AHF Podcast

Anterior Hip Foundation
  • 5.0 (5)
  • Medicine
  • Weekly

The AHF Podcast features thoughtful conversations about orthopedic surgery, outcomes, and clinical decision-making, with a particular focus on hip surgery and related innovation.Produced by the Anterior Hip Foundation, the podcast brings together surgeons, researchers, and clinical leaders to examine how evidence, experience, and real-world practice intersect. Episodes explore what the data actually shows, where assumptions break down, and how clinicians navigate uncertainty in daily practice.This podcast is intended for orthopedic surgeons, trainees, and medically literate clinicians who value nuanced discussion, critical thinking, and honest examination of what improves patient care.

  1. 5d ago

    Filling, Crown or Implant? The Case for Hip Resurfacing

    Hip resurfacing never went away; it went quiet. Paul Beaulé of The Ottawa Hospital and the University of Ottawa explains what really failed in the metal-on-metal era, who should get a resurfacing today, and how he does it through the anterior approach.Paul has offered resurfacing for a quarter of a century, since his fellowship with Harlan Amstutz in Los Angeles, and today it makes up about 30% of a practice that also covers hip preservation and total hip arthroplasty. He separates resurfacing from the large-head metal-on-metal total hips that dragged it down, explains what the registries caught early and what they missed, and argues that a new implant should change one thing at a time.From there it gets practical: which patients he offers a resurfacing and which he steers toward a total hip, the dental analogy he uses to explain the choice (filling, crown or implant), and what five-year data on ceramic-on-ceramic resurfacing show for women and smaller femoral heads. On the anterior approach, he walks through femoral exposure on a positioning table with no posterior capsular release, and explains why he now blames notching of the anterior femoral neck and off-center pin placement, more than blood supply, for early neck fractures. Paul discloses that he is a designer of a ceramic-on-ceramic resurfacing implant.He also takes on the skeptics' strongest objections, from "total hip is good enough" to revision difficulty and surgeon volume, and names the one he takes most seriously: how much acetabular bone the cup removes. For hip surgeons deciding whether resurfacing belongs in their practice, and for anyone who wants to know where it fits next to hip preservation and total hip arthroplasty.⏱️ Chapters:00:00 Introduction: hip resurfacing's second act01:25 Learning hip resurfacing with Harlan Amstutz04:57 What really went wrong in the metal-on-metal era07:22 Hip registries and lessons for new implants11:48 Follow-up for well-functioning metal-on-metal hips13:36 The ideal hip resurfacing patient today15:43 Who should not get a hip resurfacing18:29 Resurfacing vs total hip: the dental analogy20:11 Ceramic-on-ceramic resurfacing bearings23:53 Evidence on ceramic bearings: noise, women, small heads29:05 Red flags that would end a new resurfacing design30:22 Hip resurfacing through the anterior approach34:25 Femoral exposure in anterior approach resurfacing37:44 How the anterior approach lowers neck fracture risk42:20 Answering the skeptics of hip resurfacing46:03 Acetabular bone stock: the strongest objection48:19 Where hip resurfacing goes in the next decade51:06 Advice for surgeons learning hip resurfacingListen to the AHF Podcast on your preferred platform:Show page: https://jvomedia.com/shows/ahf-podcastApple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHcLinkedIn: https://www.linkedin.com/showcase/ahf-podcastYouTube: https://www.youtube.com/@anteriorhipfoundationHomepage: https://anteriorhipfoundation.comThis podcast is intended for educational and informational purposes only.The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion.#AHFPodcast #AnteriorHipFoundation #HipResurfacing #PaulBeaule #AnteriorApproach #HipArthroplasty #MetalOnMetal #CeramicOnCeramic #HipPreservation #FemoralNeckFracture #PatientSelection #OttawaHospital

    Filling, Crown or Implant? The Case for Hip Resurfacing

  2. Oct 16

    The View From Outside the US (2026 Traveling Fellows - Ep 3)

