More and more people of all ages are turning to biking, walking, running, and working out
at the gym in an effort to live healthier longer lives. As a result, we now have this
middle-aged population with a lot of wear and tear on their bodies who are now finding
it necessary to have joint replacement surgeries earlier in life. Access Health caught up with
Hip and Knee Specialist, Dr. Jimmy Chow to learn about one of the latest surgical approaches
helping to put the skip back in our step. My name is Chris Appleton. I’m 42-years-old,
and my hip actually started hurting about two and a half years ago. I went to college
at Pittsburgh State, played college football, won a National Championship, probably part
of the reason why I needed new hips. My name is Carol Allis. I’m 56-years-old.
Probably about 6 years ago, I noticed just a decrease in mobility. Two years ago it just
progressively got worse. My walking was diminishing, my ability to get up and down off the floor,
and then traveling for work really became more complicated.
We know that over the past decade the need for joint replacement in the United States
has more than doubled. And so we’re treating younger patients earlier with arthritis in
their hips so that they don’t have to live the rest of their life with arthritis in their
hips until they get “old enough.” A lot of pain, discomfort, difficulty sleeping,
could not stand for long periods of time, couldn’t sit for long periods of time, couldn’t
walk. It was very uncomfortable, very debilitating. Everyday things that people, I, took for granted,
people take for granted: tying your shoes, putting on your socks, clipping your toenails,
bending down and having to go to the bottom shelf of the grocery store, getting in and
out of cars, climbing two steps, even getting off a plane for me was one of the most horrible
feelings in the world because you have typically you get off a plane and I fly an awful lot
— every week. And you get off the plane and you have to go up the up ramp, and it was
the hardest thing for me to do was to go up that up ramp. It would take me holding onto
the railing and pulling myself up. If you think about what pain is, a subjective
form of pain measurement is probably the most accurate because it’s really how you feel
that matters. You have patients where the arthritis is so horrible it’s kind of like
chewing on a very bad cavity for a long period of time.
You think it’s your sciatic nerve, you’re getting older. It’s that curve of 45 – 50
that we all get. Originally diagnosed as lack of flexibility
in my hip, and then it was diagnosed as a sciatic nerve problem.
You know, I tried the chiropractor, I tried physical therapy, I tried injections. They
were all very short lived. Oftentimes, physical therapy, swimming created more pain at the
end of the day than it did actually relieving it. My primary care doctor did the x-ray and
noticed that the x-ray had some deformity, and he referred me to Dr. Chow. And then Dr.
Chow diagnosed that I needed a new hip. I had 0% cartilage in my left hip and 25%
– 30% cartilage in my right hip, and my Specialist recommended that at that point I start looking
at surgical options. I definitely wanted to seek the best surgeon and try to understand
the various procedures that are out there. The first time that a patient gets offered
a hip replacement, their answer is often “No. I’m not ready for that.” It’s kind of a hard
pill to swallow, and it’s considered a major orthopedic surgery. But once you get over
that initial shock and you start talking to other surgeons and you start to get a consensus
about what’s going on around your hip, then it’s much easier to digest in terms of that.
Most of the surgical approaches in hip replacement are options that involve some kind of trauma
to the surrounding muscles and tissues. This can lead to long recovery periods as well
as missed time at work. I’m only in my mid-50s, and I still wanted
to travel and do everything I had been doing. And so that’s when I made my final decision
to use Dr. Chow’s new procedure. Now, hip replacement surgery, historically,
removes a ball of the hip. That’s why it’s called hip replacement. So, the ball of the
hip is what’s diseased and becomes kind of flattened or misshapen, and it kind of grinds
on the hip. And so we replace that ball and we put a liner in the socket to protect the
pelvis. One of the earliest ways to do hip surgery were all based on keeping the hip
in kind of a straight position, and by flexing the hip into more of a fetal position all
the muscles become relaxed. The main sutures we cut are going to be skin and then fat.
Our average was 6 and 8 centimeters. And then we split the muscle without cutting the muscles.
I actually use my finger to split it. And we’re actually using the normal spaces between
muscles. And so we’re actually placing retractors into positions in between the muscles. We
exposed the envelope of the hip. We make an in-line incision, which is just a straight
line, and open it up like that. And then that capsule becomes a reverse tent for our entire
procedure. We’re not ripping anything around. We’re not putting stress on the hip that we
can avoid. We’re really trying to be very gentle with everything. The SuperPath is a
convertible surgery. It’s a surgery that starts off as SuperPath, but you can easily convert
it to the Work Horse incision that you’re used to, and worst case scenario, you don’t
get SuperPath you get a traditional hip replacement. Contrary to traditional surgery where you
cut everything and then you know, “Oh, it’s going to take you about 3 months or 2 months
to heal that part of it.” We’re not doing that. What I tell my patients, and this is
what I see as an average in my office, most of our patients are up and walking within
hours of the surgery. But the nice thing about this is it puts the healing process back into
the hands of the patient because they’re no longer sitting in bed with a bell in their
hand in order to get them to heal enough that they can go and, say, put on their own clothes
or shower themselves, or make themselves a sandwich. They should be able to do that pretty
much right away after the surgery. I went into surgery December 10th of 2014.
Within three hours of being in my room, I was up and walking on my new hip. I literally
woke up and they got me up and I was walking down the hall and I was home the next day
and I was back to work in 13 days. The day after surgery, I walked a mile on
both hips. So after both surgeries the day after and it’s encouraged that you get that
activity going as soon as possible. And I was able to walk up and down steps the day
after surgery. What we discovered is that most of the problems
that patients experience after a SuperPath hip replacement don’t necessarily come from
the surgery. They actually come from the immediate change in their activity level. So, they go
from basically not doing much to all of a sudden being able to do quite a bit, and they
can move quite a bit better, too. So, we know that the hip replacement is going to work
fine. But now what we want to do is we want to prepare that patient for their new on-set
activity load. And that’s what almost all of the physical therapy is based on. It’s
quite exciting. I have done workouts, I have done some light
jogging/fast walking in the last nine months, and I’ve done a lot of swimming this summer
and absolutely pain free. It’s been a Godsend for me. I mean, the surgery
enabled me to get back to a lifestyle that someone at 42-years-old that really is healthy
everywhere else should lead. (music).