According to the World Health Organization, Thailand ranks fifth in the world for highest alcohol consumption, and is the leading cause of road accidents. This is evident from the statistics of accidents during every holiday season with long weekends. In addition, the results of drinking alcohol also lead to other social problems, such as domestic violence, disputes, and crimes, including impacts on health issues as well, especially on the hip joint, which currently has an increasing number of patients with hip diseases.

In Thailand, there are more than 25,000 cases of hip replacement surgery per year, found in both men and women, and are more common in people aged 40 years and older. Osteoarthritis of the hip is caused by several factors, usually due to the wear of the joint surface between the hip socket and the thigh bone, including the collapse of the head of the femur, fractured hips, and avascular necrosis of the femoral head.

Middle-aged individuals, according to statistics, also have problems with hip degeneration, caused by excessive alcohol consumption, as it reduces the blood flow to the hip joint, causing that part of the bone to collapse or die. The bone becomes weak, causing the surface to become inflamed and rough. In some people, consuming a large amount of steroid compounds can lead to poor blood circulation, preventing nourishment to the hip bone head.

New Techniques in Muscle-sparing Hip Replacement Surgery

The new technique in muscle-sparing hip replacement surgery normally has the surgical incision at the front of the thigh, which may make the scar easily visible. However, with the new technique of making an incision, the surgery scar is hidden under the underwear line or what is called a BIKINI Incision. Before the surgery, the surgeon uses Digital Template Surgical Planning to plan the bone cutting and the placement of the hip replacement in the correct position, choosing the right size of the prosthetic for each individual, either Cobalt Chromium or Ceramic for longer use, and a new version of the prosthetic bone stem (STEM) to address the problem of a sinking hip replacement over time.

Subsequently, the surgeon will perform minimally invasive surgery (MIS) through a small incision, hidden under the groin (Direct Anterior Approach), importantly, the new muscle-sparing technique allows for smooth blending scars because the incision is made in front of the groin hidden under the underwear line (Bikini Incision), making it invisible when wearing shorts or swimwear, as it follows the natural direction of the skin (Langer’s line) along the line of collagen fibers in the dermis layer, which is parallel to the muscle bundle direction. Cutting along the natural direction of the skin improves healing of the surgical wound, thus reducing the incidence of keloids or scarring.

The size of the surgical wound is approximately 3 – 4 inches, under the underwear line of the patient, and is smaller than traditional surgery (which has an incision about 6 – 8 inches long because it is performed from behind or the side, requiring cutting the muscles around the hip, which may lead to more pain, weaker hip muscles, limping, and an increased rate of hip dislocation after surgery).

This new surgical technique allows doctors to better check the length of the leg and the position of the hip replacement because it is performed while lying on the back, and the use of a C-arm X-ray machine helps better position the prosthetic, allows easy checking of both leg lengths during surgery, thus reducing the problem of uneven leg length after surgery, and can replace both hips in one go. Moreover, during surgery, there is a system to prevent complications, where the surgeon wears a special suit similar to a space suit to reduce the rate of infection after surgery.

Advantages of the New Muscle-sparing Hip Replacement Surgery

• Patients recover faster
• Less pain
• Reduced rate of hip dislocation after surgery
• No need to worry about hip dislocation (No Hip Precaution)
• Can walk without tilting the body (No Limping)
• Return to normal life faster

In addition, post-surgical physical rehabilitation is assisted by an Alter G (Anti-Gravity Treadmill), which is suitable for patients after hip and knee surgery, helping them to recover faster without worrying about pain.