REGION — When a 78-year-old hip replacement patient stood up from the operating table roughly one hour after surgery and wanted to leave the hospital due to his concerns of contracting COVID-19, Dr. Anna Kulidjian, a Scripps Green Hospital orthopedic surgeon, told him he must first stand and walk unassisted.
Doing just that, the man told the surgeon felt great, grabbed a walker and headed home.
“I’ve never seen that before,” Kulidjian said. “We’ve been doing a lot of things the same way for a very long time, so when something so beautiful comes up and it’s safer in a way, it’s really exciting to be a part of that.”
Since April, Kulidjian and her team have conducted about 60 hip replacements with a new technique called “table-less anterior approach” — a procedure Kulidjian first learned in January from Belgian hip surgeon Dr. Kristoff Corten.
After introducing the technique to San Diego County, Kulidjian’s surgeries have been less invasive, resulting in lower infection rates, lower risk of injuries and faster recoveries.
One of the first to undergo the new approach, 58-year-old Neal Henning of Carlsbad, needed just two weeks before he could walk without assistive devices and four until he could start golfing again — an upgrade from the traditional six- to eight-week recovery period.
“I went out and hit a bucket of balls, and it felt wonderful,” Henning said. “One of my questions was, ‘How long will it take to recover?’ but with this new procedure it certainly has turned the page as far as letting people heal faster, and it’s totally amazing.”
Traditionally, an “anterior approach” has allowed surgeons to make an incision at the front of the hip for greater accessibility.
However, as a rigorous procedure done on a specialized surgical table, the risk for injuries or complications means that only about 10% of Kulidjian’s patients have been able to receive an anterior surgery in the past.
Now, the “table-less anterior approach” swaps the specialized surgical table for suspended retractors that move gently with the patient and safely pull tissues away from the bone, heightening visibility and accessibility for the surgeon. Moreover, Kulidjian says the approach can be used on any patient, regardless of age or size.
“I was looking for any techniques that would provide more efficient surgeries with less infections,” Kulidjian said. “To increase the efficiency and decrease the cost, those are pressures that lead to better outcomes. … So, looking for a technique that would allow us to answer some of those challenges that would improve the outcome and safety profile for each individual patient is the key, and this procedure gave us that.”
Kulidjian says the retractor technique, which could be applied to other replacement surgeries as well, will be shared first locally with UCSD Health and Kaiser Permanente before Scripps Green implements an educational center alongside Dr. Corten to demonstrate the technique nationwide.
