Nearly 375,000 Americans undergo hip replacement surgery yearly. With our aging population, that number is expected to almost double over the next twenty-five years. Two orthopedic surgeons at North Broward Medical Center, Dr. Bruce Janke and Dr. Steven Naide have been offering their patients a pioneering approach to hip replacement – one which has been performed very successfully in Europe for many years. Doctors Janke and Naide recently completed their 400th anterior hip replacement, using a special operating table designed for this procedure called the hana® table. Nationwide, the doctors are among a small group of surgeons who offer the anterior surgical approach. In South Florida, Janke and Naide are the first surgeons to be specially trained in this technique with the hana® table.

Quicker Recovery and Return to Normal Activity

The anterior hip replacement technique doesn’t cost patients any more money compared to the traditional posterior technique. What’s more, all insurances cover the procedure. And with clear benefits to using this approach, more patients would likely choose this technique given the choice.

• Quicker return to normal activity
• No post-operative restrictions
• Smaller incision
• No muscle cutting
• Faster recovery

The traditional approach to hip replacement (posterior approach) is done with the patient lying on his or her side. To access the hip socket, surgeons must cut a number of different muscles, resulting in a twelve-week recovery period and a long list of hip precautions. The major benefits of the anterior technique come from the fact that the surgery is done with patients lying on their backs, using a small incision and without cutting any muscles. Using the anterior approach, the muscles in the front of the hip are pushed aside to access the hip socket during replacement, causing only minimal muscle trauma and no need for post-op hip precautions. Recovery to the point where patients are walking independently is accomplished in only two to four weeks.

Another advantage of anterior hip replacement is more even leg lengths. People who have undergone hip replacements frequently complain that the leg with the replaced hip is longer. It’s much easier for surgeons to measure leg lengths while the patient is on his back and the pelvis and hip are level. A fluoroscopy machine is used during the operation to provide live x-rays to help place the hip implant in the optimal position.

The Hana® Table and Anterior Hip Replacement

What allows doctors Janke and Naide to perform this surgery more easily is a special table called the hana® table. The table originated in California and was developed by Dr. Motta who brought the anterior surgical approach to the U.S. It has two outrigger type devices where patients insert their feet into holders that look like ski boots.

North Broward Medical Center is one of only a handful of regional hospitals to own a hana® table. Says Dr. Janke, “The hospital was willing to back us when we explained the benefits of the anterior approach with the use of the hana® table. Not many hospitals would be willing to invest $100,000 for this kind of equipment.” Dr. Janke is also Medical Director of the hospital’s newly opened Joint Replacement Center. He adds, “We’ve had patients come from other parts of the country to have their hip surgery at North Broward. Through word of mouth people have heard of this procedure and have been amazed with the results.”

A Range of Ages and Activity Levels

There is a surprisingly diverse range of ages among the many patients for whom Doctors Janke and Naide have performed anterior hip replacement surgeries. Dr. Janke mentions a 91-year old lady who was carrying her walker three days after surgery. There’s the 43-year old soccer coach who had anterior hip replacement in June and was back to coaching soccer in August. Finally Dr. Janke recalls a 49-year old male patient who plans to resume his rock climbing in three months.

“Often we’ll see patients who’ve had one hip replacement done in the traditional way. Then when it comes time for their second hip surgery they’ll choose the anterior hip replacement approach and come to us,” Janke observes. A recent Gold Seal of Approval™ for health care quality for Hip and Knee Replacement, awarded by the nationally recognized Joint Commission, is further testament to North Broward Medical Center’s outstanding expertise in this area.