Coming Out Swinging

Tom Klein's uncommon anterior hip replacement surgery put him back on the links in 32 days 

Uncommon hip replacement surgery puts golfer back on the links in 32 days

Anterior hip replacement, an alternative approach to traditional hip replacement surgery, is helping patients recover faster and with less pain.

Northwestern Lake Forest Hospital is one of a few hospitals in Illinois to offer the procedure, performed by board-certified orthopaedic surgeon Peter Thadani, MD. That was good news for Tom Klein, an active golfer and skier. At just 50 years old, he began experiencing debilitating pain in his hip—and the possibility of losing the activities he loves.

 

A Constant Pain

Tom Klein lives in Libertyville with his wife Barbara and their children Nicole, 19, Eric, 17 and Callie, 13. He has been living with something else for the last five years: constant pain in his hip.

“It was always there… when I walked, when I slept, when I woke up, when I went to work and when I golfed,” recalls Klein. “There were times when the pain almost caused me to fall over.”

Klein, a sales executive with Rotary Paper Manifold, grew up playing tennis but learned to love golf later in life. He also took up skiing and treasures the skiing trips he takes with his family. A healthy and relatively young man, he was surprised at feeling severe pain in his hip, even though he had never been injured. He visited his physician and was diagnosed with arthritis. He also learned that even prescription medication would do little to control the pain, and he would likely need total hip replacement surgery.

But Klein wasn’t ready for that. Over the next three years, he managed to keep up with his usual activities, always gritting his teeth to get through the pain. A skiing trip in February 2012 was a turning point.

“It was the first time it hurt during the activity, and not just after,“ he recalls. “The pain was killing me, and I said ‘uncle.’ I just couldn’t keep grinding through each day. My quality of life had really deteriorated. Mentally, I was ready.”

 

Anterior Solution Eases Concerns

Total hip replacement requires replacing the upper end of the thighbone (the femur) with a durable, biocompatible metal ball and socket. In the United States, most orthopaedic surgeons are trained on a posterior approach to hip replacement, meaning they operate from the back side of the hip.

However, the anterior approach—replacing the hip bones from the front—involves less cutting into muscle, which means less pain and faster recovery. While the anterior approach has been the common method in Europe for over 50 years, it was introduced in the United States only in the last decade and is still not widely practiced.

Like many patients facing hip replacement, Klein had some concerns about the effects of hip replacement surgery. He had heard “horror stories” about infection, pain and waiting long periods before regaining full functionality. He knew that the surgery was safe and effective, but hoped for an even better solution. So when a friend told him that anterior hip replacement is the least invasive and painful approach, he began looking for a surgeon.

“I was relieved to find that Dr. Thadani performs this procedure, right near home at Northwestern Lake Forest Hospital,“ he says. “My three kids were born there, so I knew it was a great place, with amazing staff.”

 

One of a Handful of Surgeons

Dr. Thadani is one of a few orthopaedic surgeons in Lake County who regularly performs anterior hip replacement surgery, and one of the small handful of surgeons in Illinois. In his 14 years of practice specializing in hip and knee replacements, he has observed the outcomes of both traditional posterior hip replacement and anterior hip replacement.

“In my opinion, anterior is the preferred approach,” explains Dr. Thadani. “The traditional posterior approach is a good surgery, and both have a 90 percent success rate. But with anterior, the patient experiences more immediate benefits because it requires less disruption and trauma to the surrounding tissue. That means less pain, and risk of complications is lower because we can use real-time X-rays to guide the procedure. You can’t do that with posterior because of how the patient must be positioned.”

To offer anterior hip replacement, Dr. Thadani acquired additional classroom and laboratory training and an apprenticeship. He also arranged to have a surgeon experienced with the anterior approach fly in to assist with his first surgery.

“Anterior hip replacement is still a major operation,” he says. “But patients are thrilled with the fast recovery and having less pain than they expected.”

 

Hitting the Links—and Slopes—Again

After having his surgery in April 2012, Klein experienced the benefits first-hand. Traditional hip replacement surgeries can require extensive rehabilitation, and patients must avoid simple movements like crossing legs or bending over to tie shoes. They often rely on reach extenders (“grabbers”) at home and may stay on strong pain medication for weeks after surgery.

While it can take up to three months to return to some activities, Klein was back on the golf course within 32 days.

“I came out on crutches, not in a wheelchair,” he says. “I did what I was supposed to do, staying careful and doing my exercises. But I didn't feel restricted. I felt strong, and the pain was really manageable—I didn’t need any of the prescription pain meds. I started golfing about a month later and planned our next family ski trip.”

Klein credits the anterior hip replacement surgery with his recovery. But access to an advanced surgical option was not the only factor in his decision.

“If I hadn’t really liked Dr. Thadani, I would have gone elsewhere,” he says. “You have to like your guy, and he and the hospital staff did a great job. I feel fantastic, and it has been a while since I’ve been able to say that.”

 

Benefits of Anterior Hip Replacement Surgery

Compared with traditional posterior hip replacement (operating from the back of the hip), anterior (front) hip replacement offers immediate benefits:

  • Less invasive incisions
  • Less trauma to surrounding tissue reduces pain
  • Faster recovery time and return to former activities
  • Fewer postoperative movement restrictions (bending, twisting, reaching)
  • Enables X-ray guided surgery, which reduces complications such as differences in leg length
  • The anterior approach also reduces the risk of dislocation

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