“If I’m still kicking in 20 years, I’ll be doing it at the ballet barre.”
At 62, Patricia Scarangello, a ballet dancer and teacher in Aberdeen, lives an active life. She teaches at the New Jersey School of Ballet and works in TV and film, recently playing a dance instructor and choreographing a scene in the HBO miniseries “The Undoing.”
But a few years ago, she started having pain in her left hip that threatened her passion and livelihood. “It was mild at first,” Scarangello says. “I just figured I had hurt something and that it was going to go away.” But the twinges kept getting worse.
Scarangello was familiar with pain: Years of dance can take a toll on the body. The orthopedic team at Robert Wood Johnson University Hospital (RWJUH) Somerset had treated her for multiple injuries, including a procedure to repair the meniscus cartilage of her knee. So when her hip pain continued, she turned to the hospital again. The assessment: “I had no cartilage left in my hip at all,” she says.
Charles Gatt, MD, an orthopedic sports medicine specialist on staff at RWJUH Somerset, urged Scarangello to consider hip replacement surgery, but she wasn’t ready. She figured surgery could sideline a dancing career. “Being a ballet dancer, I was very resistant,” she says.
Scarangello decided to give steroid injections a try instead. She already received them in her toes, which also had lost cartilage over the years. The shots reduced her hip pain and helped her function better for periods of time. But those intervals of relief eventually became shorter and shorter. Pain became so bad that she couldn’t find a comfortable sleep position.
Dr. Gatt finally convinced Scarangello to see Stephen Kayiaros, MD, Medical Director of RWJUH Somerset’s joint surgery program, who specializes in minimally invasive joint replacement. “Even though she was pretty functional, she was limited in what she could do because of mobility issues and pain,” Dr. Kayiaros says. “She wanted to get her hip replaced to improve her quality of life, dance without pain and get back to the level of dancing she was used to.”
A Minimally Invasive Option
During hip replacement, surgeons switch the damaged ball and neck at the top of the thighbone (femur) and the socket of the pelvic bone with prosthetic parts to stop pain and improve movement.
In traditional hip replacement, called the posterior approach, surgeons access the hip joint through an incision close to the buttocks. Dr. Kayiaros specializes in accessing the joint through incisions in the front, or anterior, hip area. This less-invasive anterior approach typically results in less pain and a lower risk of complications such as dislocation of the joint.
These advantages sold Scarangello. “They don’t have to cut through muscle or connective tissue with the anterior approach,” she says. “Because of the way they position the hip, they can just move muscle aside so it doesn’t have to heal as much.”
“Typically patients who have an arthritic hip have a stiff joint and limited mobility,” Dr. Kayiaros says. “Patricia was quite the opposite, with good flexibility. She wanted to maintain her flexibility after surgery and was an ideal candidate for the anterior approach.”
Road to Recovery
Scarangello found her October 2021 surgery and recovery remarkably manageable. “It was virtually painless,” she says. She took nothing stronger than Tylenol while healing.
Anterior hip replacement patients usually resume normal activities relatively quickly, Dr. Kayiaros says. Scarangello was out of the hospital in less than 24 hours, drove within four days and soon set her sights on returning to the dance studio.
Procedures such as joint replacements will be even easier on patients when RWJUH Somerset completes a two-story addition containing a new orthopedic unit above the Pavilion building. Designed for safety and comfort, the unit will have more rooms for joint replacement patients and a state-of-the-art gym for rehabilitation.
“With the number of people undergoing joint replacement increasing exponentially, having an expansive orthopedic unit with ample private rooms will allow us to accommodate more patients and allow them to quickly get to their rooms and begin their road to recovery,” Dr. Kayiaros says.
Scarangello’s prosthetic hip is expected to last at least 20 years. “If I’m still kicking in 20 years,” she says, “I’ll be doing it at the ballet barre.”
A Comprehensive Approach to Heart Care
Robert Wood Johnson University Hospital (RWJUH) Somerset recently renamed its Joint Center of Excellence in honor of Thomas Nordstrom, MD, and family. For nearly four decades, Dr. Nordstrom was an orthopedic surgeon at the hospital, where he was former chief of orthopedic surgery. His wife, Sue, was an active member and past president of the hospital’s former Auxiliary. The onetime Bridgewater residents, who now live in West Palm Beach, FL, recently made a significant donation to support the hospital’s joint surgery program.
Dr. Nordstrom and partners pioneered many firsts at RWJUH Somerset, and he was a driving force in the 2010 development of RWJUH Somerset’s Joint Surgery Institute. The Institute standardized care, educated patients and introduced aggressive rehabilitation, among other innovations that improved patient outcomes. RWJUH Somerset has received the Joint Commission’s Gold Seal of Approval for quality achievements in total hip and total knee replacement surgery.
“Dr. Nordstrom was instrumental in the growth of our orthopedic surgery program and elevating the quality of care that we provide to our patients,” says Tony Cava, President and Chief Executive Officer, RWJUH Somerset. “Sue’s fundraising efforts over the years helped us modernize and expand our services to meet the needs of our community. We are extremely grateful for their continued support.”
Learn more about joint surgery services at Robert Wood Johnson University Hospital Somerset.