The Pros and Cons of Anterior (From the Front) Hip Replacement Surgery

X-Ray of a Hip Image By Mikael Häggström, M.D.- Author info- Reusing imagesWritten informed consent was obtained from the individual, including online publication. The consent also included mentioning occupation, age, sex, and clinical history. - Own work, CC0, https://commons.wikimedia.org/w/index.php?curid=80622115

As the orthopedic consultant for the State of Hawaii Department of Corrections, Dr. John Frauens handles inmates’ structural health problems. Dr. John Frauens’ professional interests include innovative surgeries such as anterior hip replacement, in which the incisions are made from the front side rather than the rear (as in older techniques). Replacing the joint from the forward side of the patient offers several key advantages:

- Reduced major muscle damage. The front side of the hip has fewer muscles than the back, allowing surgeons to separate them as they cut. This extra room avoids the complications of slicing through muscle tissue and removing it from the bone.

- Less pain after the operation. Cutting muscles is painful, so avoiding doing so causes less discomfort.

- Quicker recovery. Unlike the long healing time of conventional hip surgery, anterior hip replacements let patients move and bear weight when they are comfortable. These patients can walk by themselves or with assistance sooner than in traditional hip replacements, and thus spend less time in the hospital.

- Decreased risk of dislocation. The anterior procedure leaves the soft tissue and muscles that hold the hips in place intact. This lowers risk of dislocation, and allows patients to safely bend over or cross their legs. With conventional surgery, patients must wait 6-8 weeks to perform these actions, and may be advised to never over-rotate their hips.

There are also a number of disadvantages to this approach. For instance, the procedure is a greater test of surgical skills, and may take longer to learn. Further, patients with large amounts of fat or over-developed muscles may not be suited to anterior replacement. There is also a slight (1 percent or less) chance that incisions could damage critical nerves. Finally, it may take longer for wounds to heal for large patients or those with a lot of abdominal fat.

Artificial Cartilage Treatment for Knee Problems

Backed by more than three decades of clinical experience as an orthopedic surgeon, Dr. John Frauens consults with the Hawaii Department of Public Safety to guide patient care for the state’s incarcerated population under the Division of Corrections. Dr. John Frauens also founded the medical device company SoftJoint, which specializes in developing synthetic cartilage for joint replacements. 

Knee replacements are becoming one of the most commonly performed surgical procedures in the United States. While effective, the procedure is extremely invasive, and many patients would prefer more moderate treatment options. New advances in artificial cartilage may provide an alternative to complete joint replacement. 

Rather than removing the entire joint, medical researchers are investigating methods that replace worn cartilage with plastic or gel inserts that cushion the knee joint and reduce pain. Due to the complication of replicating all of the characteristics of human cartilage, many of these alternatives are still in the trial phase. However, results have been promising, and researchers are getting closer to creating a robust substitute for cartilage.

Jazz Keyboardist Keiko Matsui Releases New Studio Album

 

A board-certified orthopedic surgeon with over three decades of experience, Dr. John Frauens works as an orthopedic consultant for the Division of Corrections in the State of Hawaii Department of Public Safety. Outside of work, Dr. John Frauens spends his time golfing, scuba diving, traveling, and skiing. He also enjoys listening to jazz, and lists Keiko Matsui as one of his all-time favorite artists.

A native of Tokyo, Keiko Matsui started playing the piano when she was 5 years old and launched her professional career as a recording artist for the Yamaha Music Foundation when she was only 17. She continued working as a keyboardist after leaving Yamaha and released her first solo album, A Drop of Water, in 1988.

In the years since releasing her solo debut, Matsui has put out over two dozen albums, including studio LPs, live records, and compilations. Her latest album, Journey to the Heart, was released on August 5, 2016, and soon made it to the top of the Billboard Contemporary Jazz chart. Matsui is currently promoting her new album on a world tour that will continue through March 2017.

An Introduction to Synthetic Cartilage

Orthopedic surgeon Dr. John Frauens served the Kaiser Permanente Medical Care Program in Honolulu, Hawaii, as chief of the department of orthopedic surgery for six years and director of adult reconstructive surgery for 26 years. Dr. John Frauens now leads as founder of SoftJoint, Inc., which has developed a new synthetic cartilage for joint care.

Because human cartilage lacks the ability to heal itself efficiently, patients with cartilage damage or degeneration frequently need surgical intervention. Traditionally, interventions have taken the form of growth stimulation, which requires the surgeon to make holes in the bone that stimulate the growth of new cartilage tissue. However, researchers in recent years have made great strides in the development of materials that take the place of cartilage without the need to wait for new growth.

Artificial cartilage must be smooth enough to cushion the joints that it protects, while also being strong enough to bear the load of a human body. Ideally, the material will also encourage the growth of new cells to further strengthen the area. Advances to date have taken the form of a three-dimensional fabric matrix, which interweaves very thin fibers to create a scaffolded matrix. Recent developments of durable hydrogels, which are tough yet have a low coefficient of friction, are proving promising as a potential material to fill in this matrix and do the job of a patient's natural cartilage.

Nonprofit Common Grace Works with Children in At-risk Situations

Since 2011, Dr. John Frauens has volunteered his time as an orthopedic consultant for the Corrections Division of the State of Hawaii Department of Public Safety. Based in Honolulu, he provides orthopedic consultations to inmates throughout the state. Dr. John Frauens also sits on the board of directors for Common Grace, which pairs grade schools with nearby Christian churches to mentor children who are considered highly vulnerable.

Common Grace is a nonprofit organization that currently serves 21 elementary schools and about 150 students throughout the state of Hawaii. The children served by the organization face challenges, such as incarcerated parents and homelessness. Mentors meet with students identified by the program at the child’s school one hour once per week. Supported by the State of Hawaii’s Department of Education Superintendent, the organization received accolades in 2007 with a Partnership in Education Award.

In February 2015, Common Grace reported that one of the local churches branched out beyond its Common Grace partnership to begin offering a Parachute Club, which meets outside of school. Adult volunteers assisted with the gathering, which demonstrated new heights of community involvement for the church. While at the City Church, children enjoyed a Chinese noodle dinner, sang religious songs, and enjoyed a skit about David and Goliath. Common Grace wholeheartedly supported the church's outreach efforts in its write-up of the event.