Hip, Hip, Hurray

With the smaller cut, patients "bleed less, spend less time in the hospital and recover faster," said Sculco, who has done this surgery thousands of times. Several studies show that complication and morbidity rates are no higher than they are with the bigger incision.

Sculco said recovery time is dramatically shorter than with the Cadillac surgery. Patients typically go home after one or two days, skip rehab and can be back to work with a cane within a few weeks. But muscles and tendons are still being pushed around.

The Miata Here's where things get controversial. The Camry, as Sculco said, "is a modification of the approach we've been doing for 30 to 40 years," but the Miata represents a whole new, sporty method.

Instead of one cut, surgeons make two one- to two-inch cuts, one in the groin and one in the "back pants pocket," as Paul Manner, an assistant professor of orthopedic surgery at George Washington University Medical Center, explained. The surgeon inserts the tools there and operates while watching an X-ray monitor. Manner said not being able to see the joint directly makes the operation "a little bit harder to do. . . . [Also,] there are some issues with getting the head of the femur out and putting the prosthesis in such a small incision."

Manner said he's performed this type of surgery, which was first done in 2001, about 80 times. "Nobody out there has done all that many of these," he said, and many surgeons wonder, "Why on earth would we want to take something that works very well and fiddle with it?"

His answer: "What it really comes down to is how the patients feel postoperatively. That's the reason we do this operation. Our goal is to get rid of the pain." To that end, Manner said the Miata approach cuts pain, bleeding, hospital and recovery time.

Sculco scoffs at that. His view: "It's literally impossible not to damage the muscle in some way." And, he says, the recovery time for the Camry and Miata-style surgeries is virtually the same.

Still, like a boomer facing a midlife crisis, my friend Sandra opted for the Miata. In late March, Manner did the operation. Sandra stayed in the hospital for two nights, proved she could walk up and down stairs, then went home. She walked without a cane or walker at four days. She drove at two weeks (remember, it was her right hip, too!). At our book group three weeks after the operation, she looked great. No limp.

At six weeks, she says "walking is no problem, and I'm ready to try swimming again." She still has some discomfort and less than optimal flexibility ("picking something up off the floor is still very awkward"), but she expected worse. She's also decided on her new career: working on behalf of nursing home residents.

For Sandra, hip replacement surgery was nearly routine maintenance. A boomer's dream come true.

The columns KidLife and MidLife appear on alternating weeks. Send comments, suggestions and questions to kidmid@washpost.com. For U.S. Mail, see address on Page F2. No calls, please.