    A Toronto hip surgeon on what two weeks in the operating rooms of leading US anterior hip surgeons changed in his own practice, and what American hospitals could learn from Canada.For hip surgeons weighing the AHF Traveling Fellowship, and for anyone working to make anterior approach care more efficient inside a hospital system.This is the third and final conversation with the 2026 AHF Traveling Fellows. Host Joe Schwab sits down with Justin Chang, an adult hip and knee surgeon at Humber River Hospital in Toronto who trained at St George's, University of London, and the University of Toronto. Trained in the posterior approach, he switched to the anterior approach when he started practice and now uses it for 95 percent of his hips. He joined the fellowship to build confidence with complex and revision cases.What he brought home started in the OR: hooking a cobra retractor on the Hana table's ladder, trading a Charnley for a Gelpi, nail conversions in Houston, complex revisions at OrthoCarolina, and the soft tissue restraint that separates good anterior surgeons from masters. The bigger lessons came from around the surgery: sterilization and tray flow, OR time tracking, PA-supported teams, and how a high-volume surgeon stays present with every patient. He also makes the case that a generation trained almost exclusively in the anterior approach will need to do its hardest revisions from the front, and explains why he expects hip resurfacing to make a comeback.Coming from a fee-for-service system where two weeks away means two weeks without income, he is candid about the cost, and about why the network of host surgeons and co-fellows he built was worth it. Asked what American surgeons could learn from Canada, his answer is efficiency: how Humber River runs an efficient anterior hip workflow inside a public hospital.Thinking about applying for the 2027 AHF Traveling Fellowship? Applications run through the Anterior Hip Foundation, linked below.⏱️ Chapters:00:00 Meet 2026 AHF Traveling Fellow Justin Chang02:27 Switching from posterior to anterior approach03:55 What the fellowship teaches beyond surgical technique07:43 Anterior approach retractor tips and Hana table tricks10:50 Nail conversion and complex revision via anterior approach13:20 Why young surgeons will revise through the anterior approach16:41 Anterior hip surgery in the US vs Canada18:29 What US hospitals can learn from Canada about efficiency19:32 Soft tissue handling and what surgical mastery looks like21:35 How master surgeons communicate with patients at high volume23:36 Bringing home OR time tracking, OrthoGrid, and PA teams26:22 Is the AHF Traveling Fellowship worth two weeks away?30:18 Future of anterior hip surgery: revisions and resurfacing32:09 Advice for future fellows: practice building and marketing33:45 The biggest takeaway that wasn't a techniqueListen to the AHF Podcast on your preferred platform:Show page: https://jvomedia.com/shows/ahf-podcastApple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHcLinkedIn: https://www.linkedin.com/showcase/ahf-podcastYouTube: https://www.youtube.com/@anteriorhipfoundationHomepage: https://anteriorhipfoundation.comThis podcast is intended for educational and informational purposes only.The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion.#AnteriorHipFoundation #AHFPodcast#TravelingFellowship #AnteriorApproach #AnteriorHip #TotalHipArthroplasty #HipReplacement #RevisionTHA #HipResurfacing #HospitalEfficiency #OrthopedicSurgery #SurgicalMentorship #JustinChang

    The View From Outside the US (2026 Traveling Fellows - Ep 3)

  3. Oct 9

    Managing Intraoperative and Early Complications (S+N Surgeon Roundtable)

