SuperPATH Hip Replacement Surgery | Richardson, TX

What is SuperPATH Hip Replacement Surgery?

“SuperPATH” refers to Supercapsular Percutaneous Assisted Total Hip Arthroplasty.

The name “SuperPATH” entails the surgical approach as well as the unique instrumentation utilized in performing a total hip replacement using the technique. Although the SuperPATH technique is not implant-specific in its truest sense, Dr. Chow developed much of the unique instrumentation used in SuperPATH hip replacement surgery with the collaboration of Microport Orthopedics, an orthopedic implant company that also develops quality prosthetic implants used in today’s hip and knee replacement surgeries the globe over. For this reason, Dr. Blair and many other surgeons trained in the SuperPATH technique utilize Microport Orthopedic total hip implants.

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What are the Benefits of SuperPATH Hip Replacement Surgery?

The SuperPATH technique is often referred to as a “microinvasive” method of hip replacement in that its chief benefit is that of minimally disrupting the skin, muscle, and other soft tissues surrounding the native hip. Traditional hip replacement surgery requires a larger incision in order to expose the muscular attachments surrounding the hip joint and the joint itself. These attachments are then re-attached at the conclusion of the surgery.  

SuperPATH hip replacement surgery provides an opportunity to access the hip joint without requiring these muscular detachments and, as a result, the required incision is smaller than that associated with traditional total hip replacement. In particular, SuperPATH hip replacement surgery allows the surgeon the ability to avoid disruption of the iliotibial band which has proven beneficial in reducing postoperative pain, shortening recovery times, and avoiding many of the postoperative complications inherent in traditional total hip replacement.


What is the Difference Between the SuperPATH Technique and the Direct Anterior Approach (DAA)?

The SuperPATH technique was developed more recently than the direct anterior approach (DAA). SuperPATH hip replacement surgery allows the patient to be placed in the lateral position for surgery (lying on their side). The surgical incision is to the back, outer part of the hip. The time spent in the hospital following SuperPATH hip replacement surgery is typically only one night. Surgeons trained in the SuperPATH technique utilize a standard operating room table. The direct anterior approach requires an incision on the front of the hip area, and may or may not require a specialized surgical table depending upon surgeon preference. For some patients, the incision site can play a role in deciding which technique is preferable for them.

Both the SuperPATH Technique for total hip replacement and the direct anterior approach (DAA) avoid violation of the iliotibial band. As the iliotibial band plays a major role in ambulation, it has been postulated that it is for this reason that patients undergoing a total hip replacement with either of these minimally-invasive techniques experience lower pain scores and improved recovery times, a factor supported by numerous scientific publications.

Both approaches are utilized successfully and demonstrate shorter surgical times and length of stay compared to older, traditional surgical techniques for hip replacement. The direct anterior approach was developed by Joel Mata, MD of California, who also developed the special table to help make the procedure easier for some surgeons, and has enjoyed a great deal of marketing support as an “improved” technique for hip replacement compared to more traditional approaches before the advent of the SuperPATH technique.

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How Long Does a Patient Undergoing SuperPATH Hip Replacement Surgery Typically Spend in the Hospital?

We never rush a patient out of the hospital before they are ready to be discharged. They must demonstrate an ability to eat and drink, they must be able to mobilize to and from a bed or chair with the assistance of a walker, and their pain must be controlled. All that said, patients are up and walking (slowly) on a walker with the assistance of a therapist the same afternoon as their surgery.

We utilize multiple pain medications working together to control postoperative pain, so patients fare very well from that standpoint. As long as they pass their other requirements, most of our SuperPATH hip replacement patients return home after only a single night’s stay in the hospital.


Is SuperPATH Hip Replacement Surgery or a Direct Anterior Approach Better for Me?

A well done total hip replacement by any technique is a good surgery. The problems that lead a patient to seek hip replacement are those of persistent and unrelenting pain not relieved by nonsurgical methods, a lack of function, and a lack of mobility.  In replacing the hip joint, the surgeon seeks to relieve pain, restore function and regain mobility for the patient. Regardless of the surgical technique selected, these goals should be the intended result. Deciding to choose one SuperPATH hip replacement surgery over another approach has to do with surgeon experience, patient satisfaction, and patient preference.


What is a “Minimally Invasive” Total Hip Replacement?

A minimally invasive total hip replacement represents an attempt by surgeons to remove and replace the diseased hip joint with minimal disruption of the soft tissues attached to and surrounding the native hip joint. Examples of minimally invasive total hip replacement include the SuperPATH technique, the direct anterior approach (DAA) and a third surgical approach referred to as the “Direct Superior” technique (similar to the SuperPATH, but differing in the surgical instrumentation and implant company used).

