PITTSFIELD -- Bonnie Ditello is on the move again.
About five years ago, the 70-year-old Pittsfield resident fell on the ice and cracked her hip. The pain increased over the years, slowing her down. She'd limp to catch up with her friends when they'd go walking.
On Jan. 30, Ditello was the fourth person at Berkshire Medical Center to undergo anterior hip surgery, the county's newest approach to total hip replacement.
Ditello was walking again, sometimes without a cane or walker, about two days after the surgery.
"I could not believe that, when I came to, I felt great," she said. "The friends that I couldn't keep up with before the operation, couldn't keep up with me after the operation."
Anterior hip surgery approaches a hip replacement from the patient's front rather than their side (anterolateral) or buttocks (posterior), but uses traditional hip replacement components. This way, surgeons can move muscle and tissue rather than cutting through it.
Forty patients have undergone anterior hip surgery at BMC since it began in January. Some even traveled to the Berkshires for the operation. Though a longer and more strenuous operation for the surgeons, anterior hip surgery results in a quicker, painless recovery time for the patients.
"It's really a cutting-edge type of procedure," said Mickey Haryanto, the service line administrator for Orthopaedics at Berkshire Health Systems. "It's the type of major orthopaedic program that's in large medical centers around the country."
So far, Dr. Jim Harding and Dr. Kevin Mitts are the only two surgeons affiliated with Berkshire Orthopaedic Associates trained to perform anterior hip surgery. They started training last summer.
According to The New York Times, anterior hip replacement was first described back in the 1970s. It is slowly gaining popularity.
"There's nothing fundamentally wrong with the posterior approach," Harding said. "For me, the anterior approach is a true game-changing procedure that doesn't come along very often in orthopaedics."
Of the 400,000 hip replacements performed annually, only about five percent are done anteriorly, Mitts said.
"There's a little bit of a slow adoption curve to this procedure, plus its intensive in terms of the investment the hospital has to make," Harding said.
Anterior hip surgery at Berkshire Medical Center is made possible by a special table and X-ray that cost at least $80,000. The table, called a hana, allows surgeons to adjust a patient's leg to varying degrees for access to the hip. The table also allows surgeons to ensure the legs are of equal length after the procedure.
The fluoroscopy X-ray projects a live image of the operation onto a monitor for the surgeons.
"You can look at your X-rays directly and know where your components are positioned, which is a huge advantage for me," Mitts said.
Patients who undergo anterior hip surgery recover faster, sometimes leaving the hospital the next day.
Other hip replacement patients are advised not to bend past 90 degrees during recovery, but "the anterior hip replacement doesn't have those precautions," Haryanto said.
Dislocation rates after anterior hip surgery are also less than 1 percent, according to Mitts.
Both surgeons said that the procedure is longer and more demanding for them. Patients do bleed a little bit more during the anterior, but not "to a critical level," Mitts said.
For Ditello, the surgery has helped her regain normalcy.
"You feel like you're putting life on hold when something happens to you and can't do a lot," she said. "It's a great feeling to know you can get back to where you were before your hip got bad."
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