Frederick F. Buechel, Jr., M.D. | Orthopaedic Surgeon | (239) 659-5633 (KNEE)
MAKOplasty® Destination Center
MAKOplasty® International Destination & Training Center of Excellence
Hip Replacement Hip replacement is surgical option for patients diagnosed with painful arthritis of the hip with the associated groin pain that occurs during weight bearing activity, standing, stair climbing, rising & sitting, and getting in an out of cars. Patients get xrays of the pelvis and two views of the hip joint to look for hip joint space loss or destruction from osteoarthritis, osteo-necrosis, inflammatory arthritis, post traumatic arthritis, or developmental hip diseases. Office consultation is necessary to obtain a history and examine the location of the hip pain and tender areas, to look for limitations in motion, to check leg length inequality, to check blood flow, skin conditions, and overall strength and walking ability, and to look for associated lower back conditions or lateral hip tendonitis/bursitis conditions.Patients that are no longer responsive to NSAIDS or have failed to get relief from weight loss, exercise, or intra-articular steroid injections can benefit from hip replacement.Implants Dr. Buechel’s Hip Replacement patients receive cement-less press-fit tapered titanium stems and press-fit acetabular implants with optional bearing surface choices. Dr. Buechel’s Recommendation for the joint articulation is a standard Polished Metal head and a Highly-Cross-Linked Polyethylene bearing. All bearing surfaces wear and generate wear debris with time in service. There are two main alternative bearing options trying to reduce the volume of wear debris created. The first alternative option is ceramic articulations, the main potential risks are bearing or head ball breakage and potential squeaking noises. The Second alternative option is metal head ball against metal acetabular bearings. Due to the known & potential metal bearing debris issues, Dr. Buechel does not prefer this option.ApproachAnterior-lateral exposure performed in the supine position (on your back) is favored by Dr. Buechel for primary hip replacement for a variety of reasons including: oThe supine position allows direct leg length comparison during the surgery to eliminate unnecessary leg length inequality oThere is a reduced dislocation risk with less restrictions oIt is reproducible, safe and time tested and used by many of the elite training programs.oIt avoids the Sciatic nerve area, significantly reducing foot drop potentialoIt avoids the Anterior Femoral Cutaneous nerve which can produce groin and anterior thigh numbness oPlaces the incision on the side, the least visually unappealing locationDr. Buechel had an extensive Residency& Fellowship Training program using this anterior lateral approach as well as posterior approaches.