Join veteran broadcaster, Dan Kennedy, as he discusses the options available to those people who elect to undergo hip replacement surgery with Dr. Ryan Pokorney, ORA Orthopedics. Dr. Pokorney, a graduate of Augustana College (in Sioux Falls, SD) and the Kansas City University, specializes in joint replacement and revision surgery.
“Hip replacement surgery has gotten more prevalent in the population over the last decade,” explains Dr. Pokorney. “I think a lot of it has to do with patient activites and people wanting to live the fullest lives possible.”
Not all hip replacement procedures are the same. Dr. Pokorney walks Dan through the two most popular approaches: the posterior lateral approach and the direct anterior approach. According to Dr. Pokorney, the difference between the two is how the surgeon gets into the hip and what those approaches mean for the patient’s recovery.
Dr. Pokorney says he uses the anterior approach with most of his patients. “The incision is over the front of the hip. We go in through the front and don’t have to cut any muscle – we just split the muscle apart and replace the hip through that approach.”
The surgical team uses the same artificial joint in the replacement, the only thing that’s different is the way they get to the joint.
There are several advantages of this method over alternative approaches:
- No cutting through any muscle.
- No need for tendon repairs.
- No precautions during the beginning of the recovery process.
- Typically a faster recovery from the surgery.
Some of the studies comparing the various approaches for this kind of surgery show patients on whom the anterior approach was performed were further along in their recovery six weeks after surgery than others.
Use of the direct anterior approach for hip replacements has gained in popularity over the past 10 to 15 years and Dr. Pokorney is an advocate. “I am able to use X-ray so I can see where I’m putting the implants. I have good confidence when I leave the operating room that everything is in the appropriate position … and that the patient is going to have a good outcome.”
So what is the criteria to determine whether or not a patient is a good candidate for this approach?
Dr. Pokorney says that most patients are good candidates for a direct anterior approach – but those suffering from arthritis and those who are obese may have to consider alternative procedures. “I really try to get the best surgery to the right person. That’s what I’m looking for.”