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Basic Introduction

The SuperPATH® hip replacement technique is the creation of Dr. Jimmy Chow of the Orthopedic Institute of the West. It was developed by Dr. Chow as a refined combination of Dr. Stephen Murphy’s SUPERCAP™ and Dr. Brad Penenberg’s PATH® techniques.

Less tissue damage during surgery combined with state of the art anesthetic and pain management techniques allows for patients to have a much more rapid recovery than traditional methods of hip replacement. The vast majority of patients go home the same day of surgery and a few go home after a one night stay. Transitional care unit or nursing home stays are basically unheard of with this technique

Dr. K. Dean Olsen is one of a growing number surgeons in the country performing the SuperPATH technique on a regular basis. He was trained by Dr. Chow and they continue to collaborate to further improve the patient experience surrounding the SuperPATH hip replacement procedure.

Why SuperPATH?

The goal of any hip replacement is the best long term result combined with the fastest recovery to normal. The SuperPATH technique is arguably the least invasive hip replacement technique. Less tissue damage during surgery allows for a much faster recovery, a safer recovery with a lower complication rate, and no restrictions after surgery. It allows for all of the benefits of a minimally invasive surgery without some of the downsides of other techniques. Some minimally invasive hip techniques have actually shown MORE muscle damage than the standard approach. By working inside of the bone without cutting any tendons, this damage is truly kept to a minimum. An x-ray taken during the procedure confirms that the implants have been inserted correctly. Poorly aligned implants have been the downfall of some other minimally invasive techniques. For surgeons performing the technique, there are no restrictions on which patients can have it. No special table or devices are needed. The procedure is safe and reproducible. Also, for the rare times that there may be difficulties in surgery, it can be converted to the standard procedure in 2 minutes with ease. As for the long term results, we do not have 20 year data on the SuperPATH technique, but after 12 years of use of the SuperPATH approach, we see similar long term results compared to other techniques.But we do know that by subscribing to well established critical principles in regard to the longevity of hip replacements while at the same time offering the patient the fastest recovery available, we can make their hip replacement experience one of highest quality and value.

Advantages of SuperPATH

  • More reliably provides a faster recovery
  • Less pain due to less tissue damage
  • Absolutely no restrictions after surgery
  • The hip is never placed in potentially unsafe, twisted positions
  • Quicker hospital discharge (same day almost all of the time)
  • Nursing home or rehab center stays are basically unheard of, even for the elderly patients
  • More natural feeling hip

SuperPATH Surgical Steps

The patient is laid on the side with the arthritic hip in the "up" position. A 3-5 inch incision is made above the tip of the bone you can feel on the side of the hip. The buttock muscles and tendons are spread apart without cutting any of them off of the hip bone which exposes the top of the hip. This is why some have termed this the "Northern Approach." The joint capsule (sack around the ball and socket) is then cut over the top of the ball and neck of the hip. Placing the capsular incision here has the advantage of not weakening the joint support to help avoid dislocations while also allowing the entire capsule to be preserved. In other approaches (especially the "Anterior Approach") the capsule is partially removed. The edge of the socket, top of the ball and neck of the hip are now exposed. Sometimes in muscular patients, one small tendon is released to improve exposure, but it does not seem to change the recovery speed of the procedure.

The next step is where the procedure gets the nickname "The Ship in a Bottle" technique. A trough is then cut into the bone of the ball and the neck to gain entry into the thigh bone. Through this trough, the thigh bone is prepared for the lower part of the hip prosthesis. This is known as the femoral component. The ball is then cut off through the neck of the femur. This decreases the odds of tissue damage as well as decreasing blood loss. The ball is then pulled straight up out of the socket having never been dislocated. Attention is then drawn to the hip socket.

A special guide designed by Dr. Penenberg is then used to position a half inch incision just behind the thigh bone and below the first incision. Through this guide, a PATH is made and a small metal tube is placed into the hip socket. This tube is the pathway for instruments to help prepare the socket when used in conjunction with the first incision. The socket is prepared for an outer metal shell into which we place a plastic liner. We are developing constantly improved ways to further the abilities of this approach for even difficult revision (re-do) hip procedures.

The joint capsule is closed as are the other layers of tissue that were opened. Sterile dressings are applied and then the patient is taken to the recovery room.