Hip & Knee Surgery
Who is vulnerable to hip fractures?
Hip fractures are caused by a variety of factors that weaken bone and, often, are caused by the impact from a fall. The common characteristics of persons who are vulnerable to hip fractures are:
- Age: The rate increases for people 65 and older.
- Gender: Women have two to three times as many hip fractures as men.
- Heredity: A family history of fractures in later life, particularly in Caucasians and Asians
- Nutrition: A low calcium dietary intake or reduced ability to absorb calcium.
- Personal habits: Smoking or excessive alcohol use.
- Physical impairments: Physical frailty, arthritis, unsteady balance, and poor eyesight.
- Mental impairments: Senility, dementia, e.g., Alzheimer's disease. Weakness or dizziness from side effects of medication.
Direct Anterior Approach
Dr. Laster is among a small but growing number of surgeons nationwide who are now offering patients a new surgical approach that may speed recovery and decrease postoperative pain for hip replacement procedures.
Called the Direct Anterior or "front" approach, this new technique involves making an incision on the front of the hip rather than the side or back as traditionally done. As a result, Dr. Laster can follow the natural spaces between the hip joint's muscles and tendons, resulting in less damage to these soft tissues.
Rehabilitation is often accelerated because the hip is replaced without detachment of muscle from the pelvis or femur. Additionally, because the gluteal muscles and other natural stabilizers are left undisturbed, it is possible for patients to regain mobility more quickly and ultimately go home from the hospital sooner. In fact, the normal postoperative restriction of limiting hip movement to 60 or 90 degrees does not apply to those patients who have undergone the Direct Anterior Approach.
Following the Anterior Approach, patients may be allowed to bend their hip freely, allowing them to resume their normal daily activities such as sitting or getting into or out of a car without restriction.
Other key advantages of the Direct Anterior Approach include:
- Hospital stay may be reduced from 3 - 10 days to 2 - 4 days
- Smaller surgical scar
- Reduced risk of post-surgical dislocation of the hip implant
Ten questions patients should ask their surgeon
- What are the major and/or most frequent complications of surgery?
- Is the skill and experience of the orthopaedic surgeon more important than the device or procedure?
- Can you give me any information on outcomes and complication rates?
- If I do not have surgery, what is the risk?
- Which device would you choose if you needed a total joint replacement now, and why?
- How much pain can I expect, and how will it be managed in the hospital and after I go home?
- How long will the device last, and what can I do to make it last as long as possible?
- What are the pros and cons of minimally invasive (mini-incision) surgery? Does it really make a meaningful difference in the result, or does it pose unnecessary risks?
- Should I believe what I see on TV or read in the ads in magazines?
- What will I be able to do/not do after my total joint replacement?