Monthly Archives: February 2014

New Hip Replacement Technique Offers Faster Recovery With Less Pain

Orthopedic Surgery

A new hip replacement strategy, an anterior approach technique, allows the patient to experience less pain, have a quicker recovery, and improved mobility.


Dr. Harold Rees described this technique after performing the surgery on one of his patients, Sean Toohey, and witnessing the amazing results.


The day after Toohey underwent a total hip replacement surgery, he was able to walk halfway up a flight of stairs at the hospital. Later, in the afternoon, he made the quick transition from using a walker to crutches to a cane.


The patient was able to start working again just 15 days after his procedure, without having to struggle with his seriously arthritic hip that had been bone-on-bone prior to surgery.


“My brother, who has had both hips replaced, was very jealous of my outcome,” Toohey said. Most patients who previously underwent surgery with other techniques will probably feel the same way, considering a report from 2009 stated that the recovery time for total hip replacement surgery is between 1 to 6 months.


Dr. Rees now uses this anterior approach in all primary hip replacement surgeries that he is responsible for at Loyla’s main campus in Maywood and at Loyola’s Gottlieb Memorial Hospital in Melrose Park after watching Toohey quickly recover with less pain and better mobility, compared to patients who underwent the posterior approach.


The technique is called the anterior approach because the surgery is performed through the front of the hip, instead of the back (posterior). In order to gain access to the hip joint, the posterior approach cuts through muscles and tendons, while the anterior technique goes between them. The incision made is about 2 and a half inches long.


Since the muscles and tendons are not cut, there is less pain while the patient recovers because they are not forced to sit on the incisions. With this technique, the patient also has a reduced risk of dislocating the new hip.


The majority of hip replacement surgeries are done using other techniques because many hospitals do not yet offer the anterior approach. However, people are becoming increasingly aware of its benefits. Within the next 5 to 10 years, Dr. Rees believes that it will become the primary technique.


Although some doctors may question the approach because it is more technically challenging, there are specially-designed operating tables that make the technique easier. The surgeons are able to accurately control the angle, position, traction and rotation of the hip and leg.


Loyola has two of these tables: the PROfx and hana. Hana can also be found at Gottlieb Memorial Hospital.


Written by Sarah Glynn

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Complex elbow fractures and further complications a greater risk for obese children

Orthopedic SurgeryPediatric obesity is currently an epidemic, with the prevalence having quadruped over the last 25 years. Children diagnosed with obesity can be at risk for various long-term health issues and may be putting their musculoskeletal system at risk. According to new research in the February issue of the Journal of Bone and Joint Surgery(JBJS), obese children who sustain a supracondylar humeral (above the elbow) fracture can be expected to have more complex fractures and experience more postoperative complications than children of a normal weight.

“These findings show that children diagnosed with obesity are more likely to sustain these complex fractures from something as simple as falling onto an outstretched hand while standing, and these types of falls are quite common,” said author Michelle S. Caird, MD, assistant professor in the department of orthopaedic surgery at the University of Michigan. “Our research aims to remind parents that there are many serious risks to childhood obesity, including fractures and surgical complications. It’s important to ensure that children get the proper amount of exercise and to build their bone banks early in life to a strong and healthy frame.”

Specific Study Details

  • More than 350 patients ranging in age from 2 to 11 years old who had undergone operative treatment for supracondylar humeral fractures were included in the study.

  • Patient records were reviewed for demographic data, body mass index (BMI) percentile, and injury data.

  • Forty-one children were underweight (BMI <5th percentile), 182 were normal weight (BMI in the 5th to 85th percentile), 63 were overweight (BMI in the >85th percentile), and 68 were obese (BMI in the >95th percentile).

  • The study included 149 patients with type-2 fractures (a break through part of the bone at the growth plate and crack through the bone shaft), 11 of whom were diagnosed with obesity; and 205 patients with type-3 fractures, 57 of whom were diagnosed with obesity.

  • Complex fractures were defined as Type-3 fractures (completely displaced), fractures with multiple fracture lines, open fractures where the bone is exposed through the skin, and multiple fractures in the same arm.

  • Using logistic regression, obesity was associated with complex fractures and more complications.

Key Study Finding

  • This is the first study to assess the implications of obesity on this type of a fracture and it validates the public health efforts in combating childhood obesity.

Similar studies also have shown that overweight children who break their femur (thigh bone) are more likely to need bigger surgery and have more complications than children who are not overweight.

“Future research needs to focus on modifying obesity in kids to test if that changes fracture complexity and complication profiles,” Caird added. “We also should focus on research to improve childhood bone health overall whether this is more calcium, vitamin D, exercise or a combination of such measures to help further build and maintain a skeleton that can structurally and metabolically support the person through their lifetime.”

The American Academy of Orthopaedic Surgeons (AAOS) has more information about Fitness for Kids and encourages people of all ages to Get Up! Get Out! and Get Moving!

The AAOS provides treatment guidelines based on the latest research. These are recommendations only and may not apply to each and every individual case.

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