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Get a New Hip, Walk Home That Day

New Technique Turns Hip Replacement Surgery Into Outpatient Procedure
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WebMD Health News

Nov. 13, 2003 -- Hip replacement surgery has allowed millions of Americans crippled with arthritis to once again walk pain-free -- but traditionally, only after weeks or months of recovery. But a new technique is helping to transform this popular surgery into an outpatient procedure -- and allowing most patients to recover fully much sooner.

With this technique, first performed in February 2001, nearly 90% of patients leave the hospital the day of or day after their hip replacement surgery, instead of the traditional weeklong stay. The technique is also proving to be virtually pain-free in many patients and results in less surgery blood loss and less chance of post-operation blood clots. It also reduces or eliminates months of grueling rehabilitation therapy and is proving to drastically cut the risk of later chance of limping.

Go Home the Same Day

"Virtually all of my patients now go home the same day of their surgery," says Chicago orthopedic surgeon Richard A. Berger, MD, who pioneered the procedure and has since performed it on more than 200 patients. "Most are walking with no support at all within a week of surgery, rather than the several months it takes with traditional surgery. For them, it's proven to be better and safer than the traditional method."

The reason: The Zimmer Minimally Invasive Solutions 2-Incision technique allows surgeons to install the same artificial hip joint through two small incisions -- each no more than 2 inches long -- rather than the traditional single incision between 4 and 12 inches long.

By doing this with new smaller surgical instruments designed by Berger, an MIT-trained mechanical engineer-turned-surgeon, those who perform hip replacement surgery can now operate between muscles, tendons, and ligaments rather than cutting through these soft tissues.

About 90% of pain resulting from hip replacement surgery -- done on some 250,000 Americans a year -- results from cutting through this tissue, Berger tells WebMD.

He and three other pioneers of the procedure -- named after Zimmer Inc., the company that manufactures the smaller surgical instruments -- document outcomes in 375 patients who have had this new procedure since Berger first performed it nearly three years ago at Rush Presbyterian-St. Luke's Medical Center in Chicago. Their findings appear in the November issue of the Journal of Bone and Joint Surgery.

At least 80% of those patients getting the Zimmer procedure left the hospital within 24 hours of their hip replacement surgery. In order to be discharged, patients must demonstrate an ability to walk and climb stairs by themselves or with crutches or a cane, and require less potent oral pain medication.

A second study, not yet published, on other patients studied since that first group indicates the outpatient rate is now approaching 90% or better, says Berger.

None of the patients studied in the published research had any complications or needed to be readmitted for additional surgery, meaning their artificial joint remained fully attached. With the traditional surgery, a small number of patients have these postoperative problems.

Berger says many of his patients require no medication for postoperative pain. And since their scars are smaller, they heal faster and lose less blood in surgery. -->

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