Keeping Active Boomers Moving – Dr. Timothy Lane
His Expertise: As an orthopedic surgeon, Dr. Timothy Lane now sees a younger crowd seeking to stay active by replacing aching hips or knees.
Hip replacement: It’s not just to get your aging Grandma Martha back on her feet again. Just ask Dr. Timothy Lane, a specialist in arthroscopic and joint reconstruction surgery at The Orthopaedic Institute.
Lane will perform some 400 hip and knee replacements this year. The demand will only increase, he observes, as Baby Boomers angle to stay active through their 60s, 70s and beyond.
In many patients, Lane approaches the hip joint from the front, or anterior position, a relatively new approach, replacing the top of the thigh bone and the socket of the pelvis with a device that pairs a titanium shell and titanium stem with a bearing of stainless steel against high-density polyethylene.
This frontal approach has a smaller incision and spares muscles, making recovery quicker.
“The majority opinion right now is that metal-on-plastic is the best choice, based on the data that we already have,” Lane says. Other options are ceramic-on-ceramic devices and metal-on-metal devices.
Hip replacement has been done since the 1960s, thanks to the pioneering work of Dr. John Charnley inEngland.
Charnley was the first to do the modern style hip replacement with a socket piece and a femoral stem. His procedure remains the gold standard, the benchmark against which all other hip replacements are judged.
A typical patient who has a hip replacement has disabling arthritis that significantly influences movement. Obesity is often a factor. Non-surgical treatments such as pain medication, rest, walking aids or physical therapy have not been enough.
The choice becomes one of living with these disabling conditions or having surgery.
“The old idea was that you’d wait until you were disabled by your hip pain,” Lane says. New data show that if you are having severe symptoms that are not controlled by other methods, but you are still active, that is the time to have the surgery done.
“These procedures are done to maintain your quality of life, not just to get you out of a wheelchair and back to walking,” the surgeon says. “The hip may be functional, but the rest of you has to be healthy, too.”
There are three current approaches to hip replacement: the posterior approach at the back of the hip, the lateral approach done from the side and the anterior approach, from the front.
The majority of Lane’s surgeries take the anterior approach, which involves a smaller incision and less disruption to the surrounding muscles and soft tissue as the ball and socket of the hip joint are replaced.
“I use the approach as a tool to do the best operation I can,” Lane says. Of his patients who have had hip replacement by an anterior approach on one side and a posterior approach on the other, most prefer the anterior approach, citing a quicker recovery and less pain. However, some patients’ anatomy favors another approach.
Lane advises anyone considering hip replacement to talk to an orthopedic surgeon.
“Have the approach that he feels is best,” Lane says. “All three approaches provide similar results. Your surgeon will use the approach he feels will give you the best outcome.
“InGainesville, and even within the orthopaedic center practice, there are surgeons who use each approach. Select someone who knows what they are doing, does a good job, and carefully attends to what they’re doing,” Lane advises.
What people want in a hip replacement surgery is not to have a major complication, to have their new hip function well, to get better as quickly as possible and to have as small a scar as possible.
“Ninety percent of the reason you have hip replacement surgery is because you want to be able to do the things you want to do in life,” Lane says.
“Fortunately in this area, the doctors who do this are good at it,” he adds.