pain, flattening of the femoral head, superior acetabulum
bone loss and osteoarthritis in both the left and right hips.
"By responding quickly during the procedure, we were able to help reduce the potential for neurological damage," Jahangiri said.
If the SSEP changes had not been detected in time, the patient would have experienced irreversible damage to the nerves of the right lower leg.
"This damage could have meant lower limb muscle weakness, numbness, severe pain or foot drop," Jahangiri said.
Source:
WTVR. She's back on her feet after hip replacement: 'Checked in around 11 and was home by 5:30'. 24 July 2019.