In March, Dr. Michael Bollinger was featured in a Washington Post article* discussing the benefits of the anterior approach method used for replacing hips.  The article mentioned that the number of Americans having total hip replacements over the past two decades has risen to more than 300,000 per year (more than doubling the figures from 20 years ago), and that patients are eventually able to walk again without pain or the aid of a cane, but only after a lengthy, rigorous and sometimes painful recovery and rehabilitation period.

From the article:

The surgery is extensive: As its name suggests, it involves removing the joint — the damaged bone and cartilage — and replacing it with prosthetic parts made of metal, plastic or ceramics. Typically, surgeons enter the joint from the rear, which requires cutting through muscle and cartilage. But with a relatively new procedure, surgeons enter from the front and only stretch the muscles aside, avoiding the cutting and minimizing pain and recovery time. According to those who use this anterior technique, the benefits are substantial.

The article goes on to say:
Anthony Unger, medical director at the Institute of Bone and Joint Health at Sibley Memorial Hospital and a clinical professor of orthopedic surgery at George Washington University Hospital, says the anterior approach is “truly minimally invasive.” Unger, who has done about 4,000 hip replacements over 26 years and has used the anterior technique for the past eight years, says “patients have better overall functionality, can sleep on their sides and be confident the new hip won’t dislocate.”

But, as with many transitions in medical techniques, some surgeons have been reluctant to change. Although agencies and hospitals don’t track hip replacements by the type of procedure used, Unger says that, based on statistics from the American Association of Hip and Knee Surgeons, only 20 percent of its members choose the anterior approach.

Mizuho OSI  hana® table

Mizuho OSI hana® table

Dr. Bollinger, an early adopter of this approach and one of the first surgeons in the North Bay to adopt it, was also quoted in the article:

Others surgeons who prefer the anterior procedure say it preserves more of the normal anatomy, which also means fewer medications and shorter hospital stays. Michael Bollinger, who operates at Palm Drive Hospital in Sebastopol, Calif., switched methods a few years ago.

With the anterior approach, Bollinger says, “we can take X-rays during the operation, to see if the new hip is placed correctly and adjust it, when necessary.” Many surgeons use a special operating table that makes this possible.

Although surgeons can also take X-rays during the posterior procedure, it is much more difficult, and they wait until patients are in the recovery room, where, Bollinger says, “there’s not much that can be done.” He explains that while the body “tolerates an imperfect alignment pretty well, if a new hip gets dislocated, it’s often because it’s not in perfectly.”

Dr. Bollinger has been using the anterior approach since 2006 and is an expert in this technique.  He continues to use it for all of his hip replacement patients.

If you have questions about this procedure, or would like to schedule an appointment to meet with Dr. Bollinger, please contact our office today.

*Note, by clicking on this link you will leave our website and be taken to the Washington Post website.