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Hip-replacement technique allows speedier recovery
March 27, 2010

Tribune-Democrat

Johnstown, PA

March 21, 2010

By RANDY GRIFFITH

JOHNSTOWN - Bricklayer Michael Marshall of Stoystown was in constant pain, but held off his hip-replacement surgery until his slow season.

The precaution was almost unnecessary, thanks to the latest surgical advance offered at Memorial Medical Center in Johnstown.

"I was shoveling snow within five days," Marshall said.

"There is pretty much no pain. It's absolutely nothing."

Marshall, 41, was among the first patients to have hip replacement surgery using the frontal, or anterior, approach made possible by the latest addition to Memorial's arsenal of medical technology.

The Hana hip and knee arthroplasty table allows doctors to replace the hip joint with an artificial implant without cutting or disconnecting the surrounding muscles, orthopedic surgeon Dr. Brian E. Gunnlaugson said.

"There is much less postoperative scarring and weakness, which means faster recovery," Gunnlaugson said at Memorial. "The difference has been really quite dramatic."

Recovery time is typically from two to eight weeks with the anterior approach, compared with from two to four months with the traditional posterior and lateral approaches.

Both of the other procedures require cutting of muscles and leave larger scars.

Anterior-approach patients are able to resume daily activities as soon as they feel comfortable. With other techniques, patients are limited.

For instance, they are not permitted to bend their leg more than 90 degrees for several weeks.

"If everything goes as planned, generally speaking, there is no restriction on movement after the surgery," Gunnlaugson said.

The procedure lives up to its hype, patients Dalton Cable of Davidsville and Thomas Adams of Richland said.

"I came home on Friday, and I was going up and down the steps on Saturday," Cable said.

"I was never down."

"I had no pain whatsoever from the operation,"Adams said. "I had a cane for about a week. (Then) I was walking with no problem whatsoever."

All three patients said their hip replacements changed their lives.

"I was in excruciating pain every time Itook a step,"Adams said.

"It was like a knife going into my groin. It went away. Now Ifeel like I did 20 years ago. It's like I am whole again."

"I was dragging my leg for a long time," Marshall said. "It is so much better now."

Manufactured by Mizuho OSI of Union City, Calif., the Hana table looks more like a workout machine than an operating table. A patient's feet are secured in traction boots attached to adjustable rods that can be moved into virtually any position, Gunnlaugson said.

"This table allows a lot of motion and range of control,"Gunnlaugson said. "It gives you the ability to move the limb where you want it."

The anterior approach was first used in 1947 and has been popular in Europe for about

20 years. United States hospitals have been reluctant to adopt the alternative because of the cost of earlier versions of the specialized table, Gunn-laugson said.

Since the joint is closer to the front, the anterior approach incision is smaller and can often be closed without sutures or staples.

But primarily, it allows the surgeon to reach the joint by moving muscles and tendons aside without cutting.

Patients with "really bad osteoporosis" or "horrible deformities" in the joint may not qualify for the frontal approach.

In addition to hip-replacement surgery, the Hana table can be used for arthroscopic surgery and hip fracture surgery, Gunnlaugson said.

Gunnlaugson was the first area surgeon to complete training on the Hana table, and

Dr. Peter James Ridella also has qualified.