New and Hip

An orthopedic surgeon successfully used a nontraditional approach to hip replacement for an elderly man with previous injuries and scar tissue.


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Doctor: Jason Hochfelder, MD, Orthopedic Surgeon, Phelps Memorial Hospital

Patient: Pren Vataj, 75, Mahopac 

Diagnosis: Hip Replacement Candidate With a Deformed Hip


THE PRESENTATION

Pren Vataj was scheduled to have his hip replaced at a prominent New York City hospital when he made a last-minute decision to see orthopedic surgeon Jason Hochfelder, MD, at Phelps Memorial Hospital. The 75-year-old self-employed landlord from Mahopac was in terrible pain, which left him unable to move without the assistance of a cane and in desperate need of a hip replacement. But he began to worry that the severe deformity in his hip might lead to a painful procedure with a long recovery.  

Vilson Vataj, 47, remembers his father’s growing concerns. “Right before he was scheduled have his operation in the city, another patient told my dad he should only have his hip replaced by someone who could perform the technique from the front of the hip [using the more innovative anterior approach]. He said this new technique was much less painful, less risky and had a much easier recovery,” Vilson explains. “We made an appointment with Dr. Hochfelder very soon after.”

 

THE JOURNEY

Vataj’s case was extremely difficult because of an old injury he’d received in a car accident in the late 1980s. His initial injuries, a dislocated hip and broken socket, were getting worse over time, and, as the years passed, massive amounts of scar tissue covered the underside, while arthritis and bone deterioration affected the entire area.

Whereas a traditional hip replacement is performed with an incision made at the posterior hip (how 90 percent of these operations are still performed), Dr. Hochfelder knew that cutting through all of that scar tissue would cause unnecessary trauma and bleeding, resulting in a much longer recovery. “It turned out Mr. Vataj was actually pretty sick,” Dr. Hochfelder says. “He’d had a heart attack and colon cancer fairly recently. He was the ideal candidate.” 

 

THE OUTCOME

Vilson Vataj says his father, after having endured pain and deformity for so many years, feels very lucky to have gotten the initial tip that sent him to see Dr. Hochfelder and is happy to report that his father’s hip is almost fully healed. “It’s about 90 percent of the way there,” Vilson says. “He’s walking without a cane; he’s back to his daily routines, back to work at 75 and feeling very fortunate.” 

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