FORT WAYNE, Ind. (WANE) - The Orthopaedic Hospital of Lutheran Health Network is one of the first locations in the state to do a less invasive method of total hip replacement surgery. The new procedure, called the anterior approach, can cut patient recovery time in half.

"I've seen amazing results in patients," Dr. Steven Fisher of Fort Wayne Orthopaedics said.

Fisher is one of only a few surgeons in Indiana doing the anterior approach. He started doing the surgery in May 2008. Since then he has performed 38 hip replacement surgeries using that method. That's 11.9 percent of the 319 hip replacements done at the Orthopaedic Hospital in the same time period.

"It's more difficult to do it [with the anterior approach], but the patients have less pain and recovery is much faster," Fisher said.

With the anterior approach, the surgeon makes an incision on the front side of the leg right above the hip. The traditional method makes a cut on the side or back of the leg.

Because the hip is much closer to the front of the leg, the surgeon doesn't have to cut through muscle to get to the hip. That means the incision is smaller with the anterior approach.

"With the traditional way you have to divide or split muscles, and that causes trauma and takes time to heal. Now you can dissect between the muscles so there's less muscle injury," Fisher said.

There is a special PROfx table designed for the surgery. The patient's feet go into boots and the surgeon can rotate the legs to dislocate the hip and put it back in the socket more easily. The table costs about $230,000.

"We normally have patients lying on their side, but now they are lying on their backs, so I'm almost upside down when I'm doing it," Fisher said.

That change in orientation, along with a smaller incision, make the anterior approach more difficult for the surgeon. X-rays during surgery also help the surgeon see.

There is still risk of complications with the anterior approach, but Fisher said they are no different then the traditional method. Insurance does cover the anterior approach, but not every patient is a good candidate. People who are very overweight or who have a lot of hip damage are not ideal.

"The six months to a year results are the same. The real difference is in the first few weeks," Fisher said.

Norm Governale knows that firsthand. He had his left hip replaced 11 years ago with the traditional method. Then in January he had his right hip replaced with the anterior approach.

"In 6 weeks with the old way I was where I was in 2 weeks with this one," Governale said. "The recovery was so much easier. It was a piece of cake."

Dr. Carlos Espinosa also had a quick recovery from his hip replacement with the anterior approach. He was a general surgeon and had performed a partial hip replacement, so he knew how long the recovery can be.

But Espinosa had his surgery a month ago and is moving like nothing had happened.

"The day after surgery I was walking without a walker and the head nurse almost fainted. So, to prevent her from having a coronary, I started using a walker. I went home on the second day and was back to work in a week after surgery," Espinosa said.

He also tested out his new hip a few weeks after the surgery.

"I went in the woods and walked for three hours. I used to need a walking stick, but I didn't anymore," Espinosa said.

Six months ago Doug Crusan also had the anterior approach. He traveled from Indianapolis to have Dr. Fisher perform the surgery.

"The recovery was better than I expected. I was back to work in 16 days," Crusan said.

Compare the traditional method with the anterior approach:

Average Hospital Stay: Tradtional: 3-5 days Anterior: 2-3 days
Incision Size: Tradtional: 10-12 inches Anterior: 4-5 inches
Muscle Trauma: Tradtional: Muscles cut detachment then repaired Anterior: No muscle detachment
Recovery Time: Tradtional: 6-10 weeks Anterior: 2-4 weeks

The anterior approach is also said to reduce pain, reduce blood loss, reduce the amount of tissue to heal, reduce the risk of dislocation, give more accurate leg length control and allow patients to return to normal activities more quickly.

Additional information can be found at www.newhipnews.com.

For more information about The Orthopaedic Hospital, go to www.theorthohospital.com.

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