"I could not have asked for better care."
Second time's the charm for RWJ orthopedic patient
Mildred couldn’t wait to escape to the happiest place on earth for some summer fun. But Disney World was anything but for the East Brunswick resident, who was so overtaken by pain in her hip that she could only tour the parks by wheel chair.
When she and her family tried a seashore trip closer to home, Mildred could not even walk to the water from her beach chair.
“I was just devastated,” she recalls.
The pain and immobility from osteoarthritis in her left hip were alone enough to fuel her discouragement, but other fears added stress. Two years prior, Mildred underwent a right hip replacement through a traditional posterior (surgery through the back of the body) approach.
While many patients have a relatively positive experience with this approach, Mildred recalled a painful recovery, coupled with a lengthy rehabilitation stay.
Symptom Onset
Only five months after her right hip surgery, Mildred’s left hip began acting up. X-rays revealed osteoarthritis. Arjun Saxena, MD, board certified orthopedic surgeon, informed her she needed another total hip replacement.
“Mildred was really afraid to undergo the surgery after her experience with the posterior approach,” Dr. Saxena recalls.
“I waited as long as I could because I didn’t want to go thru that operation again,” Mildred adds.
“Then Dr. Saxena explained to me there’s a new procedure that uses an anterior approach.”
The New Approach
Dr. Saxena explained to Mildred, with much reassurance—and literature to back it up—that she was a candidate for an alternative method to replacing the hip joint. This minimally invasive surgery through the front of the leg is referred to as an anterior approach hip replacement.
A specially trained surgeon needs only to make a small incision, and spreads the muscles and tendons instead of cutting them. This eliminates much of the tissue trauma characteristic of the traditional posterior surgical approach.
“I use a special operating table that allows me to manipulate the leg, and use fluoroscopy, or X-ray, during the surgery to accurately place the implants,” Dr. Saxena explains.
“The hope is when we spread the two muscles apart to perform the surgery, patients can have a faster recovery and less pain after surgery.”
Over the past decade, the surgery has become more common: about one in five total hip replacements are performed using the anterior approach. Dr. Saxena expects this number to grow as patients continue to experience positive outcomes, and more physicians are trained on the approach.
Surgery and Recovery
After her challenging summer, Mildred—with both fear and hope in her heart—scheduled her surgery.
“Dr. Saxena told me I’d walk that same day, but I didn’t believe him. Sure enough, I walked with the walker!”
“I didn’t even have pain in the hospital,” she continues. “The only thing I felt was discomfort, and I only had to take Tylenol. I was so surprised.”
After her previous replacement, Mildred recalls her husband carrying her up the steps to their bedroom. This time, she was able to walk it herself. She was also empowered to receive at-home physical therapy visits, and do exercises on her own time to restore strength and mobility. She much preferred this to a rehabilitation stay.
Another benefit of the anterior approach is the minimal restrictions during recovery, so return to normal functioning happens relatively quickly.
“[Mildred] was home in three days, walked into the office with cane in two weeks, and she was really happy,” Dr. Saxena recalls.
“The different approach—the muscle-sparing, minimally invasive approach—really made all the difference for her,” he adds.
He also credits the nursing care at RWJ for such positive outcomes in total joint replacement patients.
“The advanced nursing care on the orthopedic floor plays a big role in recovery. The nurses are in tune with orthopedics, are able to answer questions, assess patients appropriately, help manage pain, and identify potential problems,” Dr. Saxena says.
“The team walked me through everything; it was very clear exactly what would happen,” Mildred says, which reassured her.
“Dr. Saxena was very attentive, very informative and very professional. I could not have asked for better care.”