Total Hip Replacement

The procedure I observed this morning was a right total hip replacement, in which the patient was a 79 year old woman, whom had her left hip replaced five years prior. The surgery was scheduled to begin at 7:00 AM, however, the first incisions were not made until 8:45AM. Other than the Doc being slightly late, there was a staggering amount of preparation that went into this surgery, which may have contributed to the delay. The technicians scrubbed the patients' entire leg for a good ten minutes before wrapping it in the necessary materials to prepare for the surgery.

The patient was unquestionably a larger woman which proved to be no obstacle for the Doctor, as he navigated his way through skin, adipose tissue, and muscle to locate the greater trochanter, and eventually the femoral head which was subsequently sawed off. Unfortunately, the pictures I took during the procedure were all on my phone, which was recently destroyed, otherwise I would show a few great shots of the incisions and the sawed-off femoral head.

The procedure itself was pretty straight forward. There wasn't too many interesting things that took place while in the surgery room. Every now and then, the Physician Assistant would toss a quiz question my way, and since there was another high school student in attendance, the Physician Assistant allowed me to answer some questions, however, he shot most of the questions to the high school student, because "he hadn't already had anatomy," and I have, so he expected me to know all the answers to his questions.

Other interesting things that happened during the surgery was one of the technicians apparently became uneasy during the surgery and needed to be helped out of the room. She did not pass out, per se, but from the looks of it, she was well on her way to taking a dive into the operating rooms' floor.

There were a few moments during the middle of the procedure where the Physician Assistant had to shift and adjust the patients' leg positing, which was 1) so the Doctor could get a better view, and 2) so they can observe the way the newly added hardware would work with the patients' existing bony structures, in which they simply simulated all the motions of the hip. There was one time when the Physician Assistant joked, "I will give anyone in here $20 if they could position their leg like this," and I saw just exactly how he was holding the leg, and there is no one alive who could do that. The leg was placed into hip adduction, internal rotation, knee flexion, and and horizontally adducted to where the involved foot could reach the opposite side (right ASIS) and then bend upwards. It was certainly a freakish sight to see and very unnatural, of course.

Needless to say, the environment in their operating room was very relaxed and inviting. There were several times when the Doctor and the Physician Assistant allowed us to get closer looks and really, truly allowed us the opportunity to learn.