The Advancement of Hip Replacement Surgery Through my 30-Year-Medical-Career

Hip replacement surgery has changed dramatically during my orthopedic career. There are a variety of conditions that can lead to the need for total hip arthroplasty. Among these conditions include avascular necrosis of the femoral head, which is a disruption of the circulation to the femoral head. Trauma and fractures can lead to the need for a total hip arthroplasty, but by far the most common condition is degenerative arthritis. Symptoms of hip arthritis typically include severe pain in the groin upon weightbearing.

Years ago, the typical hip replacement was performed through a posterior approach. Although a good procedure, there was a relatively high hip dislocation rate and a relatively high component malpositioning rate due to the posterior approach.

Approximately 12 years ago, we transitioned to the anterior approach for total hip arthroplasty. Although the transition was somewhat of a difficult learning curve, it definitely was worth the effort. The surgery is done with the patient supine using x-ray guidance. Therefore, component placement and limb length is known perfectly at the time of surgery. It is a muscle-splitting approach; therefore, the postoperative pain is much improved, as is early function. Many patients can go home the day of surgery, which is truly amazing. The dislocation rate is low.

It has been very gratifying to participate in these advancements during my career.