Do you agree? Everyone I know that has had both posterior and anterior surgery say not to even consider posterior. We thank you for your readership. I, too, am struggling which approach to have. Being cared for in a hospital that specializes in joint replacement and has an extensive specialty medical staff also is key. Also, only a small percent of C-on-C bearings are being implanted at this time. Its been a couple months and I thought Id drop in with an update..over 4 yrs post op and I deal with Femoral nerve damage from Anterior, and found others who deal with the same.it may lessen with more years but who knows.Somewhere I read 15% or so end up with this..I talked 2 other people in my city, same surgeon and they have had this issue to. All rights reserved. Very important with both the traditional posterior and the mini-posterior approaches, if the surgeon is not able to visualize critical structure adequately, or if a problem were to arise such as a fracture, then either approach can easily be adjusted. SuperPath is a portal assisted THA approach that accesses the capsule superiorly through the interval between the gluteus medius and piriformis without requiring the cutting of any muscles or tendons. SuperPATH hip replacement Pros and Cons - Thoracentesis Pam. He treats a variety of hip, knee, and shoulder conditions, and performs hip and knee total joint replacements. An anterior-approach hip replacement necessitates a small incision in the groin area on the front side of the leg. I believe choosing your physician is the most important decision you can make. Hips that are out of joint have an anterior hip replacement. Simply, we keep trying to get better. She never though mentioned an increased risk of damaging femoral cutaneous nerve or possible muscle damage that would turn into improperly heeled muscle as a result. Total Hip Replacement Surgery | Kaiser Permanente There are risks and recovery times associated with surgery. I am a very active and young 69 year old female who had a THR on my left side 5 years ago. The idea is it should be a little less painful if the muscle, tendons and nerves are not disturbed. In comparison to traditional methods, anterior approaches to the hip joint are more effective. I suspect there is significant underlying osteoarthritis related to your labral pathology. Very few metal-on-metal bearings are being placed today due to the serious potential of metallosis. Introduction The posterior approach is used frequently again, in large part due to the fact that it is an extensile approach. When it comes to hip replacement surgery, the surgeons skill, the patients weight and build, and the surgeons level of experience all have an impact. Hip implants are medical devices intended to restore mobility and relieve pain usually associated with arthritis and other hip diseases or injuries. In some individuals, it takes much more force and dissection in order to accomplish this (typically, there is significantly more bleeding from an anterior approach compared to a mini-posterior approach). They thought it would give me about 5 yrs. July played my last match when I buckled. A mini posterior approach is a modification of the classical posterior approach. The initial recovery period typically takes six weeks or more. Felt very uninformed and left This too will lower your anxiety and improve your experience. A long surgery time, on the other hand, was also associated with DAA. Because my husband has circulation problems in his leg and vein removed for open heart surgery last yearhis surgeon recommended the Mini posterior surgery. It is generally agreed that the temporary numbness is more than balanced out by the substantially improved recovery, reduced pain, absence of a limp, faster return to function, and virtual elimination of the risk of hip dislocation. This is because the nerve is located in front of the hip. The only problem Ive had post hip replacement is some on/off again groin pain. It was discovered that I had a torn Labrum. Doctors use metal, ceramic, or plastic replacement parts. It is difficult to get that from information which I find curious. But I am now in chronic low grade pain thats getting worse and dont know what I should do. Also, because technically it is easier, many patients are being reconstructed with very short stems which are press fit into the bone during an anterior approach. Email us. In Dr. Lawrence Dorrs opinion, doctors and hospitals should not market a specific type of surgery as the most effective. It is so important to stay focused on the outcome of your hip replacement surgery: excellent results both short- and long-term with minimal risk of injury or complication, and not lose sight of the real goal, which is to create a perfectly positioned reconstructed hip that is stable, balanced and has the best possible chance of lasting more than twenty years. The size of the incision is determined by how large and tight the hip/thigh is and how much tissue (fat and muscle) exists between the bones of the hip and the overlying skin. Nobody wanted to talk If I have a 2nd revision of my right hip is it posterior approach or the mini-posterior approach as you discuss above? Historically, higher dislocation rates were reported with the posterior approach, but it still was used for its many other advantages. I definitely didnt have any tendons or muscle cut and was cycling on the road from day 12 and back running at week 4 . I wish you well. Nobody wants a long recovery. Fax: 954-489-4584
