Hip Replacement - Indy Style on WishTV

Uploaded by ecommunity on 08.02.2011

I was always told that if you have a little hitch in your step, it can look really cool.
It can look really hip. But if it's your hip that's causing the hitch
in your step, it can be a sign of something much more serious and can affect your quality
of life. Joining me right now is Dr. George Feliciano
and Richard Pfeiffer. Dr. Feliciano's with Community Health Network.
And I've had friends--I'm old for television, but not that old--but I've had friends who
have already gone through hip replacement procedures.
And when someone even mentions that, people cringe.
The idea of that having to happen to someone used to be a painful procedure, but not necessarily
You know, hip replacement's been around since really the '50s.
And it's continued to change as technology has, and as we understand materials, and even
get an idea of how the body actually works and what we can do to return ourselves to
our lives. And still continues to be a procedure that
has one of the highest satisfaction rates and truly a life-changing procedure.
Richard, in your case, would you just start experiencing some pain? Or was there an instance
that made you realize, "I need to see somebody"?
Well, really, over a period of time--a year or so before I visited Dr. Feliciano--I noticed
that I wasn't walking on the golf course anymore, and golf is my main priority.
And so because of that I decided to seek his opinion and get an X-ray done and have him
take a look at things. And so it just progressed over time to where
it became very bothersome. And I decided it was time to do something
about it. So I saw him in May of last year for the first
time, and at that point he did an X-ray, showed me where the degeneration was.
I had one synovial injection, I think, to start with, to see how that would work.
And when it didn't, then in November of last year I made the decision that we probably
should do it. And he recommended that we do this, and because
of the new direct anterior approach that he is so excellent at, by the way, I decided
it was the best thing for me to do. And it's been exceptional.
It's been marvelous for me.
Are you back on the course?
Five weeks after he did the operation I played golf in Florida, yes sir.
Oh my gosh. Well I know from the old--I don't even know
what the old procedure was called--but versus this procedure, being on a golf course in
a matter of weeks instead of months was probably unheard of.
Yeah, that is something that you don't really see very commonly.
And I think the direct anterior approach has kind of opened that up to a lot of people
of all sorts of range of motivations, ages, as well as severity of the disease.
To give you a little background, the traditional approach, which has been ongoing for decades--and
successful, we've changed a lot of lives even with the traditional approach--the incision
is usually made from the side. As people would say, "Well, you gotta go through
my butt to get to my hip. How does that work?" People are like, "What are you talking about?"
But we do. Everyone's familiar with the gluteus maximus muscle.
And that's the first muscle that you have to split going through the traditional approach.
And then two-thirds of the surgeons will go through the back of the hip, bringing off
five structures that they separate off of the back of the femur.
And enter the hip that way to do the same procedure that we're talking about. Other
surgeons split that gluteus maximus. They go around to the front of the hip, then, and
take off two or three tendons to actually detach and get it in the hip that way.
Through this direct anterior approach, we actually make the incisions, instead of through
your butt, actually through the front of the thigh.
So as Richard was pointing out earlier, he goes, you don't have to sit on a lump of scars
the rest of your life if you actually have two.
But, in doing so, we're actually able to accomplish the same procedure, separate really only the
capsule from the hip itself. Observe one of the biggest principles we have
in orthopedics when we operate on a leg or an arm, is to go in between two muscles and
not disturb those muscles, separate them, and through a skillful set of placement of
retractors actually open up the hip, do our job, and get out of there with disrupting
really the least possible and sparing all the other tissues, which ordinarily through
the traditional approach, you have to disrupt to get in that way.
So dumbing it down for a local talk show host like myself, basically you're messing with
less stuff to get to what you need to fix.
Correct. Very much so. Yeah.
And what do we have here?
This is a model that shows after the hip has already been done. It has half of the pelvis--it
shows the socket with the component in place: a metal ball that shows the stem. I brought
one here of what actually goes into the hip in the same model that Richard has in.
But it's actually the same weight and such of the actual stem that goes in.
And after this is done and it's successful--which you've said the succes rate is huge--you've
improved a lot of people's lives. Are there--should there be--expected limitations?
Or is the sky the limit in terms of any sort of physical activity? Obviously, he was back
on the golf course in five weeks. Years ago, everyone remembers Bo Jackson probably had
the most famous hip replacement. He attempted to return to professional sports.
But do people need to be realistic after the fact?
Well, the sense of realism that happens is the same way you drive your car. The more
miles you put on your tires, the faster they're gonna wear out. So there still is that.
Because the improvements that have come even the last ten years have been actually how
we make this ball, what we put in the socket, and the parts that actually rub together.
And that's a tremendous improvement. The direct anterior approach allows people
to have a much wider range of motion that we allow faster and sooner, so that they can
actually retain and obtain--get that motion. Whereas a lot of times we're worried about
dislocation for our patients through the traditional approach because we have detached a lot that
we have to wait to heal. And sometimes that healing is three, four,
five, six months in some of these people.
So by obviating that--removing what we usually detach and then wait to heal back--the dislocation
risk has probably dropped to even less than a tenth of a percent, you know, you might
estimate. There are no direct numbers.
And bottom line, you got your golf game back.
Got my golf game back, better than ever. I owe it all to him.
As I've said before, he's been blessed with great ability in my opinion and he also has
a lot of compassion. I could be his biggest cheerleader.
I mean, he's done a great thing for me. And I'm queasy when it comes to medical procedures,
obviously something as big as a hip.
Well stick to the golf course, maybe not cheerleading. We have Community Network's information and
Dr. Feliciano's information on our website, indystyle.tv.
Doctor, thank you so much for sharing this procedure.
Congratulations, I'm glad you're doing so well.
We'll talk courses after the break.