SVMC Surgeons Take New Approach to Hip Replacement

BENNINGTON — A new surgical method for total hip replacement gets patients at Southwestern Vermont Medical Center (SVMC) back on their feet faster and with less pain than more common methods, which can require four to six months of recovery with significant pain. Called the “anterior approach,” the new technique replaces the hip through a small incision on the front of the body.

“The anterior approach does not cut through any major muscles,” explained SVMC orthopedic surgeon William Ketterer, MD. “As a result patients have less pain and no restrictions on movement after surgery. They typically need much less time in physical therapy, too.”

More tradition hip replacements cut through muscles on the side or the back of the leg, Ketterer explained. “These are the largest muscles in the body,” he said. “Cutting through these muscles means that patients have more pain and take much longer to recover.”

Clinical studies of technique show that the anterior approach offers benefits over other approaches. In general patients can expect:

A smaller incision: the incision is about half the size of incision required for the more common posterior approach
Less blood loss: the more traditional hip surgeries require a blood transfusion. The anterior approach can be done without a blood transfusion.
Shorter recovery time: patients can move freely as soon as they are comfortable, climb stairs, sit, and walk.

Lower risk of hip dislocation: more common hip replacements cut the muscles that hold the hip in place. With the anterior approach, these muscles are not injured and function to keep the new hip in the socket where it belongs.

“More patients are realizing the benefits of the anterior approach,” Ketterer explained. “As a result, surgeons around the country are starting to switch to this technique.”

Ketterer said that the approach has been used successfully in Europe for many years; however, American surgeons have been slow to adopt it.

“This surgery is more difficult and takes more time than the posterior or lateral approaches” explained Dr. Ketterer. “The surgical opening is smaller and requires special instruments. These are likely the reasons American surgeons have delayed adopting the technique.

“However, the anterior approach is clearly better for patients. We have found that patients are up and around much more quickly and with less pain. In fact, right after surgery patients can bend and move their hips freely. There are no restrictions on the range and type of motion for the hip replacement.”

You can learn more about the anterior approach and ask Dr. Ketterer questions on Monday, March 29, at Fillmore Pond at 7 p.m. Please call Becky Wellman at 447-7000 to register.