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Anterior Hip Replacement

Innovations in Anterior Hip Replacement

April 14, 2011
12:00 p.m. – 1:00 p.m. (EST)

  • Juan Suarez, MD – Orthopaedic Surgeon

Between 200,000 and 300,000 hip replacement operations are performed in the United States each year, most of them in patients over the age of 60.Cleveland Clinic Florida is one of the only hospitals in the region to offer minimally invasive direct anterior hip replacement surgery, an advanced procedure involving no muscle cutting.

Cleveland_Clinic_Host: Today's Live Web Chat "Innovations in Anterior Hip Replacement" with Juan Suarez, MD will begin at 12 noon EST. Please submit your questions by typing them below and then clicking 'Ask'.

Cleveland_Clinic_Host: Welcome to our Online Health Chat "Innovations in Anterior Hip Replacement" with Juan Suarez, MD. We are thrilled to have him here today for this chat. Let’s begin with the questions.

JonBGood: What is the difference between a regular hip replacement surgery and an anterior hip replacement surgery?

Juan_Suarez_MD: The main difference is the approach. The anterior approach is done through a small incision on the front of the hip as compared to a posterior (back) approach. The anterior does not cut any muscle.

Athena: I am a 53 yr old, had a THR 5 months ago. Are there any specific supplements, foods, etc. that I could be consuming that would help my new bone get settled in my body? I take Actonel, calcium, vitamin D & multivitamins. Thank you!

Juan_Suarez_MD: There aren't any additional supplements that I would recommend. You are doing the right things. Thanks for your question.

suemisir: I am attending on behalf of my mother. She has a history of a fractured acetabulum in 2009. Would this exclude her from anterior hip replacement?

Juan_Suarez_MD: Not necessarily, but a full evaluation including x-rays would be necessary. Thanks for the question.

suemisir: Is this procedure approved to be covered by Medicare?

Juan_Suarez_MD: Yes.

Cleveland_Clinic_Host: For those now joining us, we are currently chatting with Dr. Juan Suarez who is taking your questions about hip replacement. To ask a question, type in the box below and then click 'Ask'

JonBGood: Are there alternatives to getting surgery?

Juan_Suarez_MD: Medications, physical therapy, injections, and arthroscopy. Thanks for the question.

BartB52: When will I be able to return to work?

Juan_Suarez_MD: Typically less than 6 weeks, depending on your occupation, sometimes within weeks.

BartB52: Can you be too old for hip replacement surgery?

Juan_Suarez_MD: Yes. However, it primarily depends on your medical health.

klekter: Do you do the new hip resurfacing that the FDA has recently approved? If so what are its advantages/disadvantages over the minimally invasive surgery?

Juan_Suarez_MD: We do not do resurfacings. They have had higher failure rates than hip replacements.

suemisir: How long is someone typically hospitalized for this surgery?

Juan_Suarez_MD: 1-2 days

AJ: What is the age that is too old?

Juan_Suarez_MD: No age is too old. It depends on medical problems and the goals of the operation that you and your physician agree upon.

AJ: How long does the replacement last?

Juan_Suarez_MD: Newer studies show more promise; ideally greater than 20 years although many factors play a role here.

JonBGood: How long is recovery after surgery for both anterior hip replacements V. regular hip replacements?

Juan_Suarez_MD: Anterior hip surgery recovery can be almost half as long.

SuzyQ: What are the most common reasons for a revision surgery?

Juan_Suarez_MD: Infection, instability, loosening, fracture.

SuzyQ: Is a cemented or un-cemented prosthesis better?

Juan_Suarez_MD: Typically un-cemented lasts longer.

Cleveland_Clinic_Host: We are receiving many great questions so far! Please remember that this chat is for general questions regarding hip replacement. If you have a medical question not related to this condition, or that is diagnostic in nature, please follow-up with your personal health care provider or use our contact link clevelandclinic.org/webcontact to submit your questions.

AJ: What type of mobility will I have? With the normal replacement I cannot cross my legs, is there any using this procedure?

Juan_Suarez_MD: Approximately 10 cases a week including hip and knee replacements

Athena: During my surgery, I had over 1" added to my leg to correct a lifelong length discrepancy. I have since had my legs measured and I am positive they are now equal lengths. However, I am still limping. I am working out without a trainer, doing resistance exercises, and walking a lot. How common is it for surgeons to add length, and do you have any suggestions (your personal opinion) on other actions I could take to get my walking "normal?”

Juan_Suarez_MD: We can correct leg length discrepancy with a total hip, but we have to make sure it is a true discrepancy and not an apparent one secondary to pelvic obliquity from a spine problem. Gait should improve with strengthening and sometimes with shoe lifts.

BartB52: What are the reasons for a partial hip replacement as opposed to a total hip replacement?

Juan_Suarez_MD: Partial hip replacements is usually reserved for hip fractures in elderly people, total hip provides more predictable pain relief.

AJ: After the hospital stay, do you go home or to a facility for further exercise?

Juan_Suarez_MD: If you have help at home, we prefer to discharge patients home. 80% of our hip replacements go home.

suemisir: Are the implants used in anterior hip replacement the same as with traditional hip replacement?

Juan_Suarez_MD: The ones we use are the same with excellent survivorship, but some surgeons use modified ones to facilitate the surgery. The problem is that the newer implants do not have a long tract record.

JonBGood: What are possible complications?

Juan_Suarez_MD: Potential complications are infection <1%, leg length discrepancy, DVT, fractures, dislocation.

SuzyQ: Will the implant set off metal detectors?

Juan_Suarez_MD: It can at times and travelers just get screened more frequently.

Cleveland_Clinic_Host: We have approximately 15 minutes left in the chat. We received a large amount of questions and we will continue to answer as many as possible. We apologize if we did not get to your question. If you have additional questions after the chat, please use our contact link clevelandclinic.org/webcontact to submit your questions.

SuzyQ: How long with a joint replacement last?

Juan_Suarez_MD: The available data reports >90% survivorship at 15-20 years, but activity level affects this.

SuzyQ: How long does the surgery take?

Juan_Suarez_MD: Direct anterior approach takes between 1- 1 1/2 hours.

Bond007: Why does my hip hurt from arthritis and when should I consider replacement surgery?

Juan_Suarez_MD: People should consider hip replacement when the pain starts affecting their quality of life and prevents them for doing their routine activities. People usually start becoming more sedentary.

AJ: Is this procedure done on obese women (270 lbs)?

Juan_Suarez_MD: It can be done, but risks and potential complications are higher in obese people.

Bond007: How long until I can drive again after surgery?

Juan_Suarez_MD: If it is the right leg, approximately 4 weeks; if it is the left leg, 1-2 weeks.

Cleveland_Clinic_Host: We are getting ready to close for today. A large number of questions were received and we apologize if we did not get to your question. We will try to answer as many questions as possible in these last few minutes. If you have additional questions, please go to clevelandclinic.org/health/livepersonchat to chat online with a health educator.

AJ: Do you go to the clinic for physical therapy after surgery?

Juan_Suarez_MD: You can, but the majority of patients prefer to have it at centers close to home

BartB52: Will I need help at home after surgery?

Juan_Suarez_MD: Yes, in the beginning you will need help at home until you become more independent. This typically lasts approximately 2 weeks.

Cleveland_Clinic_Host: I am sorry to say that our time with Dr. Juan Suarez is now over. Thank you again Dr. Suarez for taking the time to answer our questions today about Anterior Hip Replacements. If you are interested in scheduling an appointment with Dr. Suarez, or any one else from our Orthopaedic and Rheumatologic Institute in Florida, please call toll free 877.463.2010

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