Hip arthritis is a very common and debilitating condition. Fortunately, Hip Replacements are very successful operations with excellent results. They cure the disabling pain of arthritis and restore lifestyles.
Also, despite their enormous success, they do pose some restrictions as ‘Hip Precautions’. These are those in place to avoid the risk of dislocation, a serious complication of this procedure.
These restrictions include things like ‘no crossing legs’, ‘no low chairs’, ‘no squatting’ or ‘no bending forward to pick up things from the floor’
These restrictions can sometimes be long term.
With the traditional Posterior approach, the hip capsule and various muscles, in particular the short external rotators, are cut to gain access to the hip joint. The joint is dislocated and then replaced. This approach, whilst being the convention, is very traumatic to the soft tissue envelope of the hip joint.
This technique however, is the workhorse of horse of hip replacement surgery world wide and proven to be a safe, reproducible and efficient method to perform this operation.
As an alternative, in the last 5 years or so, the Anterior approach has gained popularity. With the anterior approach, minimal muscles are cut, however, again, the capsule at the front of the hip, is incised to gain access to the hip joint. The anterior approach has been used for a long time in paediatric surgery and has now also been shown to be a reproducible technique for hip replacement surgery with comparable results.
In recent years a new technique called SuperPATH, has been developed.
Dr Sol Qurashi is the first SuperPATH trained surgeon who pioneered this technique in Australia.
SuperPATHis a revolutionary development in hip replacement surgery that allows us to perform hip replacements in a manner that encourages quicker recovery and precludes hip precautions that are associated with some other hip replacement techniques. This is because of the unparalleled preservation of the hip capsule and minimal muscle sacrifice.
SuperPATH utilises an incision typically about 3 inches long and simply retracts the main muscles out of the way. Both the anterior capsule at the front and posterior capsule at the back of the hip joint, along with the short external rotators are preserved. The hip is replaced without dislocating the joint.
This allows us to “build” the hip replacement ‘in situ’ with minimal disturbance to the soft tissue envelope. It’s like building a ship in a bottle without disrupting the bottle.
The heavy emphasis of this technique’s philosophy on ‘preservation’ in our opinion has two major benefits:
1. Early mobilisation, with patients often walking within a few hours of the surgery and, more importantly,
2. No Hip Precautions.
At the end of the day, no one technique is better than the other.
If you are having a hip replacement, you should have it done by the technique that your surgeon is most comfortable and familiar with because that is the safest option for you. Whilst results can vary from patient to patient and can be influenced by a multitude of factors, a hip replacement done well is likely to have a good result irrespective of technique.
Dr Sol Qurashi
Dr Qurashi is a Sydney trained and based Hip and Knee Surgeon with expertise in Hip Replacement surgery.
He is the first SUPERPATH trained surgeon in Australia and the first surgeon to pioneer this technique in the country.
Dr Qurashi modified this technique for the ‘Australian patient’ with the creators of the approach, Dr Jimmy Chow and Dr Harbinder Chaddha, in the US and has actively contributed to instrument design and modification. He is at the forefront of teaching local surgeons in Superpath surgery.
Dr Qurashi holds appointments at multiple public and private hospitals in Sydney and consults at Drummoyne, Norwest and Penrith.
Bachelor of Medicine, University of Newcastle 2000
Internship and Residency, Prince of Wales Hospital, Sydney 2001-2002
FRACS I Royal Australasian College of Surgeons
Advanced Training in Orthopaedic Surgery, Australian Orthopaedic Association (Sydney Southside Training Program)
FRACS (Orth), Royal Australian College of Surgeons
Subspecialty Fellowship in ASSITOT/DIVOT, Germany
- Hip and Knee Replacement Surgery
- Ligament Reconstruction Surgery
- Trauma Surgery
- San Diego CA, USA
- Phoenix AZ, USA
- Denver CO, USA
NSW Medical Board (Now AHPRA) Registration since 2001
AMA member since 1999