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Back Into Forward Motion: Advances in Hip Replacement Surgery

From: Your Health Published: Aug. 10, 2011 Updated: Aug. 10, 2011

Source: Duke Health

Improvements in hip replacement surgery — first performed in 1960 — are helping new generations of patients live with significantly reduced pain and improved mobility. A muscle-sparing approach to total hip joint replacement surgery at Durham Regional Hospital has given one area engineer his active life back.

Shawn Rayburn, 35, moved to North Carolina from central New York after he left the U.S. Marine Corps at age 23. While he was still able to work as a ConC Foundations tier II engineer for Cisco with chronic hip pain, he found other activities to be increasingly painful.

“Last summer, I was walking with a cane and had severe muscle atrophy in my left leg because the pain was so intense when I tried to move,” says Shawn. “I couldn’t walk up the stairs let alone keep up with my five-year-old son.”

Diagnosing the Pain

The intense pain he experienced night and day in his left hip prompted Shawn to seek the help of Scott Kelley, MD, orthopaedic surgeon with North Carolina Orthopaedic Clinic and a member of Durham Regional’s medical staff.

Dr. Kelley explained that Shawn had avascular necrosis — deterioration of the bone due to blood loss — which had caused the heads of his femurs, his leg bones, to collapse.

The cause of Shawn’s avascular necrosis is unknown, but he theorizes his time in the Marine Corps and his penchant for extreme sports such as skydiving may have contributed to his hip joints’ decline.

In preparation for surgery, he began physical therapy to regain muscle strength. “The combination of our clinic’s preoperative education, Shawn’s age going into surgery, and our muscle-sparing approach helped him recovery quickly from the first hip replacement surgery,” says Dr. Kelley.

Getting Ready for Surgery

Specializing in hip replacement, Dr. Kelley has performed this procedure on more than 800 patients.

To replace the joint, he makes an incision about three to four inches in length (in average-size patients) on the side of the hip. Using this approach, disruption of the muscles overlaying the hip is minimized.

“My goal is to perform the only joint replacement surgery patients will ever require,” says Dr. Kelley. “Each patient is part of the decision-making process at each stage of treatment.”

At a pre-surgery physical, Dr. Kelley and his multidisciplinary team explained what Shawn could expect before, during, and after surgery, and Shawn watched an educational DVD provided by the North Carolina Orthopaedic Clinic to get more detail.

He also attended the Forward Motion Joint Replacement class at Durham Regional, which he found very helpful.

Shawn had his left hip replaced September 13, 2010. With required blood tests and paperwork completed beforehand, he felt relaxed the day of surgery.

“The nurses and medical staff at Durham Regional were very helpful and responsive, and they took time to answer questions,” says Shawn. “My mother came down from New York for the first surgery. When I went back for the second surgery on February 1, 2011, to replace my right hip joint, the nurse remembered my mother and let her know over the phone how I was doing.”

Getting Around Better

Shawn felt better the day after his first surgery.

A new physical therapy regimen was implemented at Durham Regional, which he continued on an outpatient basis in Cary, NC, three days a week.

With the pain of the left hip in check, Shawn soon realized how painful his “good” hip had become. Although only a few months later, he attended all the preoperative education classes again to ensure he was as well prepared and had not forgotten anything.

Six months after the surgery, the bone will have grown on the prosthetic joint sufficiently for Shawn to run again. For now, he’s happy to have basic mobility free from pain that most people take for granted.

“I was trapped inside the house before,” says Shawn. “Now I can take my son to the park, ride a bicycle, and go up the stairs. I wish I hadn’t waited so long to be pain free.”

Joint Replacement Program Poised for National Recognition

Durham Regional Hospital is preparing for certification by The Joint Commission for its Forward Motion Joint Replacement Program.

This certification will demonstrate Durham Regional’s achievement of national benchmarks for evidence-based care in orthopaedic joint replacement. Additionally, it will emphasize our commitment to a positive patient experience.

“Our Forward Motion Joint Replacement Program is goal-based with patients involved in every step of the process,” says Pat Lester, BSN, RN-BC, program coordinator for Orthopaedics and Neurosurgery at Durham Regional.

“Starting with the preoperative education class, each patient’s goals are identified and addressed with individualized therapy structured to meet those expectations.”

Are You Ready?

Osteoarthritis is the most common cause of pain and mobility issues with weight-bearing joints, such as hips and knees.

Triangle residents with joint pain should work with an orthopaedist to maintain mobility and function with conservative measures first, including nonsteroidal anti-inflammatory drugs (NSAIDs) and steroid injections that can provide temporary relief.

When joint pain due to damage or disease impacts everyday activities, joint replacement surgery may be the best option. Signs you may be ready for a new joint include:

  • Inadequate relief from NSAIDs
  • Diminished mobility due to joint pain
  • Pain during everyday activities, such as bending, sitting down, or walking
  • Pain persisting at rest or overnight
  • Failure of physical therapy and other treatments to manage pain