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A different approach to hip replacement

Dr. Blake Chandler sees many advantages for patients when he performs anterior hip replacement surgery – his preferred method to replace a patient’s hip joint.           

“With the traditional incision in the back of the hip, you have to cut through muscle and open up the hip capsule through its strongest part,” he explained. “The biggest advantage of anterior total hip replacement is that we don’t have to cut muscles. Instead, we move the muscles aside, making the surgery less invasive.” 

Dr. Chandler, a Board Certified Orthopedic Surgeon, also uses a MAKOplasty® robot at Henry County Medical Center to do many of his anterior hip replacements. He also uses the robot for both partial knee and total knee replacements.

“The robot enables me to do the same surgery,” he said, “but with a smaller incision to provide a custom placement of the ball and cup in the joint. The physician is still controlling the surgery; the robot is the tool that allows us to be more precise.”

A hip replacement is the resurfacing and replacement of the worn-out surfaces of the hip due to inflammation from arthritis, injury or simple wear and tear.

Whether the physician uses a robot or other surgical tools, any hip replacement surgery, including anterior hip replacement, is still major surgery, said Dr. Chandler.

“About 98 percent of total hip replacement surgeries I do now are performed by this anterior approach.”

Most patients are candidates for the anterior hip replacement approach if they are not obese or have not had previous hip surgery.

A goal for the doctor in hip replacement surgery is to make sure the length of the leg with the new hip matches the other leg, Dr. Chandler said.

“The robot makes it easier to get more precise leg lengths; we can get them down to less than a millimeter in precision,” Dr. Chandler explained. “The robot uses the patient’s CT scan to create a patient-specific ‘surgical plan’ for optimal placement of the new hip. The goal is to have less blood loss during surgery, recover even faster and have lower dislocation rates.”  

Patients can sleep on their sides rather than on their back for six weeks with a pillow wedged between their knees. Most of his patients spend about one day in the hospital and then go home. 

Tennessee has only five MAKOplasty robots that can do hip and knee replacement surgeries, and western Kentucky does not have any, Dr. Chandler said.

“We are fortunate to have one at Henry County Medical Center.”