    Every hip surgeon will eventually crack a calcar or fracture a femur — what separates a manageable complication from a cascade is what happens next.Three hip surgeons walk through intraoperative and early complications after anterior approach total hip replacement, from the first broach to the first weeks at home.Complications come with hip arthroplasty, and the anterior approach has its own: femoral fractures and calcar cracks during broaching and seating, lateral femoral cutaneous nerve symptoms, bleeding that degrades visualization, and the wound and infection questions that surface in the first days after discharge. In this roundtable, Alex Gaukhman, Molly Hartzler, and Stephen Duncan talk through where those problems really start and how they handle them when they happen.The conversation stays practical. Exposure is the root of most femoral injuries, and they explain how they adapt to tight and wide canals with diaphyseal reaming and stem choice, where automated impaction makes seating more reproducible, when a calcar crack needs only a cerclage cable and when it calls for a diaphyseal-engaging stem — and why cementing a cementless stem is never the fix. On the soft-tissue side, they cover protecting the TFL and the LFCN, targeted hemostasis, and when to stop, pull the retractors, and reset rather than push through.After surgery, they work through an early dislocation, the role of navigation, incisional negative pressure therapy, and how nurse navigators, patient photos, and checklists catch problems before they are delayed. This one is for arthroplasty surgeons, fellows, and residents — especially anyone still on the anterior approach learning curve. It closes with the complication lesson each surgeon learned the hard way, and what still deserves humility every time they step into the OR.Brought to you by Smith+Nephew — Life Unlimited. The CORI Surgical System, CORIOGRAPH Pre-Op Planning, and the CATALYSTEM Primary Hip System together offer a complete solution for primary total hip arthroplasty.https://www.smithandnephew.com⏱️ Chapters:00:00 Introduction: intraoperative and early hip complications02:17 What turns a hip complication into a cascade05:04 Femoral fractures and calcar cracks start with exposure08:08 Dorr A vs Dorr C femurs: reaming and stem choice11:27 Broaching dense canals and automated impaction14:02 Managing an intraoperative calcar crack or femoral fracture18:26 Protecting the lateral femoral cutaneous nerve21:48 Hemostasis, visualization, and when to stop and reset27:44 Early dislocation after hip replacement and navigation31:22 Preventing wound complications and incisional wound vacs35:18 Early infection after hip replacement: when to escalate38:10 Checklists and nurse navigators that catch problems early41:08 Escalation triggers and when to bring in help44:53 Complication lessons that shaped their careersListen to the AHF Podcast on your preferred platform:Show page: https://jvomedia.com/shows/ahf-podcastApple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHcLinkedIn: https://www.linkedin.com/showcase/ahf-podcastYouTube: https://www.youtube.com/@anteriorhipfoundationHomepage: https://anteriorhipfoundation.comThis podcast is intended for educational and informational purposes only.The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion.#AnteriorHipFoundation #AHFPodcast#HipComplications #PeriprostheticFracture #CalcarFracture #TotalHipArthroplasty #THA #AnteriorApproach #LFCN #PJI #AutomatedImpaction #AlexGaukhman #MollyHartzler #StephenDuncan

    Managing Intraoperative and Early Complications (S+N Surgeon Roundtable)

  4. Oct 2

    The Part Nobody Can Teach You (2026 Traveling Fellows - Ep 2)