Often, as the labrum is torn, it leads to a lifting off of hyaline articular cartilage where these two tissues meet, called delamination. My doctor does the Posterior approach, he didnt say anything about the mini part. The rest is marketing. Blood clots or bleeding. Thru X-rays Ive been told both hips are bone on bone! The vast majority of my patients return to work one to three weeks post-operatively. You can resume your active lifestyle as soon as possible thanks to a new prosthetic hip. I am a 70 yr old female with a 4grade thickness loss at acetabulum and head of femur. Here is his perspective based on careful observation of outcomes. I will let you in on something personal. My knee and foot and ankle are messed up too since leg ended up at least 3/4 shorter.I wear a shoe lift, but probably needed it sooner than I realized the shorter issue, My knee is pretty stiff and pain when I walk too much, but I deal with it, it bends good, I sleep good, no pain when I do nothing, so Im working all to do NO knee surgery, This hip was ENOUGH to last a lifetime.. Im 76 and use a lot of supplements to save knee and OA in general..I am looking at other protocols for the knee too.not insurance covered, what else is new.if its good, its out of pocket. Dear Dr. Leone, I am having Makoplasty ( robotic imaging) to my right hip in February. I have done everything I can think of to preserve my right hip, but sadly this too needs replacing. Would you recommend treating plantar 1st? I prefer spinal anesthesia when possible because fewer drugs are used and often the experience is gentler. Despite the fact that this usually takes two weeks or longer, patients can return to work when they feel completely comfortable. If its a struggle, then the situation needs to be reassessed. Doc says once recovered I should avoid flexion with adduction and internal rotation. Femoral nerve function also should be assessed. . Im getting close to needing my left hip done. I think its reasonable to request a tour of the facility where youre considering having the procedure. That said, in general people who are longer, more flexible and thin are more easily constructed anteriorly than individuals who are very stiff, contracted, thick, and have acetubular protrusion (a condition when the femoral head wears away the central cartilage and bone of the acetabulum). If a mini posterior approach is used and the resultant total hip has optimally positioned components and balanced soft tissues, and was implanted through a smaller incision with less underlying soft tissue dissection and trauma, then I believe it is a benefit. Always speak to your doctor before acting and in cases of emergency seek
The surgical "approach" in total hip replacement describes the anatomical pathway and technique that the surgeon uses to access the hip joint to perform the surgery. All orthopaedic surgery demands a long recovery period. Tina, which procedure did you have? Hello Dr. After a slip and fall at work 2 1/2 years ago I need a THR on my left hip. Ill be 60 at the time and Im 54 and weight about 130 lbs in fairly good shape. An anterior hip replacement is not covered by a specific credential system for orthopedic surgeons. Above the ankle to the thigh.Had to use leg brace to The following cookies are also needed - You can choose if you want to allow them: You can read about our cookies and privacy settings in detail on our Privacy Policy Page. Bleeding at the operative site can occur as a result of an anesthesia reaction, such as an allergic reaction. I think the recovery time is the same though. It is important that these medical and cardiac conditions be optimized by your PCP and cardiologist preoperatively. Consult an orthopedic surgeon who specializes in hip replacement surgery if you have a hip problem. Most patients after a bilateral procedure would not go home but rather a rehab unit. I went in with high expectations of coming out so much better off and here I am 5 yrs out limping more than ever and a NUMB thigh and worse knee and weak ankle. The femur is prepared with the head and neck intact reducing the chance of fracture. Because of the straightforward exposure of the femur, there is less risk of femoral fracture or poor implant positioning. Two which are receiving the most attention are the traditional posterior approach and the direct anterior approach. Each surgeon approaches these issues individually. It is critical to consider the pros and cons of each option before making a decision. The risk of revision surgery after a posterior hip replacement is the most serious concern. Patient is a UK registered trade mark. Im 51, 59 and 148 and want to get back to tennis etc, this has been long frustrating process. Depending on the degree of injury, you may need a knee brace to lock you knee