Specially designed Hana operating tables are changing the way total hip replacements are conducted, resulting in faster recovery times and reduced risks for blood clots and fractures.
A traditional total hip replacement requires patients to lie on their sides. The surgeon makes an incision around the buttocks to the hip, cutting through several muscles and ultimately replacing the damaged joint with a prosthetic one.
The Hana table allows physicians to perform an anterior hip replacement, in which the incision is made at the front of the hip near the groin. Unlike conventional hip replacements, patients lie flat on their backs. Their legs extend onto two separate bars secured at the feet in traction boots, which resemble ski boots. A patient's legs can be moved up, down, across the body or rotated so the surgeon achieves the best possible angle for surgery.
The Hana table is also radiolucent, meaning physicians can X-ray the body and project the image in real-time during the surgery. These "action shots" increase the surgeons' precision. Reaching the hip from the anterior rather than the posterior (through the muscles in the buttocks) allows physicians to push muscles aside, instead of cutting through them.
Dr. Pamela Petrocy, an orthopedic surgeon at East Jefferson General Hospital, has performed both total hip and anterior hip replacements. "The anterior hip replacement with the Hana table has made it much easier on patients," she says. "Instead of cutting through the muscle to replace an arthritic hip, you can actually go in between the muscles at the front of the thigh, so ... recovery is a lot faster."
Standard hip replacement restricts patients to a walker for about six weeks, but anterior hip replacement patients are generally walking without aid after about two weeks. "That's because you don't have to wait for the muscle to heal," Petrocy says. "It takes approximately six weeks for the muscle to become fully healed after it's been cut."
In addition to a faster recovery, the surgery is less risky than a total hip replacement. Because physicians do not have to twist the body as much during surgery, the risk of blood clots decreases. There also is less risk of dislocation after an anterior hip replacement. In a total hip replacement surgery, when the muscles on the back or the side of the hip are cut, the stabilizers are disrupted. Patients run the risk of dislocation after surgery because muscles around the hip have not yet fully healed. Oftentimes, to avoid dislocation, total hip replacement patients will have a list of restriction on how they can move. After an anterior hip replacement, patients have few or sometimes no post-operative restrictions.
According to Petrocy, the pain of anterior hip replacement is also generally less severe. "One patient I operated on just a few weeks ago, who has bad hips on both sides, asked me on the first day post-op when we were going to do the other side," she says. "That's pretty unusual after a major surgery."