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| HealthTuesday, May 29, 2007 10:32 AM CDT |
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On with the show
Minimally invasive hip
replacement benefits dancer
NORMAL — A patient from Normal who recently underwent total hip replacement was able to go home the same day because the surgery was performed in a new, minimally invasive way. The orthopedic surgeon who performed the procedure, Dr. Edward Kolb, believes the patient was the first in Central Illinois to have the procedure performed and to go home on the same day. “It’s pretty cool,” Kolb said as he stood in the operating room suite at OSF St. Joseph Medical Center, Bloomington, where he performed the surgery Feb. 20. “This is an exciting new procedure that gives us a way for patients to recover more quickly.” The patient is a longtime Bloomington-Normal dancer and dance instructor who is known as “Miss Janet” to thousands of students, former students and their families. Janet Hayslip Streenz, 66, of Normal, had minimally invasive total hip replacement of her left hip and was back teaching dance two weeks later. While Streenz hasn’t recovered all her strength and dance moves, she hopes to be hopping and kicking again within four months. “I’m so glad I had it done,” she said of the surgery. Streenz said people who need total hip replacement should ask their doctor if they are eligible for the minimally invasive procedure. Kolb, with Orthopedic & Sports Medicine Center in Normal, said the procedure and the possibility of going home the same day are for “motivated, younger patients.” For the procedure to work well and for patients to be discharged and to heal so quickly, they must be in good condition, must be willing to work at rehabilitation and can’t have had a prior replacement of the same hip, he said. Though 66 years old, Streenz was ideal because she’s in great physical condition after dancing nearly her entire life, Kolb said. Kolb estimated that 200 total hip replacement surgeries are performed each year in Bloomington-Normal. He figured that 25 percent of those patients would be eligible for the minimally invasive procedure. But Kolb expects the number of procedures to increase as people throughout Illinois find out that minimally invasive hip replacement is being performed at St. Joseph and will be performed at BroMenn Regional Medical Center in Normal. Streenz has taught dance to more than 6,000 children and adults in Bloomington-Normal since 1955. She continues to teach tap, jazz and baby ballet at Twin Cities School of Dance, 1301 Morrissey Drive, Bloomington. Last year, she semi-retired and teaches two days a week. Streenz is in good health, weighs 98½ pounds, and has missed less than two weeks of work because of illness since 1955. But she has osteoarthritis in her left hip, the big toe of her right foot, in her shoulders and her back. She inherited this form of arthritis from her mother, but the wear and tear that she put on her joints as a dancer and dance instructor aggravated the condition, she and Kolb agreed. Streenz, who raised five children with her husband Bill, began to experience arthritis pain about 20 years ago. “I just pushed through it,” she said. “I kept stretching and kept dancing.” She needed rotator cuff repair surgery of her right shoulder in 1994, surgery on her big toe in 1999, and rotator cuff repair surgery on her left side last September. About three years ago, an X-ray of her left hip joint revealed there was no cartilage left. “It was bone on bone,” she said. She knew that someday she would need hip replacement surgery. Last year, Streenz tried out for the Palm Springs Follies, which features dancers and singers from ages 55 to more than 80. She made the first cut but not the final cut. Now she realizes that was meant to be. “If I had made it, I would have been in the show for nine months,” she said. With her increasing shoulder and hip pain, “I would have been miserable,” she said. “I think God had his hand in the whole thing.” By Thanksgiving, the pain was so bad that she was crying at home each day after class. “I always put on my smile when I work and the kids never knew it,” she said. “But I’d come home and it hurt so badly that I’d stand in the shower and just bawl.” Streenz began to cry. “I felt like it was the end of my career. I guess I love it too much. Between the pain and thinking my career was over, depression set in. I prayed a lot.” Streenz saw Kolb, who took a look at her left hip and was surprised she could walk, let alone dance. He told her she would be a good candidate for the minimally invasive surgery. “It gave me a lot of encouragement and I knew right then and there that I needed to do it,” she