Jeff Stickney, MD

Board Certified Orthopedic Surgeon

(425) 823-4000

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Hip Limitations

Minimally Invasive (MIS) Total Hip Replacement

Total hip replacement surgical techniques have been refined over the last decade. Hip replacement can now be done as an outpatient in the surgery center or with a short hospitalization. Improved techniques have resulted in less discomfort and fewer complications. Changes in Surgical approach such as a minimally invasive Anterior Approach (from the front) and Posterior Approach (from the back) have enhanced recovery. Refinements of technique have allowed us to operate through a smaller incision, resulting in less soft tissue inflammation and less pain.

Historical Perspective

The surgical approach and the size of the incision is a critically important element of hip replacement surgery. The success of this operation is largely related to the surgeon’s ability to gain adequate exposure to the arthritic hip joint. Recent enhancements in surgical technique and instrumentation have allowed more limited surgical approaches in certain patients. The use of these instruments, selected implants, and minor modifications of the surgical dissection allow hip replacement to be done through a 4-6 inch incision. The potential benefits of this less invasive technique are significant:

Minimally Invasive Hip Replacement

Not all patients need the standard incision. Recent enhancements in surgical technique have allowed more limited surgical approaches in certain patients. Down-sized instruments, selected implants, and minor modifications of the surgical dissection allow hip replacement to be done through a smaller incision, with much less surgical dissection, and with less trauma to the muscles and tendons around the hip. Minimally invasive approaches to the hip can be done through an anterior or a posterior approach.

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Anterior Approach to Hip Replacement

The anterior approach is the most significant advancement to hip replacement in the past 15 years. The use of minimally invasive approaches in joint replacement has dramatically changed the recovery of Hip Arthroplasty. These techniques using smaller incisions with less muscle and tendon damage have allowed for quicker mobilization after surgery and fewer pain medications needed after surgery.
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MIS Hip Replacement

Total hip replacement surgical techniques have been refined over the last decade. Hip replacement can be done with a shorter hospitalization, less discomfort and fewer complications. There is a minimally invasive Anterior Approach (from the front) and Posterior Approach (from the back). Refinements of technique have allowed us to operate through a smaller incision, resulting in less soft tissue inflammation and less pain.
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Total Hip Replacement

Hip replacement is a predictable, successful procedure. Relief of pain and improved activity levels are the expectation after hip replacement. Total hip replacement was first performed in 1960 and over the last 50 years there has been dramatic improvement in the procedure, implants, and techniques associated with hip replacement. Today over 230,000 total hip replacements are performed in the United States annually. In the recent decade a significant advance in hip replacement surgery has been the refinement of a minimally invasive procedure.
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The benefits of MIS approach are

It is important, however, to understand that small incisions for hip replacement are a recent development. Precise placement of hip components remains the primary goal of the surgery, and this goal should not be compromised for a smaller incision. Patient factors such as weight, stiff hips, previous hip surgery, and hip deformity can require the standard sized longer incision. Patients who are interested in this approach need to appreciate that there are very important and specific requirements:

Better cosmetics

Less postoperative Pain

Less blood loss

Earlier Rehabilitation

Fewer wound complications

Outpatient / same day discharge, hip replacement

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Hip Patient Education & Scientific Articles

After One Joint Wears Out, Will More Go?

September 19, 2019

Here’s a question I’m often asked by patients: “If one of my joints has worn out, how likely are the others to go?” A recent publication from the Osteoarthritis Initiative (OAI) lends some insights into this question. The study, found in the Aug. 12, 2019 issue of Clinical Orthopaedics and Related Research, is the first of its kind. The likelihood of undergoing a 2nd Arthroplasty (Joint replacement) after hip or knee replacement had not previously

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Can Activity Trackers Assist with Recovery After Knee or Hip Arthroplasty?

December 28, 2018

Commercial wrist-worn activity monitors, like those by Fitbit, the Apple Watch or Garmin, have the potential to accurately assess activity levels and have been gaining popularity in the last few years. In a 2018 study published in The Journal of Arthroplasty, researchers set out to determine if feedback from activity monitors can improve activity levels after total hip arthroplasty or total knee arthroplasty. To conduct this study, 163 people undergoing primary total knee arthroplasty or

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Can Patients Who Live Alone Be Sent Home Safely After Joint Replacement?

April 18, 2018

According to a recent study published by The Journal of Bone & Joint Surgery in partnership with Wolters Kluwer, most patients who live alone can safely be discharged home from the hospital to recover after knee or hip replacement surgery. This encouraging finding questions the firmly held belief that patients who live on their own should first be sent to an inpatient rehabilitation facility after undergoing hip or knee joint replacement surgery. “Patients living alone

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How The SwiftPath Method is Changing Joint Replacement

November 21, 2017

Joint replacement patients need surgical options that reduce pain, reduce the need for narcotics and speed recovery more than ever. Even patients with severe debilitating arthritis are often afraid of joint replacement — and what they fear most is the pain of the surgery, complications due to using narcotics and being completely out of commission after surgery. The SwiftPath Method aims to resolve all these issues.  SwiftPath is a protocol-driven company that is constantly striving to discover advanced

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There’s No Place Like Home After Surgery

May 26, 2017

Traditionally, patients and doctors have opted for in-patient postoperative rehabilitation after total hip or total knee replacement surgery, despite the high costs. However, recent studies found that after joint replacement surgery, patients who live alone are happier and fare just as well, and possibly better, when recovering at home rather than staying at a rehab facility.  The study, published by the American Academy of Orthopaedic Surgeons, examined 769 patients who had undergone primary total hip

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Hip Replacement – Performing the Anterior Approach

September 3, 2014

Considering a hip replacement is no easy decision. There are various procedures in the orthopedic marketplace. There are 3 common approaches to the hip replacement. The Posterior Approach is the most common traditional approach. The lateral approach has a lower dislocation risk but a much higher incidence of limp after surgery. I have been performing the anterior approach for total hip replacement for years. In fact, I am the only orthopedic surgeon in Kirkland, WA

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