Kathryn Hacker is again exploring the bike trails of her hometown of Belleville, Ill. Those activities were very painful before April, when Kathryn received her first hip-replacement surgery at St. Anthony’s with orthopedic surgeon Robert Otto, M.D., of Premiere Care Orthopedics.
"I have a fairly high pain tolerance, and I put up with it way too long," recalled Kathryn, 66. "My joints were pretty much bone on bone."
"The first surgery so affected my quality of life, and it just didn’t feel like it took that much of a bite out of my routine, so I scheduled the second surgery three months later," she said.
"I am looking forward to long walks and bike rides, something that seemed impossible before my surgeries," she said. "For now, I am happy to be walking without a limp and without the pain."
Dr. Otto performed the anterior method of hip replacement surgery (entering the hip joint through the front of the body), a procedure that is performed less frequently than the posterior method. Dr. Otto is one of a select group of surgeons in St. Louis that perform this method.
"For primary hip replacements in most people, the advantage with the anterior approach is you’re not cutting through any of the muscles that help to provide stability," Dr. Otto said. "Studies also show patients have less pain, recover faster and are able to discard assistive devices earlier.
"Probably the biggest advantage going through the front is that we can get real-time, live X-rays using a C-arm or fluoroscopy machine," he said. "This allows us to position implants into an appropriate orientation that will give the highest likelihood of not wearing out prematurely and help us ensure that leg lengths are equal."
Most of Dr. Otto’s hip replacement patients, including Kathryn, have returned home the day after surgery. After comparing notes with friends and relatives who received the posterior method of hip replacement surgery, Kathryn wanted to share her positive experiences with the anterior method.
"I had to take fewer drugs than friends of mine who received the posterior method of hip replacement surgery," she said. "I'm sensitive to medicine, and the doctor was really receptive and paid lots of attention when I said I didn’t need pain medication."
Managing pain is a huge focus with total joint replacement and other procedures, said Scott Meis, Manager of Inpatient Therapy Services.
"Staff member Amy Cabbabe, M.D., of South County Anesthesia Associates, has been making many changes to our protocols and procedures–pre-operatively, intra-operatively and post-operatively–for managing pain," Scott said.
For almost five years, Dr. Cabbabe has worked to perfect the latest nerve blocks, or localized injections of nerve-numbing anesthetics, nerve catheters, spinal anesthetics and multimodal analgesic strategies. These help patients get back on their feet faster and reduce the need for narcotics, which can cause nausea and sleepiness.
"We try to be up on the latest orthopedic protocols and medications and blocks, and the physicians have been very receptive to some of the changes we’ve come up with," Dr. Cabbabe said. "Medicine is changing, and we keep up. We really want to provide the highest level of care for our patients and make St. Anthony’s an orthopedic center of excellence."