    Three 2026 AHF Traveling Fellows on what two weeks in the operating rooms of the highest-volume anterior hip surgeons in the US taught them that no video could.For early-career hip surgeons weighing the fellowship, and for anyone trying to turn anterior approach technique into surgical judgment.This is the second of three conversations with the 2026 AHF Traveling Fellows. Host Joe Schwab sits down with Jadye Kee, a joint replacement surgeon in community practice in Bryan-College Station, Texas; Pat Maher, a hip and knee surgeon at EvergreenHealth in Kirkland, Washington; and Leo Zalikha, a Stanford-trained reconstruction surgeon now practicing in Long Beach, California. Three very different practices, two weeks on the road from Hoag in Irvine to Anderson Clinic, the Southern Joint Institute in Nashville, and Louisville, and one shared question: what actually changed when they got home?The answer starts in the OR but does not stay there. The fellows describe the small things nobody voices on video, from capsule tagging and retractor timing to a calcar release that depends on how the femur drops, and what it meant to be able to ask the surgeon why. They work through judgment versus technique, how to know when the femur is released enough, when a long femoral revision still belongs posterior, the on-table versus off-table question, and how to bring high-volume habits back to a community hospital with a different patient population. Along the way: BMI cutoffs and widening indications, value-based care, and why the OR is always an N of one.What stayed with them most was not a maneuver. It was watching how surgeons at the top of their field run a room, empower a team, and give their time to the people coming up behind them, and the kind of mentors they now want to be. They close with the case for why their group beat the first one, and a one-sentence answer to what the fellowship gave them that no technique could.Thinking about applying for the 2027 AHF Traveling Fellowship? Applications run through the Anterior Hip Foundation, linked below.⏱️ Chapters:00:00 Meet the 2026 AHF Traveling Fellows01:21 What three early-career surgeons wanted from the fellowship05:48 Itinerary: Hoag, Anderson Clinic, Nashville, Louisville09:53 Watching experts up close: why every step has a reason15:24 Judgment vs technique in anterior hip replacement19:40 Bringing high-volume lessons back to a community hospital22:12 Good vs great surgeons, and finding your own technique26:42 Patient selection, value-based care, evidence vs experience31:54 Long femoral revisions and on-table vs off-table34:24 OR culture and flow: fluoro setup, walkie-talkies, two rooms38:35 The kind of mentor they want to become42:55 What the fellowship really offers beyond technique46:20 Day one again, and where they hope to be in five years52:03 Which 2026 fellows group was better?54:00 The takeaway that wasn't a technique, and applying for 2027Listen to the AHF Podcast on your preferred platform:Show page: https://jvomedia.com/shows/ahf-podcastApple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHcLinkedIn: https://www.linkedin.com/showcase/ahf-podcastYouTube: https://www.youtube.com/@anteriorhipfoundationHomepage: https://anteriorhipfoundation.comThis podcast is intended for educational and informational purposes only.The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion.#AnteriorHipFoundation #AHFPodcast#TravelingFellowship #AnteriorApproach #AnteriorHip #TotalHipArthroplasty #HipReplacement #RevisionTHA #OrthopedicSurgery #SurgicalMentorship #ValueBasedCare #JadyeKee #PatMaher #LeoZalikha

    The Part Nobody Can Teach You (2026 Traveling Fellows - Ep 2)

  5. Sep 25

    Scrubbing In With the Giants (2026 Traveling Fellows - Ep 1)

    Three 2026 AHF Traveling Fellows on what two and a half weeks scrubbing in with the most experienced anterior hip surgeons in the US actually changed in their practice.For early-career hip surgeons weighing the fellowship, and for anyone refining their anterior approach technique, revision skills, or practice model.Every year the Anterior Hip Foundation sends a small group of early-career surgeons city to city to scrub in with the highest-volume and most innovative anterior hip surgeons in the country. Host Joe Schwab sits down with Alex Savage, Anoop Prasad, and Brent Albracht, three of the 2026 fellows with academic, community, and transatlantic vantage points, to unpack the trip while it is still fresh.The conversation moves from the OR to everything around it: radiographic versus acetabular inclination in Dr. Matta's cadaver lab, anterior nail conversion in Houston, buttress fixation for large acetabular defects from the front, the femoral broach angle that had caused two perforations, and the on-table versus off-table question that came up at every stop. Along the way the fellows retrace the itinerary from San Francisco through Los Angeles, Houston, Charlotte, and Atlanta to the AHF meeting, and describe what they learned from watching how surgeons at the top of their game run teams, follow up patients, and build a practice.They are also candid about what the fellowship costs in family time and practice coverage, who it is not built for, and what they would tell next year's applicants. Their biggest takeaways were not techniques at all: confidence, an approach to practice, and perspective.⏱️ Chapters:00:00 Meet the 2026 AHF Traveling Fellows01:17 Three different roads to anterior hip arthroplasty06:01 The Shania Twain karaoke story07:33 Cup inclination lessons from Dr. Matta's cadaver lab11:22 Anterior nail conversion tips from Houston12:56 What changed in the OR after the fellowship14:50 Anterior approach revision: buttress fixation research17:18 Cadaver labs vs live cases for learning revision20:57 Fixing femoral broach angle after two perforations23:17 The fellowship itinerary from San Francisco to Nashville28:05 Team culture at OrthoCarolina29:25 Unexpected mentors and practice-building lessons34:34 What the fellows learned from each other39:41 Family, PA coverage, and the cost of three weeks away46:09 On-table vs off-table anterior hip: where each fellow landed51:57 Who the Traveling Fellowship is not built for56:59 Advice for next year's fellows: notes, GoPro, survival guide1:00:49 Confidence, perspective, and the biggest takeaways1:04:45 Which fellows group wins, and why to apply for 2027Listen to the AHF Podcast on your preferred platform:Show page: https://jvomedia.com/shows/ahf-podcastApple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHcLinkedIn: https://www.linkedin.com/showcase/ahf-podcastYouTube: https://www.youtube.com/@anteriorhipfoundationHomepage: https://anteriorhipfoundation.comThis podcast is intended for educational and informational purposes only.The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion.#AnteriorHipFoundation #AHFPodcast#TravelingFellowship #AnteriorApproach #AnteriorHip #TotalHipArthroplasty #HipReplacement #RevisionTHA #OrthopedicSurgery #SurgicalEducation #Arthroplasty #AlexSavage #AnoopPrasad #BrentAlbracht

