Joint Preservation and Replacement at University of Colorado Hospital
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UCH orthopedic specialists have literally decades of experience in joint preservation and replacement in patients over 18 years of age. Our primary goal is to extend the life of a joint before a replacement is needed.
What We Do
We utilize cutting edge technology such as surgical navigation, computer assisted methods, and arthroscopic assisted techniques to perform minimally invasive surgery and rapidly restore an active lifestyle. In addition, we use many different implants depending on patient need and an appreciation of an implant’s performance over time.
At UCH, all physician care, testing, and therapy are provided in the same system by a core group of people. Problems unique to each individual patient are addressed by our extended corps of over 700 physicians, who represent all medical specialties.
Our combined experience totals more than 100 years and over 4,000 total joint reconstructions performed. We provide specialized joint care for those patients with hemophilia and bloodless surgery for patients who are Jehovah’s Witness.
For the Hip
More and more, orthopaedic surgery is moving toward less invasive approaches. UCH joint replacement surgeons are leading the way in minimally invasive options for the Rocky Mountain region.
Hip preservation is an emerging orthopaedic field and our specialists provide this cutting edge care to our patients.
The hip preservation clinic is a combined service between our joint surgeons and our pediatric orthopaedists with one goal: Provide alternative solutions to joint replacement for people under 30.
The hip preservation clinic provides our younger patients the latest in surgical techniques to preserve their hips.
Surgical Hip Techniques
- Posterior-lateral. This technique involves the use of a single 6-10 cm incision. The incision is oriented from the front of the hip at its bottom-most point to the back of the hip at the top. An advantage to this approach is the absence of disruption of any of the gluteus medius muscle, a significant hip abductor and stabilizer for the joint.
After this procedure, most patients are admitted for a period of 2 to 5 days. Patients may expect to put weight down on the leg immediately after surgery. Instruction is given on how to restrict movement to protect the hip until full tissue healing occurs, approximately 12 weeks after surgery. Patients may progress from a walker assistive device to crutches in the 1-2 weeks after surgery and may resume driving at two weeks.
- Anterior lateral. This technique also involves use of a single incision that is 6-10 cm. The incision is oriented longitudinally over the hip on the affected side. An advantage to this technique is the potential for a slightly lower dislocation rate, as several published studies have demonstrated. Some patients are better candidates for an anterior-lateral approach.
After surgery, most patients are admitted for a period of 2 to 5 days. Patients may expect to put weight down on the leg immediately after surgery. Instruction is given on how to restrict movement to protect the hip until full tissue healing occurs, approximately 12 weeks after surgery.
- Two incision (MIS-2). This new and minimally invasive approach involves the use of two incisions; one utilizing an incision near the groin, and one high up on the side of the hip. There is no disruption of any tendon structures using this method, and resumption of activity and post-operative mobilization may be accelerated, allowing shorter hospital stays of 1-3 days as suggested by some short-term follow-up data. Not all patients are candidates for this technique.
Rehabilitation may start on the day of surgery. The advantages are that of shorter incision lengths, aggressive local anesthesia and anti-nausea medications, as well as rapid discharge and accelerated rehabilitation.
Limited Hip Joint Resurfacing
The approach allows for a more limited resurfacing of the diseased portions of the hip joint, without complete hip replacement. Now performed in a number of centers across the United States, the diseased femoral head is resurfaced only on its dome, while the acetabular cup in the pelvis may be either replaced with a metal-lined cup or left intact. The amount of bone taken for this procedure is much lower, thus allowing the possibility of future revision replacement, should it be necessary, to be as simple as the original surgery.
This technology is currently available, and we recommend that patients consult with their physician about their suitability as candidates.
For the Knee
Minimally Invasive Knee Surgery
This recently developed technique can allow rapid rehabilitation following total knee replacement, including faster return to full knee motion with markedly improved pain control, and shorter hospital stays.
Traditional total knee arthroplasty, consisting of resurfacing of the femur, tibia, and knee cap, together with re-alignment of the leg, can be accomplished through a small incision.
This innovative technique, which uses the latest generation of instrumentation, is performed without cutting any major muscle or tendon in the front of the knee cap. Avoidance of turning the knee cap over for exposure results in a dramatic reduction in post-operative pain.
Likewise, quadriceps muscle strength above the knee is almost fully intact the day after surgery, due to its lack of disruption. This facilitates more comfortable range of motion and rapid return to bending, standing, and walking without walker or crutches.
This technique may not be suitable for everyone. We advise patients to consult with their physicians if they are interested in this surgical advance.