Hip replacement surgery, things to consider.

image of total hip arthroplasty
Total Hip Arthroplasty – Copyright: eraxion / 123RF Stock Photo

Many of the patients I see post-op after a hip replacement could care less what approach or procedure was used, (it just hurts less, or more), others ask more probing questions.

As a  result of those questions asked by post-op THA patients, I determined to compile a general overview for those contemplating the procedure. We boomers are more likely than previous generations to research such procedures and, even more likely depending on the particular search to come away with a less than complete overview of the various procedures. My intent is to provide enough information whereby you may continue with a more specifically targeted search.

Never has ‘ask your doctor’ taken on more relevance; sadly, few take the time, simply following whatever is suggested.

Hip replacement or total hip arthroplasty (THA), is currently performed at a rate of <311,000 annually.  It is not my intent in this article to present possible causation of the increases, but rather to bring resources into one place for those researching procedures/outcomes/variations among the various orthopedic facilities and hospitals.. While healthy lifestyle choices of diet and exercise are a focus of, it it also my intent to publish relevant information with regard to healthcare as it pertains to us boomers.

“Approach” What it means, and where it comes from.

The way a surgeon gains access to the hip during hip replacement surgery is referred to as an “approach.” There are various types of “approaches” named according to the direction that the surgery is performed.

Current (2016) procedures owe a great deal to two surgeons,  Sir John Charnley, England in the 1950s was a pioneer in the development of prosthetics and his influence can be seen today most prevalent in the US.

  The other,   Robert Judet who in 1947 at Garches Hospital in Paris performed what is now referred to as the “new” minimally invasive anterior approach THA , the  predominate procedure in Europe brought to this country in the 80s by Joel M. Matta, M.D.

Why this is important to you as a prospective patient?

Compare/contrast of various ‘approaches’

It was due to a required in-service some years ago that I became aware of the various procedures used, with time donated to my learning from an orthopedic surgeon explaining the differences even to the point of being allowed to observe in the operating room, that today cause me to be more inquisitive into my patients outcomes and remarks during rehab.

One epiphany that came from interaction with the surgeon was noticing his insistence upon suturing each of the incisions with the three procedures observed. An extra 30mins in the OR he remarked…but lowered incidence of infections, much less visible scaring, and greater patient comfort. Staples are faster!

To say that I’m a fan of the true ‘minimally invasive anterior approach’ is no stretch based on the responses of my limited patient experiences. I say ‘true’ because as with most things (including medical procedures) today, marketing is huge and there are examples in existence that use the terminology but that do not follow Dr Matta’s protocols. The requirement of a special table (HANA) or the like (a substantial investment by the facility) not to mention a steeper learning curve is the primary obstacle from this procedure being more widespread. The above referenced surgeon remarked that he didn’t really get ‘good’ at it till he had done 50-100 of them.

Incision size, location, the lack of dislocation precautions due to not having the major gluteus maximus/ hip extensor musculature disrupted are what sways my opinion, also the lowered incidence of reported “leg length discrepancies” resulting from the posterior-lateral approaches.  There are some that have reported femoral nerve problems with this procedure, so as with any online article it pays to do your own research.

It it toward that end this article was written. To learn more from actual recipients of this procedure and their results there is a forum on topix.  Begun in Nov 2007 there are currently 1934 comments.

Live well my friends,





good images of various approaches


Overview article

Dated review:2013 but will give you ideas for more current searches/reviews

Review from 2016 USNews


Growing Old, Making Sense of it.

image credit: 123rf Getting Old, a lot of questions- any answers?

“Old age ain’t no place for sissies” Bette Davis

I, like many of my fellow boomers, stand at a crossroads of wonder. Uncertainty, fear, and indecision lie ahead as retirement plans and dreams so well laid out just a decade or so ago now are fragmented and in disarray.

What exactly happened to bring all this about? How did we get here? And where exactly is here? On one hand we’re living longer due to a massive uptick in medications, while at the same time we’re in the worse physical shape demographically of any group in our nation’s history1.

Financially many of us took a direct hit a few years back and for us continuing in the work force isn’t optional2.

There’s still quite a few of us, outnumbered only by Millennials3, which have overtaken us of late, but if that didn’t get to me I’m seeing articles such as this4 that seemingly feel boomers are the cause of all our country’s economic woes as well. Damn…that’s enough to get a fellow depressed, and sure enough, we’re leading the way in that too5. Continue reading “Growing Old, Making Sense of it.”

Sexy at 60? What’s holding you back?


photo credit: 123rf Sexy at 60 Surfers


I often tell my patients that the hardest muscle in the body to train is the one between your ears.

As one with an insatiable appetite for learning, I read posts/articles from a broad range of writers, not to mention all the ads for ‘how to’ be-do all things after 60. I read a plethora of men’s articles and even Sixtyandme (check it out ladies) to get a feel for what my fellow boomers are in to. One thing I’ve picked up on through the meet-up, dating and community sites is a recurring theme from men and women alike. From the ladies: “but I’m just not into bald, pot bellied old men”, and from the men: “but I’m not into old and obese women”. Clearly these are major over generalizations, but the redundancy of the remarks bear consideration from both genders.

The desire is obviously not an isolated one, nor gender specific. All appreciate a lean, toned physique, for ourselves as well as our partners. So, not to mention the added health benefits, why do so few actually achieve any measure of success?

Because the hardest muscle in the body to train is the one between your ears!

Anytime one of us boomers dare look in the mirror naked, we tend to focus on all the drooping and sagging that comes so effortlessly with years.

The image is lying to you!

Baring illness, it’s not just a recompense for aging- Far from it!


“We are what we repeatedly do. Greatness then, is not an act, but a habit” Aristotle


What you are really seeing is the results of your daily habits, slowly, methodically, accumulated over time. You are what you eat, is a true statement. Change WHAT you eat, slowly-methodically and in time you will see the results in the mirror as surely as you see the effects of your current diet now. Continue reading “Sexy at 60? What’s holding you back?”

What I learned from Granddad

Mutt in his prime

A decade has passed since I was last treated to look into those blue steel eyes. Having informed the 5’2” stocky little man of my desire to “talk to him”, I was immediately rebuked with an icy stare and the response: “I’ll speak with you, but you’ll not talk to me”. God I miss that man. My other grandfather was taken before I was of age to fully grasp the value of what those years contained, but “Mutt” or “Uncle Mutt” as he was called throughout the community was a profound  influence into my late 40’s, even to today. The epitome of a southern gentleman, he was without doubt forged in the furnace that produced the greatest generation.

  If you’ve read much of my material, attempting to inspire through my transformation at 60, at, what’s not readily apparent is the genetics gifted through Mutt, which, as the chest began to develop brought an instant reminder of him on the beach as a much younger man. The constant shoulder aches was gifted to me from my other granddad, a true gentleman as well, to keep me humble. Continue reading “What I learned from Granddad”