“The surgery has been a real mood booster. I’m not in pain anymore.”
Whenever Curtis Melton, 58, a pharmaceutical representative from Iselin, sees someone struggling with hip pain, he remembers how he used to live with the same pain.
“I want to tell them that they could get their lives back if they had hip replacement like I did,” he says.
Curtis was an avid tennis player, golfer and runner who once averaged 20 miles a week. Eventually, his hip pain and stiffness became so bad that he couldn’t take even a short walk in comfort.
In early 2020, Curtis made an appointment with reconstructive orthopedic surgeon Frank Femino, MD, Medical Director of the Joint and Spine Institute at Clara Maass Medical Center (CMMC).
“Curtis was really suffering. You could see the pain in his face,” Dr. Femino remembers.
An X-ray confirmed that Curtis's left hip was severely arthritic. The cartilage was so worn down that the bony surfaces of the joint had become rough and were rubbing together, a condition known as “bone on bone.”
In cases this severe, hip replacement is often recommended. However, Dr. Femino advocates first trying conservative management to alleviate symptoms before scheduling surgery. This may include weight loss, physical therapy or more holistic treatments such as acupuncture and yoga.
“I give the patient the choice to make the call,” says Dr. Femino.
Curtis discussed all his options with Dr. Femino. “He took the time to answer all my questions," Curtis says. “He even agreed to have a special conference with my wife and daughter to discuss their apprehensions. He told me that as an athlete, I was a prime candidate for hip replacement.”
“Curtis already had good muscle tone and physically he was strong,” says Dr Femino. “The hip was his only limiting factor.”
Curtis’s surgery was scheduled for March 2020, but elective surgeries such as his were postponed for a time because of the COVID-19 pandemic.
Getting Ready
In the meantime, presurgery classes at CMMC proved vital for Curtis as Dawn Bibbo, MSN, RN, ONC, Manager, Orthopedic and Bariatric Services at CMMC, helped him prepare. "She filled me in on everything to expect,” Curtis says. “She told me what exercises to do and what to wear for physical therapy and recovery, and about the kind of spinal anesthesia I’d have that would allow me to wake up clearheaded, pain free and ready for rehab.”
Hip replacement surgery, designed to improve function and ease pain, involves removal of the damaged hip joint and replacement with an artificial implant. “The hip implants I use come in different sizes and shapes, and the device is personalized for each patient,” Dr. Femino explains.
The method he imploys is minimally invasive, meaning that the incision is small and therefore heals faster. “I use a lateral approach, which is from the side, toward the front, with the patient lying on his back. This allows me to measure leg length and check stability,” Dr. Femino says. "This lateral approach is one of the most stable, with a small chance of hip dislocation.”
To help speed recovery, Dr. Femino does not use heavy opioids for pain management. “We use spinal anesthesia and also a local anesthetic around the hip, instead of general anesthesia, so patients wake up feeling fine and ready to do physical therapy,” he says.
Home That Night
Curtis’s surgery was rescheduled for June. On the big day, he recalls, he was lying on the bed in his room, waiting to go down to surgery. A doctor came in and asked for his name, which hip he was having done and other questions to check Curtis’s cognition.
‘‘Everything’s good,’’ the doctor concluded. “And who’s your doctor?”
“Dr. Femino,” Curtis replied.
“Dr. Femino?” said the visiting doctor. “Well, I want you to know he did both of my hips!”
“I thought, wow,” Curtis says. “Now I felt as if every box had been checked. I was ready.”
Curtis’s operation was at 8 a.m. “I woke up afterwards, and it was like Christmas Day. I was mentally prepared for everything that would happen.“The rehab people were great and walker by 3 o’clock, and went home at 6:30 that night. The visiting nurse began coming to my house the next morning.”
“Curtis’s positive attitude helped his rapid recovery,” Dr. Femino says. “At two weeks post-op he walked in without a cane, leapt right up on the table and said ‘I feel great!’”
Three weeks after surgery, Curtis started hitting golf balls; five weeks later, he played a round of golf. And four months after surgery, he was playing full doubles tennis again. “The surgery has been a real mood booster,” Curtis says. “I’m not in pain anymore.”
Thanks to advances in technology and techniques, hip replacement is increasingly appropriate for a wide range of people. “I’m seeing a full spectrum of patients,” says Dr. Femino. “Many young ones who want to stay active, but also patients in their 90s, who are good candidates if they’re in good health.”
Another benefit is that newer hip implants are long-lasting.
“I used to say that hip replacements can last 15 to 20 years,” says Dr. Femino. “But the ones I use now have extended wear lives. We can offer Curtis and our other patients the best chance possible for a device that will last a lifetime.”
To learn more about joint replacement surgery, visit the Joint and Spine Institute at Clara Maass Medical Center (CMMC), or call 844.63.ORTHO to make an appointment.