Another Pitch for Same Day Total Hip Arthroplasty

Is same day total hip surgery due for a renaissance?

Philip Minotti, M.D., an orthopedic surgeon with Connecticut Orthopaedic Specialists, thinks so and believes that it can change the face of hip surgery. One of Minotti’s patients, Karen Klarman-Williams, 55, received her new hip in the morning, slept in her own bed at home that night and was back at work and driving her car in two weeks.

Minotti credits his technique—using the minimally invasive direct anterior approach—with the rapid recovery of his patients, according to New Haven Register writer Ed Stannard. This approach allows surgeons to avoid cutting the large muscles, which are merely pushed aside during the surgery.

Since the 1990s, “the average hospital stay has been three days” for a hip replacement, said Minotti, who was one of the first doctors in his region of the country to perform the same-day joint replacement surgery.

With patients being able to go home the same day as the surgery he said that the procedure is a paradigm shift in terms of rate of recovery. “None of my patients go to rehab anymore, ” he said. Stannard quoted Minotti as noting that the anterior approach does not result in a better artificial hip. “The advantage, in my opinion, is rate of recovery. The advantage to the direct anterior approach is much less damage, less pain, faster return to function. The final result is equivalent to doing it any other way, ” he said.

Stannard noted that while the anterior approach has been done for some time, “It is much less common because it’s considered to be a non-traditional approach.” Minotti said that it is “more difficult to teach and it’s more difficult to learn, and it’s just now, over the last five years, gaining traction in all corners of the country.”

Another of Minotti’s patients is Anthony Avallone, 44, who had been in pain for two years with arthritis of the hip. Avallone had his surgery in December. He said of his experience, “I went in for an appointment on Monday, had surgery at 7, was out of surgery by 9, in recovery, walking by 12:30, walking up stairs and I left by 5, ” Avallone was off all pain medication in four days and driving in five. He is presently back to work and coaching youth sports.