Freedom to move… the ability to enjoy life’s activities and move without pain… something important to everyone in every age group. Something you take for granted until osteoarthritis takes away your freedom of movement. Daily activities like walking, or sitting comfortably in a chair, or shopping, have become a struggle.


When your hip was healthy, the movement of bending, straightening, and twisting was absorbed by the cartilage. Cartliage, the cushion between the bones, allowed the ball to move freely in the socket.


When the cartilage is worn away, or is damaged, bones rub against each other.

The rubbing causes inflammation, and the inflammation causes pain.The pain from a bad hip may be felt as thigh pain, knee pain, or groin pain. The inflammation may cause stiffness, limping, muscle weakness, or a leg length discrepancy.


Total hip replacement has freed patients from the pain and the stiffness.The new technique for hip replacement, minimally invasive surgery (MIS), has quickened recovery, and restored lost freedoms in a shorter
recovery time.


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Dr. Penenberg performs the single incision MIS hip replacement. The painful, arthritic hip is replaced with an implant referred to as a prosthesis.

Dr. Penenberg may use a metal and plastic prosthesis or a metal and ceramic device.Dr. Penenberg’s incision to implant the prosthesis is 2 to 3 inches long.The goal of the new MIS technique is for patients to experience less postoperative pain, a shorter hospital stay, and a faster recovery period.

You may be able to return to your normal routines in 3 to 5 weeks, as opposed to the 3 to 4 month recovery period with the traditional surgical approach, and the traditional 6 to 8 inch incision.



The majority of hip replacement patients will never need a revision. A hip replacement may fail for a number of reasons, and fortunately, revision surgery will correct most of these problems.


Not all orthopedic surgeons perform hip revision surgery. Surgical solutions for failed hip prosthesis may be simple or complex. The surgeon’s experience with revision surgery is paramount to a successful outcome.


Dr. Penenberg has extensive experience with hip revision surgery.


Patients are referred to him for evaluation from all over the United States. His experience includes simple revisions and complex revisions. An example of a simple revision would be a liner exchange, secondary to wear and tear. A complex revision might be the result of trauma requiring autograft and allograft supplementation for bone deficiency.


Dr. Penenberg has a special interest and expertise in the treatment of hip replacement patients with joint infections.  He works with a team of specialists in infectious disease and internal medicine to plan a sophisticated course of treatment to eradicate the existing infection and potentially reimplant a hip prosthesis.


An emerging Total Hip Arthroplasty: An alternative to the promising, but higher risk, Direct Anterior approach to THA.

All the benefits associated with the Direct Anterior technique such as:

Shortened hospital stay (80% home after one night)
Shortened time on cane
Possible to return to driving in a week
No post op precautions/ restrictions (sit in nl chair, ROM exercises, cross legs)

Additional benefits:

Eliminates risk of permanent thigh numbness
Provides surgeon with safe, extensile option if ever required (NY Times Feb 2010)
Markedly reduced risk of infection
Markedly reduced risk of blood transfusion
Extremely rare occurrence of wound problems (vs Direct Anterior Approach)
No associated skin numbness (vs the Direct Anterior Approach)
Eliminate fluoroscopy and potential risk of this type of intra operative xray exposure (as used with the Direct Anterior Approach)

Utilize computer guidance in the form of digital radiography to provide the greatest likelihood of:

1. correct component placement
2. correct component sizing
3. limb length optimization

The soft tissue approach and the associated patented instrumentation developed by Dr Penenberg, were first described in the Journal of Bone and Joint Surgery in 2008. Dr Penenberg has performed over 3000 hips utilizing this approach. He chose the term DIRECT POSTERIOR™ in order to identify his method as a source identifier and to differentiate his approach from the traditional posterior approach where numerous tendons are cut and muscle can be extensively traumatized. The Direct Anterior approach referenced above was so named because it described a method of getting into the hip with minimal trauma.

Dr Penenberg’s approach achieves the same goal but the term direct also applies to the “direct access” to both the femur and acetabulum via unique instrument adaptations (see patents issued and pending). This “direct angular access”, via the direct trajectories to both the femur and acetabulum, facilitates precise, safe bone preparation and implant placement. There is no need for a special, but cumbersome operating table with a potentially risky traction apparatus, in order to gain access for bone preparation and implantation.”