Anterior Hip Replacement Helps Patient Dive Back into Life

When I found out my friend and fellow volleyball player, Brit Creelman, early 50s, had recently undergone a total hip replacement (anterior approach), I asked if he could share about his decision and recovery. Here is his story.

You can also read part 2, in which Brit discusses how he navigated his health plan to be able to select the experienced surgeon he wanted.

Hip Replacement, Anterior ApproachThe anterior approach to hip replacement can help patients have a shorter recovery time.
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Advantages and Disadvantages of Anterior Hip Replacement

How long have you known that your hip pain was due to arthritis?

My hip pain started about 5 or 6 years ago. I thought it was a torn groin muscle and went to physical therapy, which made it worse. My hip started to freeze up on me, and I finally went to see an orthopedic surgeon. He X-rayed my hip and said I had moderate to severe osteoarthritis and was a classic candidate for total hip replacement.

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I scheduled the surgery at that time, but then cancelled a week later. I wanted to get second opinion and I was not comfortable with that surgeon. Later I received an MRI that corroborated the first surgeon’s treatment recommendations. I wasn't comfortable with the second surgeon either, though.

What other treatments did you try before considering surgery?

While I was pursuing other options to surgery, I saw a rheumatologist and he said there is some lubricant material than can be injected into the hip—called viscosupplementation or hyaluronic acid injections—to buy time. He said the injection is commonly done for knee and not so much for hip (and that it wasn't typically covered by insurance for hip). I was told that it might not work, and if it did, it would likely just be for a few months.

I started swimming and the hip improved, so I put things on hold as far as considering surgery. I joined a swim team and found that I could do intense interval swim training without hip pain.

For a couple months, the hip pain was significantly lessened. But then the pain started to get worse again. I consulted a sports physician, because I thought he might have more suggestions for nonsurgical or alternative treatments. However, he reviewed my MRI and said I didn't seem to have other options. According to him, whenever I was ready to cry uncle, I should have the surgery.

What made you decide on the anterior approach for your hip replacement?

All along I have been interested in the anterior approach due to its potential for quicker recovery, compared with the traditional posterior approach. The quick recovery was important because I have a long commute and I would have had to take 6 weeks off work with the posterior approach, due to not being able to drive long distances.

In addition to driving, there are a number of behaviors you’re not supposed to do after traditional hip replacement—such as not crossing your legs, not moving certain ways in bed, and other common movements—and I was worried it would be stressful to constantly monitor my movement like that. My surgeon told me there were virtually no prohibited actions after anterior approach surgery except deep yoga stretching.

As far as I was able to gather, however, it seems that the procedure is more difficult for the surgeon and outcomes can actually be poorer overall—except for surgeons who have done hundreds of hip replacements with anterior approach.

Luckily, I found a surgeon I could go to with a national reputation who has done hundreds of anterior hip replacements. I also confirmed he had the surgery table that is designed for anterior hip replacement, which I don’t think all hospitals have. It is a medieval-looking device that stretches your body in various contortions. I went to see him and felt good about the visit and took the earliest date available for surgery.

As hip osteoarthritis develops, the joint can eventually degenerate enough that replacement is the best option.
Watch the video: Hip Osteoarthritis Video

What did you do to prepare for the surgery?

My best preparation was being in as good of shape as possible, especially my core muscles. I was swimming 2 to 4 times a week with my swim team right up to the day before surgery. The strangest thing is that I have never been in better shape than I was at the time of surgery. Even though my hip has been toast for years, I could swim 3,000 yards without pain. As a result, I was off crutches two days after surgery, and off using a cane two days after that. After a week, I was at the gym on the stair machine. Three weeks after surgery, I was back in the pool doing interval training. I was confident that my recovery would be quick and it has been.

In fact, rehab was so quick that I ended up overextending and causing injury of another part of my body. The day before returning to work, I was feeling so strong and elated that I did a whirlwind of things around the house and worked out hard at the gym—and I ended up pulling my back. This has taken weeks to recover from, ironically longer than the rehabilitation for the hip.

In addition, my sister, who is a nurse, came to stay with us for 3 days after the surgery, and this was wonderful. I would highly recommend that others arrange for someone else to kind of take over and manage stuff for the first couple days after surgery—keep track of medications, pay attention to all follow-up care instructions, etc. There were general instructions I received from the hospital that contradicted the specific recommendations of my surgeon, so this was initially a point of confusion.

The biggest struggle post-surgery has been ongoing insomnia and night sweats since the surgery. I think this is a reaction to the anesthesia.

Looking back, is there anything you would have done differently before surgery?

I would have done more stretching before the surgery, especially the hamstrings and quad muscles. I had ligaments that were quite strained or perhaps even torn during the surgery due to the contortions I was put into for the anterior approach. Perhaps more stretching for a couple weeks before could have reduced this problem.

What do you most look forward to doing again once you’re recovered?

Playing tennis and volleyball! But the best thing is simply being without pain.

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Post written by Carrie DeVries