Gardner Orthopedics – Simplifying Hip Replacements
An innovative yet simple approach is putting Gardner Orthopedics on the cutting edge, literally, when it comes to truly minimally invasive hip replacements.
Dr. Peter Ameglio has been working for the orthopedic practice for almost a year, but while practicing in New England he learned a different approach to hip surgery. He brought the so-called “super capsular approach” to Dr. Ronald Gardner who welcomed the fresh idea. The procedure may sound complicated, but it is one of logic according to Ameglio, and it all begins with the patient’s body position during surgery.
Anterior hip replacements are performed on a person who is in a supine position, or on their back. If you try to find your thigh bone in this position, it’s not easy. There are muscles on the front of the thigh and hip that are in the way. If positioned on your side like you’re sleeping, it’s easy to feel the thigh bone, even if your hips have a bit of extra cushion on them. You can feel the thigh bone more easily than trying to feel it from the front of the hip. The position impacts how easily the surgeon can gain access to the joint to replace it.
Dr. Ameglio explains, “In the super capsular approach (patient on their side) you don’t have to dislocate the hip joint; it’s less traumatic.” The surgery is easier on the patient than the traditional posterior approach, the recovery time is shortened and the possibility of complications is low.
When hip surgery is done in the anterior approach (patient on their back) Dr. Ameglio says, “You have to extend the operating table and the hip joint to gain access to the thigh bone to place the stem within the marrow cavity.” The stem is what attaches the ball to the thighbone.
The process of getting to the hip joint through the anterior approach can sometimes be quite difficult; it requires retracting or pulling on the muscles until the hip joint is well visualized. An artery that courses through the front of the joint needs to be ligated before the joint capsule is opened. The joint is then dislocated and the ball is cut from the thigh bone. Getting a stem into the thigh bone deep in the wound at an awkward angle can cause the thighbone to break. If a break occurs, the surgeon has to make yet another incision to repair it.
Because it can be so difficult to maneuver the stem around the muscles in the anterior approach, the hip stem is now being made shorter. While a shorter stem is easier for the doctor, the verdict is still out on the reliability and longevity of it.
About the supercapsular or mini posterior surgical approach, Dr. Ameglio says, “We are excited by this innovation because its one of those things that you stop and think ‘why didn’t we think of this?’. It just makes sense as far as injuries to the soft tissue. By moving the incision a little further up and repositioning the patient, it makes all the difference in recovery, and patients say it feels more natural.”
He adds, “It’s important to know that surgery is a last resort. Even though we are surgeons, we are not here to cut first. We want to help keep you out of the operating room if possible.”
The doctor takes a holistic approach to treating his patients, looking at their lifestyle, their body alignment, how they walk, etc. Often a little physical therapy is all that is needed to keep someone out of the operating room.
Dr. Ameglio is an athlete; he competes in triathlons like the half Ironman, and runs extreme distances in Ultra Marathons. He understands his patients’ desires to live full and active lives, not just in the younger years but also as they age. It’s a philosophy he brings to the office every day as he seeks to relieve pain, treat injuries and give Southwest Floridians a better quality of life.
About Dr. Peter Ameglio
Dr. Ameglio will be celebrating his one-year anniversary at Gardner Orthopedics in February. Born in Washington, DC, he grew up in Panama.
Returning to the states, he completed his undergrad at the University of New Hampshire, and studied pre-med in Maryland where he worked at Johns Hopkins. Graduating from medical school at Albert Einstein in New York, he had successful practices in New Hampshire and Maine before relocating to Southwest Florida to be closer to family, including a twin sister in Miami.
Initially specializing in foot and ankle treatments, Dr. Ameglio moved up the leg to knees and hips. He calls it, “a natural progression to look at the entire lower extremity and how things function as a unit.” He estimates performing some 200 joint surgeries a year.
3033 Winkler Avenue • Ft Myers