Steve Craver is a self-proclaimed golf fanatic. But when his nagging hip pain began to put a damper on his game — and on his rounds as a postal worker — Steve said “enough.” At just 56, he didn’t want to curtail his very active life. “I went to see my orthopaedist, who took X-rays,” he says. “I wasn’t surprised to learn that it was bone-on-bone. I had been walking crooked for years!”
His doctor told him to see J. Ryan Macdonell, MD, at MedStar Montgomery Medical Center — an orthopaedic surgeon and expert in hip and knee replacement. “Mr. Craver had severe arthritis in his hips, difficulty walking and persistent pain,” says Dr. Macdonell. “For him, medication and physical therapy just weren’t working. He was a good candidate for anterior total hip replacement — and since he was active and healthy, I knew he would recover quickly and do very well.”
Anterior Approach: Less Pain, Faster Recovery
Direct anterior hip replacement is a muscle-sparing approach that speeds recovery. In this procedure, the surgeon makes a four-inch incision at the top of the thigh from the front of the patient. That means that very little muscle is cut to gain access to the hip joint, which translates into less pain and a much easier rehabilitation.
“It’s my preferred technique today, and I have used it with excellent results,” Dr. Macdonell says. Steve didn’t need convincing. “I was very impressed with Dr. Macdonell and eager to get it done.”
Before surgery, Steve attended a seminar at MedStar Montgomery to better understand what to expect after surgery. “The physical therapist took a look at me and predicted I probably wouldn’t need much therapy — and she was right,” says Steve.
Recovery at Warp Speed
In early November, Dr. Macdonell replaced Steve’s right hip with a four-piece joint implant made of a metal rod with a ceramic head on top and a metal shell with a plastic liner. Studies have shown that these hip replacements can last for more than 20 years.
“I went into the hospital early in the morning and was walking around the unit’s floor later that night,” Steve says. He sailed through rehab — climbing stairs before most patients do. While not all patients bounce back at warp speed like Steve, a rapid rehab protocol does help patients get on their feet quickly and recover faster.
“The anterior approach gives patients confidence to get out of bed and start walking soon after surgery,” Dr. Macdonell says. Steve had a little therapy at home, but found he didn’t need much. Two weeks after surgery, he was back practicing his golf swing. Soon after that, he was trekking across hills and woods while deer hunting.
In fact, Steve was so impressed with the success of his first surgery that he returned to have Dr. Macdonell replace his left hip as well. Just daysbefore the procedure, Steve wasn’t uneasy at all. “I was actually looking forward to it,” he says, laughing.