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New Hip Replacement Procedure Results in Faster Recovery

December 18 2014

On Thursday, December 11, a surgical team at CHI Health St. Elizabeth was the first in the state of Nebraska to perform a same day, outpatient, total hip replacement without an overnight stay. The patient spent approximately 12 hours in the hospital from arrival to discharge for what has traditionally required three nights in the hospital.

For the procedure, the patient underwent a total hip arthroplasty with a spinal anesthetic through a direct anterior approach. With the direct anterior approach, the incision is made in the front of the hip as opposed to the side or back. This avoids detaching muscles or tendons from the hip, which can result in a more rapid recovery and a significant reduction in postoperative pain.

In addition, the patient had a long-acting local anesthetic injection at the time of surgery and nearly immediate physical and occupational therapy after the procedure. The combination of these procedures coupled with the patient's motivation allowed for a same-day dismissal.

Traditional hip replacement can involve muscular, ligament and tendon detachment, which can require several months to heal. After traditional total hip replacement surgery, patients are advised not to cross their legs, bend the hip more than a right angle and are advised to use a pillow between legs when sleeping to minimize the risk of dislocations.

“While outpatient hip and knee replacements have been performed to an extent in other metropolitan areas, this is the first time it has been performed in the Lincoln medical community and the state,” says James Gallentine, MD, orthopedic surgeon. “The direct anterior approach can be advantageous, because patients appear to have a faster recovery, no limitations with hip movement, and increased stability with fewer dislocations.

Advances in pain management and surgical techniques have made an outpatient total hip replacement possible. "We are very proud of the entire surgical team. The success of an outpatient anterior hip replacement involves everyone – starting with patient education to the surgical team and post-operative care,” says Kim Moore, president, CHI Health St. Elizabeth.

Dr. Gallentine adds, “this procedure is a total team approach. Everyone – the patient, their family, the anesthesiologist, surgical team, nursing staff and therapists – has to be on the same page. Patients really benefit from total hip replacements. Hopefully, this advancement makes the entire process easier for all involved. Ultimately, total hip replacements help people return to a lifestyle and other activities they are passionate about.”