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Surgeon: Anterior hip replacement is viable option for a broad range of patients

Surgeon: Anterior hip replacement is viable option for a broad range of patients


For OrthoNebraska’s Sayfe Jassim, M.D., specializing in total joint replacement surgery means being able to give people their lives back.

“My fiancé jokes about my enthusiasm toward hip and knee replacements,” he says. “There are so many patients – they can’t walk or enjoy their normal, day-to-day life – and you can bring that back. That’s very fulfilling.”

New to the team as of August, Dr. Jassim brings an additional distinction to OrthoNebraska. The state’s largest and most comprehensive group of orthopaedic subspecialists is now home to Omaha’s only hip replacement surgeon whose fellowship training focused on the anterior approach.

“With the anterior hip, it’s a high learning curve,” Dr. Jassim says. “It’s a difficult procedure to do mainly because there are some very specific nuances that are not intuitive. Having done a fellowship in anterior hip replacement, I went straight through the learning curve to being proficient.”

Most hip replacements are performed with a posterior approach. (Surgeons operate from the back of the hip through an incision close to the buttocks.) With the anterior approach, a “four-finger breadth incision” is made at the front of the hip, slightly to the side.

“The anterior approach is much more direct. You don’t have to go through many tissue-planes before you’re at the hip joint, and you don’t have to cut or detach any muscle. I think that helps in regard to early mobility and early pain control. Patients are quicker to get up and walk. They’re quicker to return to activities.”

Dr. Jassim says “the most common of the uncommon side effects” associated with an anterior hip replacement is potential numbness along the outside of the thigh, which typically resolves within six months.

Throughout the United States, the number of adult total hip replacements is skyrocketing due to their success and the fact that baby boomers are much more active than previous generations at their age, says Dr. Jassim.

A broad range of patients can undergo these procedures – whether the precipitating factor is arthritis, trauma or a lifelong deformity. In evaluating anterior versus posterior approaches, Dr. Jassim says, a “well-done hip from the front or back will do well at one year when you compare the two cohorts.  But I do think getting to that point is easier with the anterior hip.”

Potential blocks to the anterior approach include a patient’s body build and levels of hip complexity. Dr. Jassim says patients with native hip deformity, for example, would be better-suited for a posterior approach: “If I need to see more, I can quickly make the incision a little bigger or I can make my tissue window bigger. It’s very hard to do that from the anterior hip.”

Dr. Jassim went to medical school in Sioux Falls, South Dakota, where he grew up, and then spent five years in Omaha in orthopaedic surgery residency at the University of Nebraska Medical Center.

“That’s how I became more aware of OrthoNebraska,” he says. “We did some of our rotations through OrthoNebraska.”

From there, Dr. Jassim went on to fellowship training in Phoenix, attracted, in part, by successes in anterior hip replacements: “My interest in the anterior hip really came from seeing the surgeries and how the patients did thereafter.”

He’s thrilled to bring that knowledge and fellowship-trained distinction back to Omaha and OrthoNebraska, which is total joint replacement certified and recognized as a destination for joint replacement based on multiple factors, including lower-than-average infection rates, nurse-to-patient ratios and lengths of stays.

“OrthoNebraska has a very well-established system for customizing treatment for each patient and getting them back to what they want to do,” Dr. Jassim says.“Everything is very well-organized and efficient. That’s a system-based quality, which is definitely what drew me here.”

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