recalled. Surgery was scheduled for Feb. 20 at St. Joseph. The procedure was a success. Before she was discharged that evening, Kolb videotaped her walking down a hospital hallway with crutches. Back home in Normal, the first two days after surgery were hard, Steenz admitted. She was still woozy from the anesthesia and was in pain. But pain relief medicine helped, along with home health nurses, physical therapists and occupational therapists. Even Kolb came to see her at home. After a week, she was using just one crutch. Eleven days after surgery, she had cabin fever, got into her car, drove to the dance studio and walked in without a cane. “Julie (Weidmann, president of the Twin Cities School of Dance board of directors) stood in the hall with tears in her eyes. She couldn’t believe it. “After that, I went to Jewel grocery shopping. I was exhausted when I got done but was pretty proud of myself.” The next day, March 4, she went to her church, the Church of Jesus Christ of Latter-day Saints, and gave a testimony. “I was so grateful and felt God had saved me from a whole lot of trouble.” Streenz returned to teaching dance two weeks after surgery. She had an assistant during her first week back. While she’s now back to dancing, she can’t hop, leap or run. She goes to the Center for Health at Ft. Jesse for physical therapy twice a week. “I’m still sore,” she admitted, pointing to a bottle of Tylenol Arthritis Strength. “But before surgery, the pain was all over. This is so much better.” She needs a nap each afternoon. But she hopes that will end within a few months and she will recover her ability to hop, leap and run. Kolb said Streenz’ recovery is going as he expected. He expects her to recover most of her daily activities and dance moves — without significant restrictions and pain — given her motivation, good physical condition and experience. “There’s gratification in seeing patients recover and getting back to their activities quicker,” Kolb said. “But I would encourage her to avoid the extremes of her activity.” While Streenz conceded “I don’t know if I’ll ever get my splits back,” she plans to continue to teach. “It’s hard for me to see giving it up. I have a new lease on life.” Doctor explains new procedureBy Paul Swiech pswiech@pantagraph.com BLOOMINGTON — Total hip replacement surgery five years ago generally meant an 8- to 10-inch incision on the side of the hip. Today, it’s usually a 4½- to 5-inch incision on the side, said Dr. Edward Kolb, an orthopedic surgeon with Orthopedic & Sports Medicine Center, Normal. But the minimally invasive hip replacement surgery that Kolb performed recently on Janet Hayslip Streenz involves no incision on the side. Instead, it involves two smaller incisions: a 2-inch cut in front of the hip and a 1½- to 2-inch cut on the buttock in back of the hip. “The main difference now is we’re approaching the hip between the muscles rather than through the muscle,” Kolb explained. Traditional hip replacement involves cutting through muscles and tendons to get to the hip. Minimally invasive hip replacement involves going between muscles and tendons to get to the hip, Kolb said. The MIS 2-Incision hip replacement procedure was developed by Zimmer Inc., a Warsaw, Ind.,-based maker of reconstructive orthopedic implants. Results should include less patient pain and quicker patient recovery, he said. The procedure begins with the incision in the front. Kolb goes between muscles to get to the front of the hip joint. The head and neck of the femur (the thigh bone) is removed, allowing Kolb to see the acetabulum, the cup-shaped hip socket into which the head of the femur is set. Any remaining cartilage is removed and the artificial acetabulum, which is made of titanium, is put into place. The second incision in the buttock is made to access the femoral canal. The canal is reamed to prepare the femur for the prosthesis. The prosthetic femoral stem is placed into the femur, the prosthetic femoral head is attached to the stem, the head is set into the artificial acetabulum and the patient is sewn up. The bone grows and attaches itself to the metal, Kolb said. Traditional hip replacement surgery results in an average three-day hospital stay. The minimally invasive procedure should result in people leaving the hospital the same day or the next day, Kolb said. Kolb said the procedure generally is for motivated patients in their 40s and 50s. Because the surgery allows patients to get back to work more quickly, the surgery should decrease the cost of hip replacement surgery to society, he said. E-mail this story | Print this story | Search archives | RSS Show comments |  Hide comments | Hide comments on all stories |
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