Despite the promises of improved DAA patient outcomes, the direct anterior approach has proven to not be a straightforward technique for a surgeon to master. It takes both time and practice to be able to perform a DAA hip replacement and still avoid its unique complications. This can be a challenge for a practicing surgeon to accomplish, and complication rates can be higher in practices where the number of successful hip replacements are fewer. The surgery itself can also be labor intensive and complication-specific as alluded to above if a specialized table is used.

In any total hip replacement surgery procedure, a patient may be at risk for postoperative dislocation, fracture during the surgery, tendon, nerve or blood vessel injury, and even infection after the surgery. Surgeons take a number of steps to minimize these risks, including skin preparation, aseptic technique, laminar air flow and body exhaust systems, as well as efficient surgical technique. However, patient positioning and ease of technique are two prominent factors that lead surgeons who perform SuperPATH hip replacement surgery to believe that the SuperPATH represents the latest evolution in the continuing development of minimally invasive hip replacement, providing the benefits inherent with the minimally invasive technique while avoiding those complications related to the direct anterior approach.


The Bottom Line

As mentioned before, a well-done total hip replacement is a good surgery. Replacement of a painful and increasingly limiting hip joint promises to rid a patient of worsening symptoms of pain, immobility and loss of function. A hip may be replaced through an anterior, anterolateral, direct lateral, modified direct lateral, standard posterior, supracapsular, percutaneously assisted, or any of a number of minimally invasive surgical approaches.

Dr. Blair believes that, in his hands, SuperPATH hip replacement surgery represents the latest advancement in the continuing evolution of hip replacement; allowing patients to benefit from reduced postoperative pain, reduced postoperative recuperation, and reduced risk for complications associated with hip replacement surgery. With all of his experience and surgical knowledge, Dr. Blair describes SuperPATH hip replacement surgery as “the hip replacement surgery I would recommend for any member of my own family who needed to have a hip replaced.”

Texas Orthopedic Surgery Consultants proudly provides patients with SuperPATH hip replacement surgery in Richardson, TX and surrounding areas, including Plano, Garland and Addison, TX. Contact us at (972) 235-5633 or fill out a Contact Form here.

 


The History of the SuperPATH Technique

Sir John Charnley, MD, of England was the first to pioneer the modern total hip replacement in November of 1959. Dr. Charnley was an engineer and a true scientist in addition to his superior abilities as a surgeon. Many orthopedic surgeons had sought to produce a surgical technique for replacement of the diseased hip, but it was Dr. Charnley who was able to advance a technique for a reproducible total hip replacement with his “low friction arthroplasty,” which utilized a cemented metal stem and ball articulating with a cemented plastic acetabular cup.  Dr. Charnley’s patients regained their ability to walk and were able to escape the rusty claws of chronic pain from diseased hip joints. Both patients and surgeons flocked to Dr. Charnley’s British hospital to benefit from his great discovery.

In the ensuing decades, others added to Dr. Charnley’s work by promoting new advances, including replacing the hip through different surgical approaches and directions, creating implants which did not require cement, and reducing many of the complications noted after these early total hip replacement surgeries.

Early efforts at hip replacement using an anterior surgical approach date as far back as 1947, when French surgeon Robert Judet used the technique to replace a hip at Garches Hospital in Paris. When Dr. Charnley’s work in England produced the first reproducible method of hip replacement, the surgeons who favored the anterior surgical approach began to assimilate the two techniques. In the late 1990s and throughout the turn of the most recent century, the direct anterior approach found favor among many surgeons seeking to further these advances in reducing patient pain and complications from hip replacement, and simultaneously reduce the time required for rehabilitation from hip replacement surgery. Much was made in marketing regarding the benefits of the direct anterior approach, and many surgeons sought to assimilate the technique in their own busy practices with varying degrees of success.

The SuperPATH technique was first advanced by Jimmy Chow, MD of Phoenix, Arizona who conceived of its benefits after his experiences with his Adult Hip and Knee Replacement fellowship training with orthopedic pioneer Stephen Murphy, MD of New England Baptist Hospital. His training had resulted in his learning of an innovative supercapsular approach. Dr. Chow had also learned of the benefits to both the surgeon and patient from the Percutaneous Total Hip (PTH) technique of Brad Penenburg, MD of Cedars-Sanai Hospital in Los Angeles, California. Dr. Chow sought to combine the strengths of these two contemporary hip replacement techniques and envisioned a unique way to merge the two in a new surgical endeavor. With his mentors’ guidance and support, the SuperPATH technique was born.

The surgeons who perform SuperPATH hip replacement surgery believe that this most recent advance in hip replacement promises similar improvements over more traditional hip replacement while at the same time reducing the risks of complications unique to the direct anterior approach for hip replacement surgery.


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