A New Mexico man who less than a week ago had a second hip replacement done with an approach not widely used in the Four Corners is raring to return to work.

Dan Kilough got a new ball-and-socket joint on the left side from Dr. Brinceton Phipps, who used a frontal approach instead of the traditional rear entry.

“I feel like a 20-year-old,” said Kilough, who in March had his right hip replaced by Phipps with the same procedure. “This time it feels better than the first time, and that one was wonderful.”

Replacing a hip from the front instead of the rear has been around for some time, but has become more popular in the last 10 years, Phipps said Thursday.

The American Academy of Orthopedic Surgeons estimates that about 20 percent of its members know how to do anterior entry. The procedure takes the surgeon between muscle groups instead of through a muscle group, Phipps said.

“It’s harder to get in from the front, and there’s a steep learning curve,” Phipps said. “It takes 40 to 100 cases before a surgeon feels comfortable.

“But I like the approach because placement (of the artificial stem and cup) is more accurate, risk of dislocation is reduced, and there’s faster recovery.”

Fifty percent of his hip patients abandon their cane or crutches by two weeks after surgery, Phipps said. He does 80 to 100 hip operations a year.

Phipps learned the anterior method in 2006 while doing his residency at the University of California, Irvine, hospital. He later took specialized courses in the same.

Phipps’ partners at Animas Orthopedic Associates, Dr. Gareth Hammond and Dr. Jennifer Forrest, also practice the anterior method of hip replacement.

“We’re hopeful that 90 percent of patients will get a 25- to 30-year survival rate from a new hip,” Phipps said. “But I always say that we’re not as smart as the guy who made the original.”

Hip replacement, which began in the 1960s, involves placing an artificial cup in the pelvis to receive a ball on top of a metal stem that is anchored in the femur.

It’s not a delicate operation, but involves pushing, pulling and hammering, Phipps said.

“It’s the medical world’s carpentry, he said.

Degeneration of cartilage that causes arthritis is the most common reason for replacing a hip, Phipps said. Trauma-produced fractures and bones weakened by blood loss also can lead to hip replacement, he said.

An estimated 450,000 people a year in the United States have hip surgery, Phipps said. In joint operations, the number of hip replacements is second only to the number of knee operations, which tops 1 million annually.

Phipps has patients ranging from 21 to 91 years of age.

Kilough, who has a welding and metal fabrication shop with his brother in Cedar Hill, said he put up with bone-on-bone contact in his right hip for five to six years before turning to surgery in March.

“I consulted six to eight surgeons from Albuquerque to Denver and heard only horror stories – how I was going to need another hip after eight to 10 years,” he said. “But Dr. Phipps knows what he’s doing.”

Marilyn Swanson has two new hips by anterior hip surgery, the first operation in California, the second by Phipps.

“I’m happy with both,” said Swanson, 74, a retired journalist. “I ski bumps, hike, ride a bicycle and practice yoga, so I didn’t want to stop or modify my routine.”

She didn’t have to, she said. She went snowshoeing two weeks after her surgery with Phipps.

daler@durangoherald.com