    Scrubbing In With the Giants (2026 Traveling Fellows - Ep 1)

  6. Sep 18

    Anterior Approach Revision (S+N Surgeon Roundtable)

    Can you really revise a failed total hip through the anterior approach? Three surgeons who do it every week explain when they stay anterior, when they still go posterior, and how they plan the exposure.A practical roundtable on anterior approach revision hip arthroplasty for arthroplasty surgeons, fellows, and residents.The knock on anterior approach revision has always been that it is not extensile. Eric Cohen, Kris Alden, and Molly Hartzler take that head-on: from the ASIS to the lateral knee, total femurs, cup-cages, and periprosthetic fractures are all on the table, and the recovery data increasingly favors the front. They also draw their lines honestly. One of them has not done a posterior revision in fifteen years; the other two still pick the approach case by case, and they explain exactly which red flags send them posterior.The conversation gets specific quickly. How to diagnose and sequence a failed hip before approach even enters the discussion. How to plan an incision you can extend, and what to do with a prior bikini scar. Whether to excise the old scar and whether to keep or remove the capsule. How to regain your bearings with fluoroscopy and a functional standing pelvis film when the landmarks are gone. And on the acetabular side, how to balance defect fill, biomechanics, and cup orientation, when a single integrated revision system changes the plan, and where dual mobility and constrained liners actually belong.It closes with the one mistake almost every surgeon makes when they first revise from the front, a guardrail for anyone early in the journey, and a look at where anterior approach revision is headed as implants and instruments finally catch up with the approach. This episode was recorded in partnership with Smith+Nephew — Life Unlimited. The REDAPT Revision Hip System and OR3O Dual Mobility give surgeons a flexible, stability-focused approach to revision total hip arthroplasty — from compromised bone and fixation challenges to instability. Learn more at https://www.smithandnephew.com ⏱️ Chapters:00:00 Introduction: anterior approach revision roundtable02:17 Is anterior approach revision really extensile?03:31 How modern revision cups changed screw and cup-cage decisions05:59 Exposure and diagnosis before technique in teaching revision07:12 Sequencing a failed total hip before choosing an approach09:26 Red flags for going posterior instead of anterior13:44 Acetabular bone loss and revision cup technology15:20 Anterior approach revision for instability18:29 Planning extensile exposure: bikini vs longitudinal incisions26:20 Reopening the old scar and handling the capsule30:24 Orientation without landmarks: fluoroscopy and stability testing34:51 Filling defects and choosing an acetabular revision system37:41 Dual mobility vs constrained liners in revision41:49 The most common early mistake in anterior approach revision42:43 Head size, dual mobility, and avoiding over-constraint44:37 Parting advice and the future of anterior approach revisionListen to the AHF Podcast on your preferred platform:Show page: https://jvomedia.com/shows/ahf-podcastApple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHcLinkedIn: https://www.linkedin.com/showcase/ahf-podcastYouTube: https://www.youtube.com/@anteriorhipfoundationHomepage: https://anteriorhipfoundation.comThis podcast is intended for educational and informational purposes only.The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion.#AnteriorHipFoundation #AHFPodcast#RevisionHip #RevisionTHA #TotalHipArthroplasty #AnteriorApproach #AcetabularRevision #CupCage #DualMobility #ConstrainedLiner #HipInstability #PeriprostheticFracture #EricCohen #KrisAlden #MollyHartzler #SmithNephew

