Nancy Kehoe spent most of nursing school in chronic pain with two severely arthritic hips. She had tried anti-inflammatories, acupuncture and even went to a chiropractor, but nothing seemed to improve her quality of life.
“When I would bend over patients, I could hear my hips ratcheting,” said Kehoe. “I was trying to hold out until after graduation to look into more aggressive approaches, but the pain was so intense, I couldn’t wait any longer.”
Once an avid, long-distance hiker and cross country runner, pain had stopped Kehoe from hitting the trails, and she was not nearly as active as she wanted to be.
“Sitting in classes all day wasn’t helping. I had a very limited range of motion in my hips and a herniated disc in my back,” said Kehoe.
Nancy Kehoe experienced chronic pain from two arthitic hips before having anterior hip replacement surgery at UC San Diego Health System.
After a family friend’s recommendation, Kehoe reached out to the Department of Orthopedic Surgery at UC San Diego Health System and was connected to Francis Gonzales, MD
, who diagnosed her quickly and recommended two hip replacements using the anterior approach.
Only 15 percent of the top joint replacement centers in the United States have the expertise and technological capability to perform anterior hip replacement surgery, where the incision is made in the front (anterior) of the hip as opposed to the side (lateral) or back (posterior). The anterior approach allows the surgeon to work in between a natural muscle plane without detaching muscles or tendons from the hip or thigh bone, avoiding undue trauma to the muscle and surrounding tissue.
“With traditional hip replacements, we have to cut muscle to do the surgery, which affects the recovery process and may limit immediate hip movement in the early post-operative period,” said Gonzales, orthopedic surgeon specializing in adult joint reconstruction. “The muscle-sparing approach is performed in between muscle groups, gently pushing the muscle aside during the hip replacement instead of cutting through it.”
Gonzales, who is fellowship-trained in anterior hip replacements, is the only surgeon in San Diego performing the technique using computer-assisted navigation on a specialized surgical table from Mizuh OSI, which allows for live imaging guidance and manipulation in real time to confirm that the hip replacement implants are precisely placed.
“The specialized surgical table used during an anterior hip replacement is a vital instrument used during the procedure. It enables the surgeon to perform the surgery with ease and decreases the complication rate,” said Gonzales. “The table allows for safe leg placement not possible with a traditional surgery table.”
Patients with osteoarthritis and other forms of degenerative joint disease generally have less pain, a faster recovery and fewer dislocations after an anterior hip replacement.
“On a scale of one to 10, 10 being the worst condition, Nancy’s hips were at a 12 to 13,” said Gonzales. “We performed an anterior hip replacement on each hip four weeks apart. We saw an immediate improvement after the surgeries.”
Kehoe was walking the same afternoon she had surgery and drove about a week post procedure.
Post surgery, Nancy is back in the saddle and grateful to Dr. Gonzales for helping her get back to the activities she loves.
“I live alone and was concerned I would not be able to perform daily activities during recovery. Before the surgery, I could barely put my own socks on,” said Kehoe. “Now, I am able to go about my daily routine and can even sit with my legs crossed and pull my knees up to my chest, which I thought would be impossible. I skipped down the hall in the doctor’s office during a follow up appointment I was so happy.”
A year after surgery, the 55-year-old is back to living a full life, has graduated from nursing school, is now a registered nurse (RN) and is slowly reuniting with some of her favorite activities – running on trails and horseback riding.
“I only missed one semester of nursing school. The surgeries were a small disruption in my life,” said Kehoe.
Gonzales said Kehoe is a true example of how successful the anterior approach can be for patients.
“The results of this approach motivate our team to continue exploring new, leading edge techniques that will enhance the overall patient experience with joint replacements,” said Gonzales.
“It’s like a miracle to be able to walk, stretch and move without pain. This has profoundly changed my life, and I think of and mentally thank Dr. Gonzales every day.”
Most patients are candidates for the anterior hip replacement. Previous surgery, revision surgery or certain deformities may make an anterior approach not feasible.
For more information on anterior hip replacement, please visit: http://sportsmedicine.ucsd.edu/joint-center/hips/Pages/anterior-hip-replacement.aspx
Center for Joint Care