HEALTH & FITNESS
technology
It's Hip!
New technology makes orthopedic surgery less traumatic.
Ilene Wolff
Special to the Jewish News
T
hey're good for balancing a baby
or a bag of groceries, mastering
the yoga lotus pose and keeping
your upper body connected to your lower
body. What are they? Your hips!
Unfortunately, the ball-and-socket con-
struction of hips can wear out. This can
cause pain, affect a person's balance and
movement and may keep one from per-
forming activities of daily living or pursu-
ing physical activities such as dancing and
sports.
Fortunately, orthopedic surgeons at
Royal Oak-based Beaumont Hospitals
offer traditional hip replacement surgery
in addition to several alternatives for those
whose hips are in less than optimal condi-
tion.
Not Yet, Doctor
Ira Zaltz, M.D., "looks" inside the hips with
magnetic resonance imaging and ultra-
sound to guide him in reconstructing the
hip joint, which can delay or eliminate the
need for hip replacement. Using minimally
invasive surgery, he can repair cartilage
and can move and reshape the hip socket
and the head of the femur, the long bone
that makes up a person's thigh.
"About 80 percent of hip arthritis is
caused by abnormal anatomy. Either the
socket is too shallow, leading to abnormal
stress in the joint; or the femoral head
impinges on the rim of the socket, lead-
ing to cartilage damage and tears;' says
Zaltz. "What I do at Beaumont are differ-
ent surgical procedures to normalize the
hip mechanics in order to relieve pain,
improve function and slow or stop the
arthritic process
This procedure is good for those in their
teens to early 40s. If people that young
had a hip replacement, it would wear out
and then have to be redone in about 10-20
years. This limits a surgeon's options to
create a smoothly functioning hip joint. It
would also require significant changes in a
person's lifestyle, limiting his activities.
Keep Moving
For those younger than 60, who are physi-
cally active and have healthy bone, James
Verner, M.D., offers a procedure known
as hip resurfacing. He implants a dome-
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July 31 2008
shaped insert into the hip's socket portion
and reshapes the head of the femur to
accept an anatomically sized metal sphere.
The head of the femur is retained and
there is no large stem to insert into the
femur itself as there is in hip replacement.
"One advantage to hip resurfacing is
that we can still do a hip replacement later
if necessary because we still have a lot of
bone to work with,"Verner saysAnother
advantage of resurfacing over traditional
hip replacement surgery is that patients
can resume unrestricted activities once
they are healed.
"For younger patients with excellent
bone strength — most often men under
60 — the resurfacing eventually enables
them to return to high-impact activities
such as running and other sports."
There is good range-of-motion because
the socket is larger and the ball can move
more freely than with a hip replacement.
These benefits come at a price though:
The procedure is technically difficult
because the surgeon is trying to preserve
most of the joint and is working in a small
area.
A Kinder Cut
To those for whom a hip replacement is
the best option, Perry Greene, M.D., offers
a minimally invasive procedure. He makes
a 3- to 4-inch incision instead of 12-14
inches as in traditional hip replacement.
"My experience is that patients with
minimally invasive hip replacement sur-
gery are more comfortable and active
in the first month afterward than those
who have the traditional approach;' says
Greene. "The only contraindication to
minimally invasive hip replacement is pre-
vious surgery on the legs!'
The advantages to minimally invasive
hip replacement are that there is less trau-
ma to the bone and surrounding tissue
and less postoperative pain, which leads
to a reduced need for pain medications.
Patients usually go home one day sooner
than those having traditional hip replace-
ment surgery. And they usually are more
comfortable and active within a month
after surgery.
Poor Bones
The average hip replacement lasts 10-20
years, depending mostly on a person's
activity level and size and some underly-
Perry Greene, M.D., James Verner, M.D., Michael Hubers, M.D., Ira Zaltz, M.D. and
Chairman Harry Herkowitz, M.D., all of the Department of Orthopaedic Surgery at
Beaumont Hospital, Royal Oak.
ing health condition such as osteoporosis,
kidney disease and steroid use. If a per-
son's hip replacement wears out, Michael
Hubers, M.D., offers an option that can be
used even in those who have lost signifi-
cant bone — due to either age, reaction
to wear, fracture or previous infection
— whose hip replacement revision would
be complex.
Hubers is able to offer this option due to
a replacement hip socket that's made out
of an extremely porous metal, tantalum.
It was initially used in the construction of
submarines and shares many physical and
mechanical properties with bone.
Because tantalum is so porous and
scratchy, it allows bone to grow into its
open spaces, creating a stronger bond
between bone and replacement.
"In patients with severe bone loss, the
hip wasn't easily rebuildable before says
Hubers. "Now we can rebuild it without
bone grafts, that often fail!'
Revising a hip replacement with this
technology is faster and easier, resulting in
less time under anesthesia and decreased
blood loss.
Beaumont Hospital in Royal Oak has
been recognized as fourth in the United
States and tops in Michigan for the num-
ber of Medicare patients receiving hip
replacement surgeries, according to the
Orthopedic Network News.
"Being ranked among the national lead-
ers on this list for hip replacement proce-
dures reinforces our surgeons' expertise,
dedication and specialization in these
areas;' says Harry Herkowitz, M.D., chair-
man of Orthopaedic Surgery at Beaumont
Hospital, Royal Oak.
"Volume and experience equate with
high quality and better outcomes and
allow us to provide specialized nursing
care units and operating rooms exclusively
for joint replacement surgery"
Beaumont also offers rehabilitation ser-
vices that will help patients improve their
ability to move and perform functional
activities in their daily lives after hip
replacement surgery.
❑
Ilene Wolff is a marketing specialist with Royal
Oak-based Beaumont Hospitals.