    Anterior Approach Revision (S+N Surgeon Roundtable)

  7. Aug 28

    JointMedica & the Hip Resurfacing Comeback

    Hip resurfacing was written off after the metal-on-metal era — but the patients kept coming back happy. Two surgeons who never stopped offering it explain what changed, and what a vitamin E polyethylene bearing does to the failure mode that ended it.For hip surgeons weighing whether resurfacing belongs in their toolkit, and for anyone interested in where orthopedic implant innovation actually comes from.Sharat Kusuma left clinical practice to lead JointMedica as CEO, developing the PolyMotion resurfacing device. Craig Della Valle, of Rush University Medical Center in Chicago, took Sharat on as a fellow nearly twenty years ago and is now an investigator in the device's IDE study. Both learned the operation in the Birmingham era — Craig with Derek McMinn, Sharat during six months in England with McMinn, Ronan Treacy and Andrew Manktelow.Neither of them skips the hard parts. Craig is candid about revising his own metal-on-metal failures, about resurfacing taking longer and paying the same as a total hip, and about how much of the case rests on results he cannot randomize. Sharat argues the real ceiling is instrumentation rather than the operation, and that implant companies — not surgeons — should carry the burden of making a difficult procedure easy. They disagree, usefully, about how familiar the PolyMotion cup will feel the first time a surgeon picks it up.A long stretch of the conversation is about the anterior approach specifically: whether resurfacing is harder or easier from the front, what the capsulotomy actually demands, and why centering the guide pin in the femoral neck is the step still waiting to be solved. If you do anterior approach hips and have wondered whether resurfacing is a reasonable extension of what you already do, start there.⏱️ Chapters:00:00 Why hip resurfacing is getting a second look02:40 The problem a stemmed total hip still doesn't solve05:29 Learning resurfacing in Birmingham and the first 20 cases08:50 Dislocation, fracture and infection rates in resurfacing13:55 The coming wave of periprosthetic fractures19:20 Practicing through the metal-on-metal fallout27:17 Is hip resurfacing niche? Sizing the candidate pool33:22 Inside PolyMotion's vitamin E polyethylene bearing40:50 Why cup stiffness affects acetabular bone response45:02 Anterior approach resurfacing: synergy, not rivalry55:36 Centering the guide pin and avoiding neck fracture1:05:15 Telling a surgical fad from a real advanceListen to the AHF Podcast on your preferred platform:Show page: https://jvomedia.com/shows/ahf-podcastApple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHcLinkedIn: https://www.linkedin.com/showcase/ahf-podcastYouTube: https://www.youtube.com/@anteriorhipfoundationHomepage: https://anteriorhipfoundation.comThis podcast is intended for educational and informational purposes only.The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion.#AHFPodcast #AnteriorHipFoundation #HipResurfacing #PolyMotion #JointMedica #AnteriorApproach #HipArthroplasty #MetalOnMetal #BHR #VitaminEPolyethylene #IDEStudy #SharatKusuma #CraigDellaValle

