Pasco News

New approach to hip replacement surgery begins at Trinity hospital

TRINITY — A relatively new approach in hip replacement surgery allows surgeons to make a small incision through the front of the thigh and minimizes the pain and recovery time from hip replacement surgery.

The first “anterior approach” hip replacement procedure at the Medical Center of Trinity was performed by Stephen Hanff, an orthopedic surgeon with Florida Joint Care Institute in Trinity.

The anterior approach surgical procedure minimizes the pain and time from surgery to recovery. It allows the surgeon to reach the hip joint from the front of the hip as opposed to the side or back approach. This allows for a smaller incision — four to five inches as opposed to 10 to 12 inches — and a faster recovery time.

With other approaches, a patient may spend three to four days in the hospital post-surgery and need the use of a cane or walker for the next two to four weeks. This approach allows most patients to leave the hospital after two days and have half the recovery time.

Hip replacement surgery, also called total hip arthroplasty, is when diseased hip joint is replaced with an artificial joint, called a prosthesis. Hip prostheses consist of a ball component, made of metal or ceramic, and a socket, which has an insert or liner made of plastic, ceramic or metal.

The implants used in hip replacement are biocompatible, meaning they’re designed to be accepted by the body, and they’re made to resist corrosion, degradation and wear, according to the Mayo Clinic.

Hip replacement is typically used for people with hip joint damage from arthritis or an injury. Followed by rehabilitation, hip replacement can relieve pain and restore range of motion and function of the hip joint.

With the anterior approach, the hip can be replaced without detachment of muscle from the pelvis or femur during surgery. The surgeon can work through the natural interval between the muscles. The most important muscles for hip function, the gluteal muscles that attach to the pelvis and femur, are left undisturbed and therefore do not require a healing process.

The hip replacement surgery is performed on a special table, called a “Hana Table,” designed specifically for this surgical approach.

Hip replacement surgery has been a common practice since the 60s and 70s, Hanff said, and the anterior approach has been used for the last ten years or so with use increasing more dramatically in the past five years as evidence of successful surgeries has surfaced.

“The majority of surgeries still use [the side or back approach] and the success rate is still so good,” Hanff said. “To change is to have a paradigm shift in the industry. It’s slow to embrace.”

He added: “It’s not that the old way is bad. I don’t slight other physicians for doing it. Physicians are reluctant to jump to something different all the time because we like to see evidence supporting the new technology. It takes a leap of faith and you don’t want to do a disservice to your patients.”

Risks for the surgery are about the same for any other approach to hip replacement surgery, Hanff said. Blood clots, fractures, infection and change in leg length are some of the risks. The only one unique to anterior approach. however, is thigh numbness that can last for weeks or months.

The Hana Table, which allows patients to lie on their back facing the ceiling, does make it easier for X-rays to be taken post-surgery to ensure that the new prosthetic is correctly aligned with the other leg and hip, so change in leg length is less of a concern.

Hanff has performed more than 1,000 hip replacement surgeries, with about 30 so far using the anterior approach. He performs more than 100 hip replacement surgeries a year.

For more information call (727) 834-5630 or visit

(727) 815-1067

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