Hamilton says that “a decade ago, very few residencies and fellowships taught the anterior approach. Now, several institutions around the country have at least one surgeon teaching it. So when students leave and begin their practices, it’s no longer foreign to them.”
Hamilton, who has performed 1,100 anterior procedures and strongly supports the method, says that despite growing interest, “it will take a generation of new surgeons” before use of the anterior approach is widespread.
Patients aren’t informed
Many patients aren’t aware of the option. The case of Daniel Ellsberg — who in 1971 released the Pentagon Papers, a secret study about U.S. involvement in Vietnam — is instructive. His hip had been hurting for about a year, and when he decided to have surgery, his primary-care physician recommended a respected surgeon. Just days before the operation last July, a friend told him about the anterior approach.
“I’d never heard of it, and neither my doctor nor surgeon mentioned it. I called the surgeon’s office, learned he did the posterior procedure, asked for and got a recommendation for one who performs the anterior one, and my experience was amazing. The same day as the operation, I walked down the hall with a walker. I was home in three days, and a week later, [I] walked one or two blocks without pain or a cane. In a month, I bodysurfed at the beach,” says Ellsberg, who is 81 .
Margot Machol, who is two decades younger and lives in Washington, had both hips replaced — the first with the posterior procedure several years ago, the second with the anterior procedure last October. Unger performed both surgeries.
“After the first, I needed pain medicine when I came home from the hospital. Also, I had a long list of restrictions of what I could and couldn’t do so the hip wouldn’t pop out. For six weeks, I had to sleep on my back, couldn’t cross my legs and wasn’t able to drive.
“After the second, I didn’t take any pain pills once I was home, slept on my side soon after the surgery, had almost no rules and drove my car in two weeks. I even wanted to ski over Christmas, because I felt fine,” Machol says.
Koeppel is a writer based in Washington.