{"id":15048,"date":"2018-03-21T10:40:03","date_gmt":"2018-03-21T16:40:03","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=15048"},"modified":"2024-12-24T09:26:56","modified_gmt":"2024-12-24T16:26:56","slug":"anterior-approach-to-total-hip-replacement","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/anterior-approach-to-total-hip-replacement\/","title":{"rendered":"Hip pain hope: The anterior approach to total hip replacement"},"content":{"rendered":"
<\/div>

Brian Ashley knew pain. The arthritis in his hips started almost 10 years ago, in his late 40s, and it only grew worse over the years. In the past three years, that pain started affecting his performance at work, as well as his sleep and overall health.<\/p>\n

\u201cI enjoyed hiking years ago, but that was curbed by this condition,\u201d Ashley said. \u201cI still liked to do fun mountain things, but I\u2019d do a drive instead of a hike. I really became less active, so much that if it wasn\u2019t something I had to do for work, I didn\u2019t want to do it.\u201d<\/p>\n

Ashley\u2019s work performance suffered to the point that after many years in manufacturing, he was let go from his supervisor position. It was at that time that he and his family decided something needed to be done<\/a>.<\/p>\n

\"\"
Brian Ashley, with two new hips, proudly helps out at a holiday craft show in Loveland. Now that his pain is gone, he\u0092s able to volunteer more with his church and with a Longmont artist co-op, which hosted the event.<\/figcaption><\/figure>\n

\u201cI was unemployed and needed to make a change,\u201d he said.<\/p>\n

With help from his family physician, Dr. Robert Nouhan<\/a>, Ashley connected with UCHealth Orthopedic<\/a> Surgeon Dr. Gavin Bishop.<\/p>\n

Physical therapy first<\/h2>\n

Bishop immediately started Ashley in physical therapy.<\/p>\n

\u201cWhen I first met Brian (Ashley), he was having a hard time getting out of a chair and had a lot of pain with walking,\u201d Bishop said. \u201cPeople can become less active because of their pain, which in turn makes them gain weight, which in turn contributes to their pain.\u201d<\/p>\n

Bishop said he likes to see if patients can improve through physical therapy before deciding on surgery. In Ashley\u2019s case, there was little doubt that his left hip would benefit from surgery. Physical therapy helps strengthen the body for surgery, allowing recovery to be more successful.<\/p>\n

\u201cI was around 260 pounds, which is very heavy for me, so we talked about me losing weight, and I did shed a few pounds (before) surgery,\u201d Ashley said.<\/p>\n

Anterior approach to total hip replacement<\/h2>\n

After more than a month of physical therapy, Bishop performed a direct anterior approach to total hip replacement on Ashley\u2019s left hip.<\/p>\n

A total hip replacement replaces the hip joint with an artificial one. Unlike a traditional replacement, which is performed from the back or the side of the hip and requires muscle to be detached and then reattached, the direct anterior approach involves a surgeon accessing from the front of the hip and going between muscle, Bishop said.<\/p>\n

\u201cI like this (anterior) approach because you don\u2019t have to detach any muscle and it results in a faster recovery and better outcomes\u201d he said.<\/p>\n

Although the anterior approach has been available for a few decades, Bishop said, it is enhanced with a special table and specific instruments and therefore many orthopedic surgeons don\u2019t offer the option.<\/p>\n

The first hip<\/h2>\n

With the first hip surgery behind him, Ashley returned to rehab, where he continued to do well and increase his physical activity.<\/p>\n

\u201cAfter surgery, the tissue needs to heal so there is some discomfort, but it\u2019s usually less with the anterior approach\u201d, Bishop said.<\/p>\n

Ashley said he was noticeably stronger within six weeks of the surgery and was out walking his dogs a couple of miles a day for continued therapy. He even felt well enough to make a road trip to upstate New York.<\/p>\n

\u201cI\u2019d had problems for so many years with that hip, but now it was so much stronger and the pain was gone,\u201d he said. \u201cBut it was an interesting experience because the other hip, which had always been the stronger one, was now the weaker one.\u201d<\/p>\n

The second hip<\/h2>\n

After his excursion to New York, Ashley felt it was time to explore surgery on his right hip.<\/p>\n

\u201cI could have waited a few more years, but since I had the time I wanted to do it now,\u201d he said.<\/p>\n

Bishop took the same surgical approach.<\/p>\n

\u201cThat hip went even better,\u201d Ashley said.<\/p>\n

Ashley still participated in inpatient rehab for a week, and he also signed up for at-home physical and occupational therapy.<\/p>\n

Again, within six weeks, Ashley was feeling better and taking on more miles of walking.<\/p>\n

\u201cAfter the second surgery, I had this memory of being a kid in high school and walking down the halls,\u201d Ashley recalled enthusiastically. \u201cI was walking like that again, and it was just striking to me because it had been such a long time.\u201d<\/p>\n

A new beginning to the rest of life<\/h2>\n

On a recent business trip to Chicago, Ashley had yet another positive experience: sitting in an airline seat without pain.<\/p>\n

\u201cThe fact that I could be more active has impacted the rest of my life,\u201d he said. \u201cI\u2019ve lost about 40 to 50 pounds through this whole thing, and am back to my normal walking gait, not hunched over trying to avoid pain.\u201d<\/p>\n

Because of Ashley\u2019s weight loss, he was able to stop taking his high blood pressure medications, and though he still has Type 2 diabetes, he is now off insulin. Ashley has also stopped taking Wellbutrin.<\/p>\n

\u201cI don\u2019t take anything for anxiety anymore,\u201d he said. \u201cAnd we are doing more activities. I\u2019m volunteering through the church and an artists\u2019 coalition.<\/p>\n

\u201cI went into this process with a bit of trepidation because it was the first surgery I\u2019d ever had in my life,\u201d Ashley said. \u201cBut it just went so well. I\u2019ve had no discomfort through the process. I don\u2019t even think I took pain medication after the first day. Everyone took very good care of me. It\u2019s something that I shouldn\u2019t have waited years for. My life is definitely better for it.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Brian Ashley knew pain. The arthritis in his hips started almost 10 years ago, in his late 40s, and it only grew worse over the years. In the past three years, that pain started affecting his performance at work, as well as his sleep and overall health. \u201cI enjoyed hiking years ago, but that was […]<\/p>\n","protected":false},"author":2164,"featured_media":15050,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[3063,183],"class_list":["post-15048","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-orthopedic-joint-replacement-preservation","tag-orthopedics"],"acf":[],"yoast_head":"\nThe anterior approach to total hip replacement - 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