• Hip or groin pain that limits your daily activities
• Hip pain that makes it hard to get in and out of chairs
• Hip pain that keeps you awake at night
• Hip pain that doesn’t improve with other treatments, like injections, braces, or exercises

Any of these conditions may call for surgery, and the Orthopedic Performance Institute practices two techniques:

Posterior Hip Replacement

With this technique, the surgeon makes incisions in the back of the hip. Muscles and ligaments are separated to gain access to the hip bone. Dating back to the 1950s and even before, it is the traditional and most common method for hip replacement.

It may be the only option for these patients:

• Patients who are obese
• Patients who have certain medical conditions such as severe arthritis
• Patients who have had previous hip surgeries

Anterior Hip Replacement

The Orthopedic Performance Institute offers the anterior technique that can offer benefits not available with traditional hip replacement surgery. Since this surgery is more technically demanding, OPI is one of the area’s leading practitioners of the technique.

With anterior surgery, the surgeon approaches the hip bone from the front. It is known as “muscle-sparing” surgery because it does not require cutting of muscles. Because there is less muscle trauma, patients experience less postoperative pain and a faster recover time.

To qualify for the anterior hip replacement surgery, candidates must:

• Be in generally good health
• Maintain an average weight with less muscle mass and fat in the thigh area
• Be mobile, active and independent before surgery
• Have a good support system at home

The anterior hip replacement technique has fewer restrictions on mobility and activities than traditional hip surgery. Patients can immediately use their hip, allowing it to bear their total weight (as long as it’s not uncomfortable) and are allowed to bend it freely. This results in a faster resumption of their normal daily activities.

Recent advancements in surgical technique, instrumentation and patient selection have made anterior hip replacement a preferred option for qualifying patients who require total hip replacement. If performed by an experienced surgeon on the properly selected patient, an anterior hip replacement can result in a rapid recovery during the weeks after surgery.

Dr. Christopher Phelps

“I like to perform the anterior technique on hip replacement patients when possible because the patient experience is dramatically better. They recover quicker and have less pain,” says orthopedic surgeon, Dr. Christopher Phelps.

Don’t let hip pain take you away from your active lifestyle. Contact the Orthopedic Performance Institute in San Antonio to consult with the experts!

The post Anterior and Posterior Hip Replacements: A Comparison appeared first on Orthopedic Performance.

When do I need a hip replacement?

When traditional, non-surgical treatment options have failed to manage the pain from an arthritic hip, joint replacement (arthroplasty) can be a valuable tool. The surgeons and staff at Orthopedic Performance Institute are dedicated to combating the effects of osteoarthritis and are determined to guide patients back to an active, enjoyable lifestyle.

We combine patient preparation with advanced surgical techniques, innovative pain management tools, and enhanced rehabilitation strategies to revitalize the lives of patients every day. The foundation of our program is extensive patient education coupled with comprehensive support to ensure success from the beginning. Prepare to excel!

What does a hip replacement involve?

In a total hip replacement (also called total hip arthroplasty), the damaged bone and cartilage is removed and replaced with prosthetic components.

• The damaged femoral head is removed and replaced with a metal stem that is placed into the hollow center of the femur. The femoral stem may be either cemented or “press fit” into the bone.
• A metal or ceramic ball is placed on the upper part of the stem. This ball replaces the
  damaged femoral head that was removed.
• The damaged cartilage surface of the socket (acetabulum) is removed and replaced with a metal socket. Screws or cement are sometimes used to hold the socket in place.
• A plastic spacer is inserted between the new ball and the socket to allow for a smooth gliding surface.

A successful recovery is accomplished through extensive patient education and preparation combined with minimally invasive surgical techniques, advanced pain management therapies and rehabilitative support. Surgery itself takes about 1.5 hours; patients should plan to be up and walking with the therapist in the hospital on the day of surgery.

How is pain managed during surgery?

General anesthesia, given by IV, is administered by the anesthesiologist for surgery. Oral medications and additional injectable medications may be given as needed for pain or relaxation.

When should I expect to go home?

Patients should plan on a 1-2 night hospital stay after hip replacement surgery. We then allow the patient to fully recover at home with the assistance of in-home physical therapy and nursing

services as needed. Most patients are discharged with oral pain medication. These medications, when taken as directed, typically provide excellent pain relief at home. A physical therapist will walk with you prior to discharge from the hospital to ensure you are stable and comfortable.

Who is a good candidate for outpatient joint replacement surgery?

The success of total joint replacement surgery is dependent on several factors. One of the most imperative factors is preparation and education of the patient. Our team is dedicated to ensuring our patients achieve their goals of returning to an active, pain free lifestyle but your
understanding, participation and commitment are imperative to the success of your procedure. These guidelines are the basis of our patient selection strategy for joint replacement surgery. Speak with one of our experienced providers to determine if you are a good candidate for joint replacement surgery.

