First BHR Done With Direct Anterior

Warning - Photos below are very graphic and of real surgery!

11/14/08 Update

I spoke to Jim and he is doing fantastic, flying all over the world and keeping busy.

Posted on 4/26/07

I haven't seen it yet, but my LBHR 3/15/07 Kennon/Keggi was done in Waterbury, CT using Anterior Approach with no transected muscles (one was split lengthwise to create room for the acetabular work). I started commuting the 2 1/2 hours on the train and 1/2 mile walk to work in NYC at 32 days. I have some soreness due to long term atrophy of supporting muscles (my BHR replaced a 44 year old bone graft). My PT says my recovery is far, far ahead of the curve he usually sees, and the flexibility of my hip is extraordinarily better than the Posterior Approach BHRs he has treated.

If your doctor doesn't do anterior approach (and almost none do) you should at least get information on it before submitting your body to the major muscle damage of posterior approach.

4/26/07 email sent to Vicky Marlow

I was actually the first Anterior BHR done here - here as far as I know is anywhere in the US.

Ted Kennon and John Keggi have been perfecting the anterior approach and developing the needed instruments on cadavers at Yale.  They knew they had it nailed and planned to start them in May.

Due to my history (I have a long email about me that I owe you) they knew I was about a perfect patient for a first trial.  Dr. Kennon called me the night before surgery, outlined the approach differences, benefits and detriments and asked if I wanted to try it.  I said yes the following morning as we prepared for surgery.

It was kind of funny in the hospital because the nurses, PA's, and even patients kept saying "Oh, you're the one."

And the answer is yes, I am.  Yes it really is an anterior BHR.

Jim

4/27/07

As they say, you asked for it.....  I know you're not squeamish so I don't have to forewarn you.  I do have to explain that my incision is a little unusual due to the prior incision from my bone graft.

I have my follow up May 14th.  They are planning to publish the report, so I'm sure I'll get a copy eventually.

Another thing that was almost funny was the number of people who told me they were in the OR for a portion of the surgery as everyone was very interested. One of the PA's on the ortho floor even said he wanted to know about it as he wants to be patient number 5.

In my case, Dr. Kennon did the surgery, assisted by Dr. John Keggi.  For now they assist each other on their BHR's.

The photos will come in a separate forwarded email.

Jim

October 5, 2007

I knew John Keggi and Dr. Kennon trained in England, and they were assisting each other in their first surgeries. To me it seemed like a great team - so how could I go wrong?

As they teach and work at Yale, they have facilities that are great for developing new techiques and tools. They used the anterior approach for THR's and didn't like the damage the posterior approach caused. If they couldn't develop the techniques and tools to do anterior approach BHR's I think they would have severely limited their offerings of it.

The night before my surgery they called me. They felt I was a great candidate for an anterior BHR because of my size, history, health and attitude. After talking about the advantages and disadvantages, and reviewing how the work would go, I said yes. I figured as I was the guinea pig, they'd take extra care as they didn't want the first one to fail.  And it has turned out very well. Besides not one of the cadavers they had used to develop the tools and techniques had complained......

So many people went through the OR to watch, and came to the floor to check up on me it was almost funny. The one I was most interested in was one of the PA's who was going to have an anterior BHR but didn't want to be in the first few. I met him at their office on a follow up visit and he was happy with his.

By the way - a funny story - one of the people I have spoken to was done by Keggi at Waterbury. The first night the duty nurse forgot to bring him water, so he got out of bed and got it himself.....
I'm not that tough - or is it that stupid?

Later Vicky.

June 5, 2008

I am fine - working full time in NYC, doing pilates classes, sailboat racing and having fun.

My hip usually doesn't exist.... My hernia surgery bothers me more. I have absolutely full range of motion. When I work my leg too much, I limp as I get tired, but that is more from old atrophy than new surgery.

In fact, the most disconcerting thing I have to deal with is that my incision itches where it healed in keloids. Oh well, as long as I don't scratch in public it doesn't matter.....

On Jim’s incision - I had a shelf operation bone graft in 1963, which left me with a 13" incision. Because of that surgery, Dr. Kennon incorporated my prior incision into my BHR, which is why the new incision is a little strange in shape.

Reaming with head tucked

Inserting cup

Measurement

Femoral prep

Planning femoral head

Femoral head ready

Femoral head in place

Evans final x-ray