The Latest in Hip Surgery: One Patient's Success Story

Pain from Osteoarthritis
Day Acheson has always been active. Growing up, he played soccer and began rock climbing and mountaineering at age 20. In his late 30s, Day began to notice problems with his left hip, but continued his active lifestyle. At 40, he was diagnosed with osteoarthritis and made the decision to limit his activities in order to preserve use of his hip for as long as possible.

“I have worked in the health care field for 25 years and have helped many people rehabilitate after joint surgery, but I was always reluctant to consider surgery for myself,” says Day. “As an alternative therapist, I’ve used acupuncture, tai chi and yoga regularly, which have each contributed to prolonging the life of my hips. However, by my late 40s, I found I needed to give up many of my outdoor interests including ice skating, skiing and running, as they all became too painful.”

Considering Surgery
Day knew he needed to consider surgery in order to continue enjoying his favorite activities, but he didn’t want the procedure to limit his range of motion. He came to meet with Daniel Snyder, MD, Orthopaedic Surgeon and Assistant Director of the Center for Joint Reconstruction Surgery at Newton-Wellesley Hospital. Dr. Snyder introduced Day to minimally invasive hip replacement, called mini hip, as an option.

“The mini hip surgery uses a bone-preserving stem that is designed to fill the femoral neck as opposed to the femoral shaft; therefore, leaving more of the bone,” says Dr. Snyder. “The prosthesis we use allows the patient to have unrestricted activity and unlimited range of motion once they have recovered from surgery. We use mini hip as an alterative for patients who are not candidates for hip resurfacing. In Day’s case, his poor bone quality made this a better option.”

Mini Hip Procedure
After meeting with Dr. Snyder, Day decided to go ahead with the mini hip procedure since he bone quality was found to be too poor for resurfacing. During the surgery, Dr. Snyder used a direct-anterior approach, which is a technique that spreads the muscles instead of cutting them to gain access to the hip joint. A small incision of about seven centimeters is needed to prepare the joint and fit the prosthesis.

“The size and shape of the mini hip components makes the direct-anterior approach, which is the most soft tissue preserving, easier to do,” adds Dr. Snyder. “Since we are able to preserve more bone and not cut through the muscle, recovery for patients is faster. They usually stay one or two nights in the hospital and have crutches for less than a week then a cane for a few weeks.”

Day knew that Dr. Snyder has preferred the anterior approach for several years, which is why he chose him to do the surgery.

A Successful Surgery
“I knew that this method would help decrease my recovery time,” says Day. “I underwent the operation in September 2010 and was up walking the day of my surgery. During my hospital stay, I encountered a very positive attitude from staff as well as from all the patients happily walking around with their new joints. Although the rehab was hard work, I was thrilled with the results. Within a week I was down to one crutch, largely finished with the cane at four weeks and at five weeks I was cautiously resuming my favorite activities of rock climbing and motorcycling. By 12 weeks I felt as if no surgery had ever been done.”

Procedure on Second Hip
After having success with the surgery on his left hip, Day decided to have Dr. Snyder perform the procedure on his right hip, which was also seriously affected by osteoarthritis.

“My second hip surgery was planned from the outset as a mini hip due to the ease of recovery and athletic abilities that I experienced with my left hip,” says Day. “I also really liked having such a small incision. As it turned out, my recovery the second time was much quicker than the first. I returned to my normal activities within days instead of weeks.”

In the second week after his second operation, Day was walking without assistance and even biking to work. In a month, he was taking part in activities like mowing grass, outdoor rock climbing, canoeing, kayaking and running. He could even cross his legs for the first time in 15 years! Day attributes his success to being dedicated to his rehabilitation. He utilized his knowledge of muscle function, yoga and tai chi to undergo an intense rehab routine.

“Each morning I completed a stretch-exercise routine so that I could walk without a limp,” he adds. “In addition to the usual in-home and outpatient physical therapy, other important therapies incorporated in my rehab were acupuncture, active release muscle therapy, tai chi, Zen therapy and yoga sessions. I was back at work in the second week and after another six weeks my life was as busy as always.”

Rapid Recovery
Dr. Snyder explains that many patients who undergo the mini hip procedure have a rapid recovery from the surgery.
 
“I’ve had quite a few patients who experience this same speed of recovery,” says Dr. Snyder. “One advantage to Day’s recovery was his use of tai chi. I encourage all of my patients to take up this practice. I find it to be an excellent way to recover from hip problems since it isolates the hip muscles and strengthens them.”

After a few weeks, Day no longer needed to complete his morning rehab. He was cleared by outpatient physical therapy and began to include more of his favorite activities now that both hips were fully functioning.

“As the weeks progressed I continued to try my favorite activities and have been delighted that all are a joy again,” he says. “Both of my hip joints feel seamless and have returned to normal strength and flexibility. I find it easy to do powerful activities that I long ago gave up. I am pleased that my waiting brought me to this place and am grateful that the technology in hip replacements advanced to meet me when I needed it. I know that I have many years of enjoyment of life ahead of me.”

More Information
For more information about the Center for Joint Reconstruction Surgery at Newton-Wellesley Hospital, call CareFinder at 1-866-NWH-DOCS (694-3627) or visit www.nwh.org/jointcenter.

Daniel Snyder, MD, Assistant Director and Orthopaedic Surgeon
Center for Joint Reconstruction Surgery
Dr. Snyder is board certified in orthopaedic surgery. He received his medical degree from Tufts University School of Medicine and completed his residency at Bay State Medical Center and Tufts New England Medical Center. He completed his fellowship in pediatric orthopaedic surgery, focusing on the hip and pelvis, at Tufts New England Medical Center.

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