Frederick F. Buechel, Jr., M.D. | Orthopaedic Surgeon | (239) 659-5633 (KNEE)
MAKOplasty® Destination Center
MAKOplasty® International
Destination & Training Center of Excellence
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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.
Approach
Anterior-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:
o
The supine position allows direct leg length comparison during the surgery to eliminate unnecessary leg length
inequality
o
There is a reduced dislocation risk with less restrictions
o
It is reproducible, safe and time tested and used by many of the elite training programs.
o
It avoids the Sciatic nerve area, significantly reducing foot drop potential
o
It avoids the Anterior Femoral Cutaneous nerve which can produce groin and anterior thigh numbness
o
Places the incision on the side, the least visually unappealing location
Dr. Buechel had an extensive Residency
& Fellowship Training program using this anterior lateral approach as well as posterior approaches.
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.
Approach
Anterior-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:
o
The supine position allows direct leg length comparison during the surgery to eliminate unnecessary leg length
inequality
o
There is a reduced dislocation risk with less restrictions
o
It is reproducible, safe and time tested and used by many of the elite training programs.
o
It avoids the Sciatic nerve area, significantly reducing foot drop potential
o
It avoids the Anterior Femoral Cutaneous nerve which can produce groin and anterior thigh numbness
o
Places the incision on the side, the least visually unappealing location
Dr. Buechel had an extensive Residency
& Fellowship Training program using this anterior lateral approach as well as posterior approaches.
Frederick F. Buechel, Jr., M.D. | MAKOplasty® International Destination Center | 239-659-5633 (KNEE)
Physicians Regional Medical Center, 6101 Pine Ridge Road, Second Floor, Naples, FL 34119
2012 © by Robotic Joint Replacement Center
Frederick F. Buechel, Jr., M.D.
Board Certified Orthopaedic Surgeon
MAKOplasty® Robotic Knee Resurfacing
& Total Knee Replacement Specialist
(239) 659-5633 (KNEE)
