As Tommie Sikes of Savannah prepared for hip replacement surgery last October, he knew what to expect. He’d already had his right hip replaced five years earlier and now it was time to replace the left one.

He knew that the results would be worthwhile—the aching pain in his hip would be gone and he’d be more mobile. But he also knew that the recovery would be slow. After his first hip replacement, Sikes was out of his routine for four months. This time, he agreed to undergo a relatively new procedure known as minimally invasive hip replacement. It made a big difference.

“After it was over, it didn’t hurt as badly getting up and walking for the first time. I healed a lot faster. Less than three months after surgery, I was back at the gym,” says Sikes.

The Anterior Approach Minimally invasive hip replacement surgery is also called “anterior approach” hip replacement because of the way surgeons access the hip. With traditional or “posterior approach” hip replacement, a patient is placed on his side. The surgeon accesses the hip joint by cutting through skin, tissue and a muscle that helps the patient walk. It requires an incision across the back of the hip that can be up to 12 inches long.

With the anterior approach, the patient lies on his back. The surgeon makes a three- or four-inch incision across the front of the hip and accesses the joint by going between the muscles in the leg, rather than cutting through them. The surgeon looks at live X-ray images called fluoroscopy to guide him through the procedure. Because no muscles or tendons are cut, the newer anterior approach leads to a much quicker recovery.

“Patients are up the next day after surgery and walking with a walker. They go home in two to three days. We allow them to bear weight as they can tolerate it. They can go to full weight bearing in as quick as two to three weeks,” says Edward Whelan, III, M.D., an orthopedic surgeon at Southeastern Orthopedic Center in Savannah. Whelan also adds that after surgery the anterior approach has less risk of dislocation.

Although the anterior approach is growing in popularity, it is not yet widely used in Savannah. This is because surgeons must be specially trained in the procedure, and hospitals must invest in special equipment for it. The StepOne joint replacement program at Memorial Health University Medical Center (MHUMC) offers anterior approach surgery. An operating room at MHUMC is outfitted with a table called the PROfx™ that was designed by orthopedic surgeon Joel Matta, M.D., at Good Samaritan Hospital in Los Angeles. The PROfx looks like a cross between a surgical table and cross-country ski simulators that you might find at the gym.

“The table allows us to move one leg under the other and put the femur in position. We use an X-ray to see what we’re doing and to make sure we’re pointing everything in the right direction and sizing the prosthesis correctly,” says Whelan.

Worth the Wait Phillip Macri traveled more than 300 miles from his home in Melbourne Beach, Fla., to Savannah to have anterior approach hip replacement surgery with Whelan. Macri is retired from the Air Force and stays active fishing and working in his yard. When he found out he needed hip replacement surgery, he researched his options carefully and knew he wanted the anterior approach. He was very happy with the results.

“It was exactly what I expected. I had a very good recovery and no ill effects,” says Macri. Since having surgery, he no longer has pain when he’s trying to sleep or when he walks, and he’s back to his normal, active lifestyle.

Sikes is also on the go again with his new hip. After having both anterior and posterior surgery, he says there’s no question about it, he’d never go back to doing it the old way.

“It’s fantastic that they’ve moved up so much in medicine. They’ve come a long way,” says Sikes.

The minimally invasive anterior approach is expected to grow in popularity in coming years, as more patients demand it and more surgeons learn how to do it. It’s the latest way to help people stay active throughout their golden years.