Game On: Anterior Approach to Hip Replacement Speeds Recovery

Even though Barnett was living and working in Cleveland as a professional baseball coach, he decided to make an appointment with Dr. Jacobs for his surgery in Baltimore.

Like many individuals involved in professional sports, Michael Barnett has had his fair share of aches and pains. But the 59-year-old had never really had any major health problems other than a shoulder injury in college that shattered his hopes of playing professional baseball. That, however, did little to dampen his enthusiasm for the sport.

“I decided to get into coaching and have been doing it ever since,” Barnett says. “It’s been great ... I wouldn’t change anything.” During his career, he has served as a batting coach for teams all over the country, developing many lifelong friendships along the way. So when hip pain and stiffness from arthritis resulted in a recommendation that he consider hip replacement surgery, he turned to a former colleague for advice.

Michael Jacobs, MD

“Ed Hodge is a batting practice coach who used to work for the Baltimore Orioles,” Barnett explains. “We have stayed in touch over the years and I knew he had hip replacement surgery.” Hodge referred him to Michael Jacobs, MD, an orthopaedic surgeon noted for his expertise in treating patients with hip and knee conditions at MedStar Orthopaedic Institute, here in Baltimore.

Despite the fact that Barnett was living and working in Cleveland for that city’s professional baseball team, he decided to make an appointment with Dr. Jacobs, and he’s glad he did. “I wanted to recover as quickly as possible in order to get back to work,” he says. “After a thorough assessment of my condition, he told me I was an excellent candidate for a procedure that could get me back on my feet again faster—the anterior approach to hip replacement.”

Now that he is pain free, Barnett has resumed his active lifestyle.

Dr. Jacobs is currently team orthopaedic specialist for the Baltimore Orioles, a position he has held for the past five years, and previously held from 1994 to 2001. This has given him a unique understanding of the psyche of individuals involved in professional baseball.

“Baseball players and coaches are on the go constantly. They play 162 games each season, not to mention time spent training and travelling. They love the game... it’s what they live for. These individuals are passionate about baseball and downtime is not acceptable,” he says. “When they have an injury, they just want to get it taken care of and move forward. They never complain, and most of them actually enjoy rehab. And the coaches are the best. Their dedication to the sport is unmatched, and they are ideal patients.”

Dr. Jacobs specializes in anterior hip replacement—a procedure he has performed more than 1,500 times during his career on patients of all shapes and sizes and with all types of hip problems.

The main advantage of this procedure versus other hip replacements is a shorter recovery period. Patients are immediately able to bend their hip freely and bear full weight when comfortable, allowing them a quicker return to normal functioning and far fewer restricted activities. About 90 percent of patients are candidates for this approach.

To perform the anterior hip replacement procedure, Dr. Jacobs uses a special Hana® table that positions the patient’s leg to provide optimal access to the hip. This allows him to replace the damaged joint from the front of the hip without cutting through muscles, as is necessary with a lateral (side) or posterior (rear) approach. It also allows him to make a much smaller incision than is typical with the more traditional approaches.

“Most patients can walk the same day as the procedure, and many can even go home the day of surgery. The remaining patients typically leave the hospital on the next day,” Dr. Jacobs says. “The downside to this is that some patients feel so good they tend to overdo it. So I always remind patients that despite how they feel they still need to take the time to recover properly.”

In 2014, Dr. Jacobs replaced Barnett’s left hip using the anterior approach and, shortly thereafter, the coach was back in the game. Then, in 2017, he started having problems with his right hip, resulting in another trip from Cleveland to Baltimore for a consultation with Dr. Jacobs. In November, Barnett had that hip replaced using the same procedure.

“The second time was even easier than the first,” Barnett says.

“It was a piece of cake, thanks to Dr. Jacobs and his team. I couldn’t be happier. I run across a lot of people in this game who ask me who I would suggest for this surgery, and I always recommend Dr. Jacobs.”

Barnett, who enjoys flying as a hobby, notes that it was hard to get in and out of a plane before his surgery because his hips were so stiff. Now he is back in the pilot’s seat.

Barnett has since resumed his active lifestyle. When he is not coaching he can be found working out in the gym, walking four to five miles a day in the parks around the stadium, and flying, a hobby that was challenging for him prior to his hip replacement. “My hips were so stiff, it was incredibly difficult to get in and out of a small plane,” he notes. “Now I’m back in the pilot’s seat, too.”

MedStar Orthopaedic Institute’s joint replacement program was recently re-certified by The Joint Commission, earning the Gold Seal of Approval for Hip and Knee Joint Replacements.

“This rigorous survey evaluates the program’s compliance with national standards for safety and quality of care,” Dr. Jacobs notes. “Receiving this certification sets our program apart from others by emphasizing our dedication to providing patients with best practices, treatments, and procedures.”

To learn more about the hip and knee specialists at MedStar Orthopaedic Institute or to schedule an appointment, visit, or call 877-34-ORTHO (877-346-7846).
This article appeared in the fall 2018 issue of Destination: Good HealthRead more articles from this issue.

Learn More

To learn more about the hip and knee specialists at MedStar Orthopaedic Institute or to schedule
an appointment, visit, or call 877-34-ORTHO (877-346-7846).

Potential benefits of the direct anterior approach to hip replacement include:

  • Less post-operative pain
  • Shorter recovery time
  • Shorter hospital stay and quicker rehabilitation
  • Less scarring
  • Less blood loss during surgery
  • Decreased chance of hip dislocation
  • More rapid return to normal activity
  • More accurate leg-length control