January 31, 2011
At 60 years old, Hugh Crebs moved around like a much older man: waddling, finding it difficult to get in and out of the car, seeing stairs as almost impossible to climb.
He saw his family doctor for his back and leg pain and took the heavy-duty painkiller Vicodin for nine months.
He saw an orthopedic surgeon for what he thought was a knee problem. After taking X-rays, the surgeon said Crebs needed a dual hip replacement and could expect to be out of work for up to six months — per hip — to recover.
Crebs, a school custodian from Naperville, couldn’t afford that much time off. His wife, Madeleine, was worried he might get one hip replaced and never go back to replace the other. So they got a second opinion from Dr. Steven Louis of Hinsdale Orthopaedics, whose new approach to hip surgery could cut Crebs’ recovery time by half.
It’s called the direct anterior approach — a technique in which the surgeon replaces the hips through cuts to the front of the body, rather than the side or back of the body. Louis first performed the procedure in 2009 and has completed more than 100 of the surgeries since.
Louis uses a special surgical table to help him position the patient better. Despite the additional training and technology, the cost of the surgery is the same because it’s still hip replacement surgery.
Candidates for the surgery include people with arthritis who have tried nonsurgical solutions first, such as weight loss, activity modification, walking with a cane, or using physical therapy, oral medications, injections and joint supplements.
Patients who have had previous surgeries to the pelvis might not be good candidates for the anterior approach because the hardware could get in the way, Louis said.
“The posterior or the side is a great surgery anyway; (patients) do really well,” Louis said. “I just think that my patients do a little bit better in the short run with this particular approach.”
Crebs thinks so, too. He underwent his dual hip replacement surgery Oct. 25, which used the direct anterior approach. The next day, he was up and walking around his hospital room. The next day he was walking the halls and stairs with a physical therapist, and three days after surgery, the hospital released him.
Three months later, he’s driving, running errands, climbing stairs and walking normally. He plans to return to work soon.
“I’ve still got a little pain but not like it was,” Crebs said.
Louis is offering a free public seminar on the topic at 7 p.m. Jan. 25 at Advocate Good Samaritan Hospital in Downers Grove.
To view the original story: http://www.suntimes.com/lifestyles/3428998-423/louis-surgery-approach-body-hip.html