What are the risks associated with joint replacement surgery?

Our surgeons perform hundreds of successful joint replacement surgeries each year and our staff is dedicated to the safety of each of our patients. However, there are potential complications associated with any surgery. Below are some of the risks associated with joint replacement surgery and the precautions we take to minimize these concerns.

Infection. Prior to surgery, your pre-operative testing will help identify active infections and potential sources of infection. These will be treated appropriately. Surgery will not take place if there is any potential active infection present (ex. skin wounds, respiratory infections, bladder infections). During surgery, our team follows meticulous sterile technique. Patients are treated with IV antibiotics and the surgical site is thoroughly cleansed. Post-operatively, we provide detailed instructions regarding wound care and recommend avoiding dental procedures for six  months, including routine cleanings due to the increased risk of joint infection.

Blood Clots. Notify our staff prior to your surgery if you have a history of blood clots. After surgery, you will take Aspirin two times daily. We encourage early walking and regular activity. Compression stockings and foot/ankle pumps can also be helpful in decreasing clotting risk and improving lower leg swelling. We offer Sequential Compression Devices (SCD) for purchase ($225). This simple, battery powered device gently squeezes the lower leg to encourage blood flow and decrease the risk of clotting.  Our knowledgeable staff will educate and fit you with this device prior to surgery.

Additional risks associated with every surgery do exist and include numbness, pain, blood vessel or nerve injury, and complications associated with general anesthesia. Expect to have a localized area of numbness near the incision that will remain indefinitely. This is a change in sensation due to the nature of the incision and does not lead to pain or a loss of function.

What can I do to prepare for surgery?

Your health. Our team is always available to provide patients with step by step guidance through the process of joint replacement surgery and recovery, but a successful outcome is dependent on patient preparation and participation.

• Assemble a packet of your medical and personal information, including copies of insurance, health directives, etc. This information can be brought with you to the hospital as well.
• Avoid alcohol use at least 48 hours before surgery.
• Avoid/quit tobacco use as soon as possible.
• If you are in need of any dental work, such as an extraction or periodontal treatment, schedule it well in advance of your surgery. Due to the risk of infection, no dental work is allowed, including routine cleanings, for six months after surgery.

If you’d like to be evaluated as a candidate for hip replacement surgery, contact the Orthopedic Performance Institute.

The post Hip Replacement FAQs appeared first on Orthopedic Performance.

Knee or hip joint replacement, also called arthroplasty, can be a valuable tool when traditional, non-surgical treatment options have failed to manage the pain from an arthritic hip or knee.

Osteoarthritis, the most common form of arthritis, is a progressive, degenerative disease in which the cartilage of the knee or hip slowly wears away. Cartilage serves as a cushion between the bones of the joint, and when the cartilage of the joint wears away due to osteoarthritis, the resulting pain and inflammation can be debilitating.

Your chances of osteoarthritis of the weight-bearing joints of the knee and hip increase with age; the condition most often affects middle-aged and older people. Osteoarthritis may first appear between the ages of 30 and 40, though symptoms may not be present in the early stages. Later in life, many Americans will experience joint pain due to arthritis that can make enjoying life very challenging.

Orthopedic surgeons, Dr. Matthew Dwyer and Dr. Christopher Phelps, with the Orthopedic Performance Institute, are dedicated to combating the effects of osteoarthritis and are determined to guide patients back to an active, enjoyable lifestyle.

Historically, knee and hip replacement have been Performed as in-patient procedures, involving one or even two-night stays in the hospital. Since 2018, both Dr. Dwyer and Dr. Phelps have been performing joint replacements on an out-patient basis. This is accomplished through extensive patient education and preparation combined with minimally invasive surgical techniques, advanced pain management therapies and enhanced rehabilitative support.

Our outpatient total joint replacement program eliminates the need for overnight hospital stays and allows patients to return to an active, enjoyable life with minimal downtime. The surgery itself takes about one and a half hours, and patients spend about five to six hours total at the surgical center before being discharged to recover fully at home.

The success of outpatient joint replacement journey is dependent on several factors. One of the most imperative factors is appropriate patient selection which can be based on good general health, age, and at-home support, followed by preparation and education of the patient about:

• At-home rehabilitation and post-operative exercise.
• Wound care and pain management.
• Recognition and avoidance of possible complications. Complications such as infections or blood clots are associated with any surgery, and precautions are taken to minimize these concerns.

Dr. Dwyer and Dr. Phelps have a genuine commitment to patient health and have performed hundreds of successful joint replacement surgeries each year. For more information about knee and hip replacement surgery or any orthopedic condition, call (210) 545-7171 or visit our website. The Orthopedic Performance Institute has offices in Stone Oak and Boerne.

Get back your active life with the Orthopedic Performance Institute.

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