After Years of Pain and Dysfunction, He’s Grateful for ‘Amazing’ Outcome From Minimally Invasive Hip Replacement

Orlando Ruiz, 63, recalls when he started to feel pain and “locking up” in his left hip. It started more than 15 years ago when he worked as a claims adjuster, a job with many physical demands including climbing ladders, balancing himself on roofs and crawling into attic spaces. Those are the types of movement that can wreak havoc on a bad hip.

“I couldn't take time off to have a surgery,” he recalls. “Throughout the years, the pain continued even after non-surgical therapy. It would hurt me if I would be kneeling down for a little while, and then I would stand up. It would really hurt then or it would kind of lock up. Then I avoided those positions. I could walk miles and I could do many things. But it was certain positions where it would hurt like crazy and lock up.”

He then considered having hip replacement surgery after getting married and returning from his honeymoon in Dubai. But the COVID-19 pandemic hit and put surgery on hold again. It wasn’t until early this year when Mr. Ruiz finally underwent hip replacement surgery by Giovanni Paraliticci, M.D., an orthopedic surgeon with Baptist Health Orthopedic Care and an orthopedic surgical oncologist with Miami Cancer Institute.

Mr. Ruiz’s surgery was a challenge because the patient also was experiencing lower back pain and pain from a deformed lower left leg, which needed to be ”straightened” during the hip replacement surgery because it had rotated outward over the years. A major contributor to Mr. Ruiz’s condition was advanced arthritis.

Giovanni Paraliticci, M.D., an orthopedic surgeon with Baptist Health Orthopedic Care and an orthopedic surgical oncologist with Miami Cancer Institute.

 

“This pain that he was experiencing in the hip was way beyond what he had in the past,” explains Dr. Paraliticci. “He wanted to find a place, a staff and a surgeon that would take good care of him and he would feel welcome. After shopping around for different opinions, he finally landed with us and he loved the experience at our hospital and the experience with our staff in the office -- how they welcomed him, how we sat down with him, and how we explained to him the procedure. I have a model in my office of the hip and I explained how we do the procedure.”

Dr. Paraliticci explained to Mr. Ruiz about the many benefits of the direct anterior approach -- a type of hip replacement surgery that involves minimally invasive techniques. The surgeon makes a small incision near the front of the hip to allow for removal of damaged bone and cartilage, and implantation of an artificial hip without damaging surrounding muscle and tendons. Patients leave the hospital sooner than they would with some other approaches -- sometimes the same day of the surgery.

Explains Mr. Ruiz: “Dr. Paraliticci had to work on it more than he thought because of the 15 years of wearing it out. It was just in such bad shape that he had to work a little more on it. He also straightened out my leg. I used to walk with my left toes pointing out. Now, they're normal and he adjusted the length of my leg. Now, my spine is straight, so I have no lower back pain.”

The anterior approach to hip replacement is often performed with the use of a special operative and visual instruments. In the case of Mr. Ruiz, Dr. Paraliticci used the VELYS Hip Navigation, which is a non-invasive system that provides surgeons with real-time data and visuals.

“After doing the surgery, I released the tissues around the hip joints so that he has a new ball joint in the hips,” explains Dr. Paraliticci. “That way I was able to rotate his leg and put it in a natural position. And because it was short, I used intraoperative navigation in which I'm able to navigate the hip and put the length of the operated leg in very close proximity to what is the contralateral. I lifted the leg, leveled it and put it straight. Now, his leg is not tilted and he doesn't have the length discrepancy that he had before. His leg is not pointing outward -- it's pointing frontward.”

Nowadays, Mr. Ruiz is walking long distances and taking part in his recreational activities without pain or discomfort, including going fishing. Sitting or standing on a boat, especially in rough waters, would have been impossible before his hip replacement surgery.

“He's doing great,” said Dr. Paraliticci. “ I saw him recently and he was very happy. He's spoken with his neighbor. He's spoken with his friends. He's spoken with a bunch of people that he knows and he's telling them how much this surgery changed his life.”

“It's amazing,” said Mr. Ruiz. “I can walk. I went fishing after the surgery and I've gone fishing a few more times. But recently, I spent the entire day out there and it was the first day in years that I've come back and had no pain.”