Get a New Hip, Walk Home That Day
New Technique Turns Hip Replacement Surgery Into Outpatient Procedure
Two Incisions, Smaller Instruments
With traditional hip replacement surgery, a large incision cutting into tissue is needed for surgeons to see and maneuver the artificial hip joint into place. But with the new technique, the two small incisions allow the surgeon to view the bone area from two different angles, and the smaller instruments allow for maneuverability in the smaller space.
The new procedure also doesn't require surgeons to twist the leg as was traditionally done, so veins aren't "kinked" -- raising risk of a post-op blood clot, says Berger. "So far, not a single patient I operated on has developed a blood clot," he tells WebMD. "By comparison, 3 to 5 percent of those getting traditional hip replacement do."
Others are equally impressed with the Zimmer procedure, which is also being developed for knee replacement surgery.
"With the smaller instruments in the hands of specially trained surgeons, this offers numerous benefits to everyone," says Dana C. Mears, MD, PhD, of the University of Pittsburgh Medical Center. He also contributed to the newly published report and first conceived the concept of a two-incision surgical technique for hip replacement procedures about 10 years ago.
"The patient has a faster recovery and less pain, if any," Mears tells WebMD. "The hospital can release patients sooner. And since months of the rehabilitation process can cost $20,000 or more per patient, and many getting hip replacement surgery are on Medicare, by reducing that rehabilitation to days or eliminating it altogether, the health-care system can save billions of dollars a year."
Another first with the Zimmer procedure: X-rays are used during, rather than following, hip replacement surgery to ensure the artificial joint is properly aligned and installed.
While Berger and Mears are among the first surgeons to do the Zimmer procedure, it's now performed by some 300 orthopaedic surgeons in the U.S., who receive special training by Zimmer Inc. and must be specially licensed to use the smaller instruments.
Not for Everyone
"This procedure is technically more demanding for the surgeon, but patients have less pain and can get back to their normal functions and everyday activities much sooner," says surgeon Donald M. Kastenbaum, MD, assistant chairman of orthopaedic surgery at Beth Israel Medical Center in New York City. "I don't want to call it better than traditional hip replacement surgery, but it's certainly a better procedure for certain patients. Anytime a patient can return to work or their regular activities sooner, it's a good thing."
Generally, the procedure is not recommended for severely overweight or overly muscular patients, says Kastenbaum, who has performed the Zimmer hip replacement surgery technique since August but was not involved in the published study.
"I did my first Zimmer procedure two weeks ago and I'm thrilled with it," says Michael C. Racklewicz, MD, an orthopaedic surgeon in Wilkes-Barre, Pa. "For me, the biggest advantage is not only that there's less pain involved for the patient, but there is less tissue trauma. My patient was able to walk with a cane immediately following the surgery, and with no limp at all.
"It will be years before we really know the long-term outcomes," Racklewicz tells WebMD. "But from what I know and have personally seen so far, this new method is really something."