    JointMedica & the Hip Resurfacing Comeback

  8. Aug 21

    Managing Instability in AA Hips (S+N Surgeon Roundtable)

    Dislocation after anterior approach total hip replacement still runs around 2% in the first two years — so what actually moves that number?Three hip surgeons work through instability prevention end to end, from the first clinic visit to the final construct.The anterior approach has pushed dislocation rates in the right direction, but it has not solved instability — and the belief that it has is where surgeons get caught. In this roundtable, Jeff Barry, Blair Ashley, and Chance Gray work through what the database and registry literature actually show, why anterior approach hips come out the front and the back rather than predictably out the back, and how much of that risk is genuinely modifiable.The conversation gets specific quickly. They disagree productively on whether instability risk can be optimized in the patient at all, or whether it is simply a surgeon's problem to engineer around. They cover cup targets in the setting of hip-spine mismatch, what a standing AP film really tells you, the intraoperative stability checks each of them refuses to skip, and how to escalate a construct — head size, lateralized liners, offset and length, dual mobility — without letting the most constrained option become the default.This one is for arthroplasty surgeons, fellows, and residents building their own instability algorithm, and for anyone who has looked at a well-positioned cup on a postoperative film and wondered what they missed. It closes with each surgeon's single piece of advice for avoiding that lesson the hard way.⏱️ Chapters:00:00 Introduction and what the data says about dislocation03:47 Why instability prevention starts in the clinic05:57 Cup position first when diagnosing an unstable hip08:30 How anterior and posterior hips dislocate differently12:34 Instability risk after revision anterior approach surgery14:28 Counseling patients on dislocation risk and risk factors19:14 Why instability is a surgeon problem, not a patient problem22:55 Planning for hip-spine mismatch in anterior approach hips27:32 Explaining the hip-spine relationship to patients31:48 Where CT-based planning tools fit into instability risk35:09 Dual mobility and high offset stems for high risk patients40:22 Non-negotiable stability checks before you close45:32 Intraoperative red flags and navigation beyond fluoroscopy50:04 Escalating head size, lateralized liners, and offset56:24 Are constrained liners obsolete in the dual mobility era1:00:43 An end-to-end instability prevention algorithm1:07:39 Parting advice on preventing dislocationListen to the AHF Podcast on your preferred platform:Show page: https://jvomedia.com/shows/ahf-podcastApple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHcLinkedIn: https://www.linkedin.com/showcase/ahf-podcastYouTube: https://www.youtube.com/@anteriorhipfoundationHomepage: https://anteriorhipfoundation.comThis podcast is intended for educational and informational purposes only.This episode was recorded in partnership with Smith+Nephew — Life Unlimited.Learn more at https://www.smith-nephew.comThe content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion.#AnteriorHipFoundation #AHFPodcast#HipInstability #HipDislocation #TotalHipArthroplasty #THA #AnteriorApproach #DualMobility #Spinopelvic #RevisionHipArthroplasty #ConstrainedLiner #JeffBarry #BlairAshley #ChanceGray

    Managing Instability in AA Hips (S+N Surgeon Roundtable)
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About

The AHF Podcast features thoughtful conversations about orthopedic surgery, outcomes, and clinical decision-making, with a particular focus on hip surgery and related innovation.Produced by the Anterior Hip Foundation, the podcast brings together surgeons, researchers, and clinical leaders to examine how evidence, experience, and real-world practice intersect. Episodes explore what the data actually shows, where assumptions break down, and how clinicians navigate uncertainty in daily practice.This podcast is intended for orthopedic surgeons, trainees, and medically literate clinicians who value nuanced discussion, critical thinking, and honest examination of what improves patient care.

Information

  • Creator
    Anterior Hip Foundation
  • Years Active
    2024 - 2026
  • Episodes
    88
  • Rating
    Explicit
  • Copyright
    © 2026 JVO Media
  • Show Website
    AHF Podcast

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