A retiree from his family business, a husband of 48 years, the father of two sons and the grandfather of four, William Decker, 73, has a lot to keep him busy and on the move.
But more than a year ago, a severe bout of arthritis in his right hip was making it difficult to enjoy everything from time with his family to playing his regular golf game.
“My hip pain was just so great that it was actually too painful for me to walk, and I couldn’t keep taking Aleve all of the time,” Decker said. “When the pain just became too much, I started doing some research and talking to friends who have had hip replacements.”
What Decker found was that there are now options when it comes to hip replacement surgery based on a person’s health and risk factors. While some patients choose, or are only candidates for the traditional posterior approach, another option for some patients is the anterior approach — a muscle-sparing hip replacement that often results in a reduction in pain and recovery time following surgery.
In discussions with friends, Decker learned that those who have had the traditional hip replacement or posterior approach, which is performed with the patient in a lateral (sideways) position, their pain and recovery time following surgery was more extensive than those who had an anterior or frontal approach hip replacement.
“In fact, one person had both hips replaced — one posterior and one anterior — and said the anterior approach was a lot less painful, and the recuperation time was a lot less because the surgeon does not have to cut through the muscle,” he said.
Choosing the best option
Once Decker knew the type of hip replacement surgery he wanted, he just had to find the right surgeon at his preferred hospital, Missouri Baptist Medical Center, where he has been a patient on several occasions.
Fortunately for him, Christopher Mudd, MD, a Missouri Baptist board-certified orthopedic surgeon, is one of the few surgeons in the area who currently does the minimally invasive, direct anterior total hip arthroplasty. Although first introduced in the 1980s, it’s only been available to patients in the St. Louis area in recent years due to the limited number of surgeons performing the procedure.
“Mr. Decker is a very active guy, and he had high expectations for himself and what he wanted from the procedure,” said Dr. Mudd, who has been doing the anterior approach at MoBap for more than two years, thanks in part to the hospital’s investment in the Hana surgical table, which is designed specifically for this procedure.
“The anterior approach allows the surgeon to minimize the trauma to the muscles while accessing the hip joint. It is performed with the patient flat on their back, and an X-ray machine is used to verify the position of the implants during surgery,” Dr. Mudd explained. “The Hana table is used to position and manipulate the patient’s legs in the operation.
“Patients who have the anterior approach, like Mr. Decker, typically experience decreased inflammation, less pain, quicker return to function and simpler restrictions after surgery,” he said. “However, not all patients are ideal candidates for this procedure.”
For example, Dr. Mudd does not recommend the anterior approach for patients with certain body types, complex hip deformities, or reconstruction after previous hip trauma. He also counsels his patients that anterior hip surgery in elderly or profoundly osteoporotic patients has been shown to have a slightly increased risk of femoral fracture and femoral component loosening compared to traditional hip surgery.
“Although anterior hip arthroplasty is an exciting alternative to traditional exposures to the hip, traditional hip replacement surgery is still a very reliable procedure for many patients,” he said.
And, in fact, he has found that if a patient has had a good result with the posterior approach on one side, he will often do the posterior approach again on the other side, if needed.
“It is important that the patient and surgeon discuss unique patient risk factors and understand all of their options,” he added.
Following his surgery, Decker remained in the hospital for about a day-and-a-half and the staff had him up and walking right away, he said. After leaving the hospital, he continued with outpatient therapy at Missouri Baptist for several weeks.
“The best thing a patient can do to come through this surgery without a hitch is to listen to their doctor and do the therapy,” Decker said. “The outpatient physical therapy at Missouri Baptist was excellent. They are a highly qualified group of therapists. In fact, I can’t say enough about everyone at the hospital. They really go out of their way to make you feel like you are important.”
After therapy, to keep us his strength, Decker eventually began working with a personal trainer, who he continues to see three times a week. He also has returned to his regular golf game.
“My recovery has been incredible. I’ve never looked back,” he said. “I was fortunate because Dr. Mudd gave me a great deal of confidence in his attitude, and he knew what he was doing. And my experience at MoBap was exceptional. They made me feel welcome. I know if I do need a hospital, I know where I am going.”