By Kathleen Berger in collaboration with MU Health Care
The science behind a new surgical table is improving the experience of hip surgeries for patients.
Madeleine Gehrke, 22, benefitted from the table during her second hip surgery in January 2019.
“I was surprised to not be in pain,” she said. “I was like, ‘Did I even have my surgery? What’s going on?’ ”
Gehrke came to University of Missouri Health Care’s Missouri Orthopaedic Institute to find a solution to her right hip pain after enduring complications when her left hip was repaired in 2018. She said she wasn’t sure what to expect when Nathan Skelley, MD, suggested she try a new surgical approach; a procedure involving an innovative surgical table.
Gehrke agreed to try the new surgical approach. She explained how she’s not one to give up or settle for less since her days as a competitive swimmer.
“They actually tried to kick me off the Y (swim) team,” said Gehrke. “They were like, ‘this girl, not a swimmer’.”
By not giving up, Gehrke landed a college scholarship and spent three years swimming for the University of Missouri in Columbia. She quickly established herself as a standout in the pool. She earned All-American honors three times as a member of relay teams that placed at the NCAA Championships.
Then hip pain sidelined her when the pain became unbearable.
“I seriously could not even walk to the grocery store, which is like two blocks away from my house without being in a lot of pain.”
The problem was femoroacetabular impingement (FAI) or hip impingement, meaning the bones in Gehrke’s hip joint hit each other when she moved. It’s a condition in which the head of the thigh bone fits irregularly in the hip socket and causes friction. FAI is a common cause of hip pain in young people and can lead to early osteoarthritis if the rubbing damages the cartilage in the joint. It’s likely caused by genetics and aggravated by repetitive motion.
Fixing the problem requires a surgery called hip arthroscopy. Because the hip is a ball-and-socket joint, the doctor needs to create enough space between the femoral head and the hip socket to maneuver the instruments.
The traditional method of hip distraction requires placing a post between the patient’s legs so the hip stays in one position while the legs are pulled, opening up the space in the hip joint for the surgeon’s instruments.
Gehrke had the traditional arthroscopic surgery on her left hip in June 2018, but experienced a common side effect afterward.
“I had a lot of numbness in my leg for a really long time,” she explained.
Numbness is one of the side effects caused by the traditional operating table that uses a post between the patient’s legs.
“That creates a lot of pressure, a lot of discomfort for the patients, and there’s a lot of risk for soft tissue injury, nerve damage, urinary dysfunction, sexual dysfunction,” said Skelley.
The procedure solved Gehrke’s hip problem. She returned to swimming at MU, but midway through last season, she felt a familiar pain, this time in her right hip. She knew that she would need another surgery.
Gehrke sought out Dr. Skelley, a surgeon at the Missouri Orthopaedic Institute.
“She had no issues with the previous surgery on the hip, but the problems were related to the bed and the traction post,” Skelley said. “She had a lot of pain, discomfort and some nerve issues related to that post. When she came to me, I explained that we have a new table at the Missouri Orthopedic Institute that allows me to do the same surgery she had on her other hip, but we could do it without the post.”
The post-less traction table for Gehrke’s second surgery secured her feet in traction boots. The table tilted her head lower than the feet, allowing gravity to create enough separation in the hip socket to perform the surgery.
“We’re able to tilt the table so that their weight distracts the joint and we no longer need to use a post,” said Skelley. “So, it’s a much safer surgery, it’s a much more pain-free surgery for the patients, and they get a quicker recovery.”
Gehrke did not experience numbness after her second surgery.
There are many different conditions that can be treated through this type of hip surgery, including problems with the cartilage, bone, ligaments, and tendons.
Gehrke no longer swims competitively for the Tigers, but she is back to swimming and enjoys other activities such as weightlifting. And she is grateful to be living pain-free.
“Now that I don’t have pain, I feel great,” Gehrke said. I really do feel like I can do pretty much any exercise that I want.”