Chef Antonio Lombardi leads his busy team in a carefully choreographed ballet. Together, they produce the authentic Roma dishes that patrons of his Olney, Md., restaurant have come to love.
But when hip pain began to slow him down, he knew it was time to act. “I had X-rays that showed both hip joints were deteriorated by arthritis. Joint replacement was recommended,” says Chef Lombardi. “The first surgeon I saw told me I’d be out of work for months recovering. I knew I couldn’t take that much time away from my restaurant.”
That’s when the chef met J. Ryan Macdonell, MD, an orthopaedic surgeon and expert in hip and knee replacement at MedStar Montgomery Medical Center. He performs a procedure with a much faster recovery time: direct anterior hip replacement.
Saving Muscle for Faster Recovery
“Direct anterior hip replacement is a muscle-sparing approach that speeds recovery,” explains Dr. Macdonell. “In this procedure, I make a four-inch incision at the top of the thigh from the front of the patient. Gaining access to the hip joint saves muscle, which translates into less pain and a much easier rehabilitation.”
Chef Lombardi, 57, required the surgery on both of his hips. In April 2018, he had the first procedure on his left side. During the surgery, he underwent general anesthesia and his deteriorating hip was replaced with a metal, ceramic, and plastic joint implant that should last for decades. The procedure took less than 90 minutes. “I went into the hospital at 5:45 a.m. on a Monday, was back in my room by 11:45 a.m., and up on my feet walking soon after that,” he says. “I went home the next day, had some home physical therapy, and went back to work on Thursday!”
Protocol for Optimal Recovery
Chef Lombardi benefited from a rapid recovery protocol for joint replacement that relies on a diverse team of experts, says Dr. Macdonell. “Even before surgery, we want to ensure the optimal result by eliminating medical issues that might impede recovery. That might mean weight loss or reducing blood pressure, for example. Patients also attend a pre-op class where nurses and physical therapists from the hospital’s joint unit describe what patients can expect.”
Physical therapy is part of the process, Dr. Macdonell says. “Some patients with muscle weakness will benefit from physical therapy before surgery. And just hours after surgery, patients will be up and moving to reduce pain and the possibility of blood clots. After they leave the hospital, patients will likely have home physical therapy for a week or two, and then continue with outpatient therapy right here at the hospital.”
During his post-operative outpatient physical therapy, Chef Lombardi scored a perfect “two-fer.” While strengthening his left hip, he was also preparing for surgery on the right. “I was rehabbing one hip and strengthening and stretching my right leg and hip muscles, so I would do even better after my second surgery,” Chef Lombardi says. Just three months after the first procedure, Dr. Macdonell replaced the chef’s right hip. “I could tell right away that I was stronger this time," he says. This is the outcome we want to see with every patient we treat,” Dr. Macdonell says. “Our ultimate goal is to maximize function and improve the quality of their lives.”
For Chef Lombardi, living pain-free has been delicious. “My hips are great now. I was really happy with the whole process, from A to Z. Everyone at the hospital was an angel. I’d recommend the procedure to anyone.”
“This is the outcome we want to see with every patient we treat. Our ultimate goal is to maximize function and improve the quality of their lives.”
—J. RYAN MACDONELL, MD