in extension when walking until the quad function returns. What Is Superpath Hip Replacement - HipsAdvice.com I am a 67 year old woman who has danced semi-professionally and has always been very active including doing Ashtanga yoga and caopeira. An anterior approach to hip replacement allows the surgeon to perform more limited views of the hip joint during the surgery, making the procedure technically challenging for less experienced surgeons. Conserves the two main muscles that make up the front of the hip and upper thigh aspirated via the direct anterior approach. Also I have read that there is a sharp learning curve that must take place in order to do the direct anterior approach. If your X-rays reveal that you already have bone on bone due to osteoarthritis, then you typically dont need either an MRI or Pet Scan, unless another diagnosis is suspected. 35 (2):153-62. I am an obese female and will be 62 in February. The most common type of total hip replacement is done in the anterior anterior part of the hip. My advice is to consult with your surgeon regarding how stable the replaced hip is and the most appropriate rehab to follow post-operatively. Each question is scored from 1-5, with 1 being no problems and 5 being severe problems. My doc said the angle of my hips is not the worst but also not the best. SuperPath Hip Replacement Baton Rouge | SuperPath Surgeons Baton Rouge Do either of your techniques require the traditional anterior or posterior precautions? Use of the forums is subject to our Terms of Use
I think its always beneficial to speak to other patients who have been cared for by that physician and learn about their experiences and results. After reading your blog Im thankful he suggested this approach. I exhausted all other non-surgical options, such as physical therapy and meds but to no avail, so now plan to have a THR in March. Do I have a risk of fractures during a posterior right hip revision due to my prior complications already? I came home with crutches, abandoned them at the front door and have not used them since. A shorter hospital stay and faster recovery are typical of this because there is less damage to the muscles. I think seeing several surgeons for different opinions is good judgment. It is not acceptable to lean forward while sitting down or standing up, and it is not acceptable to bend past 90 degrees (as shown in the angle in the letter L). I am 37 and have suffered from AVN since I was 14. 2015 Aug. 3 (13):179. A modern artificial hip joint is designed to last for at least 15 years. Fortunately, many folks who experience back symptoms before THR report improvement or resolution after. Surgical Approaches Used for Hip Replacement - Verywell Health It is 100 percent normal and expected to be scared before surgery. I recently had a spontaneous hip fx and was diagnosed with hip displasia. Clearly, yours was. Its Inosine and Sphingolin. Along these same lines, there is a smaller incidence of sciatic nerve injury with the anterior approach but an increased incidence of femoral nerve injury. invasive posterior vs not so good with AMIS) whilst on the other hand, with one of your replies you state that surgeon experience should be considered with AMIS success rates and in other replies stating that both alternatives are good. It healed well but then I got major psoas pain which a cortisone shot helped. SuperPath Hip Replacement (Surgery) : 3D Animation - YouTube disadvantages of superpath hip replacement. I am looking at how many hips they have done and where they are doing them. Nerve regeneration can occur up to 18 months following injury, but the chance of full recovery decreases with delay in recovery time. Risks of SUPERPATH hip replacement surgery Risks due to the surgery may include (but are not limited to): Pain Bleeding Infection Permanent or temporary nerve damage Extra bone or tissue damage Drop in blood pressure during the procedure Leg deformity Blood clot or clots (that could travel to heart or lungs) Delayed wound healing What you can do is keep as good an attitude as possible and keep rehabilitating your leg. Gary. Many times, the depth of the destruction that is found during surgery is much more advanced than initially anticipated, particularly as we age. I often suggest to my patients that they speak to other patients for whom Ive cared and to whom they can relate to learn about their experiences. Due to security reasons we are not able to show or modify cookies from other domains. I have been doing ALOT of research about the different approaches to THR and looking for the absolute best surgeon. Lastly, if one has had P or AL is there anything that can be done to offset the need for restricitons? I weigh 185 and am 54 and realize its ideal to lose weight prior to surgery (working on it as always). You are free to opt out any time or opt in for other cookies to get a better experience. Im not sure why you developed a problem with your IT band. Should I look to another approach and surgeon? Thank you, Rita. I would look at the published track record of the hospital where the surgery is scheduled to be sure its performance record is good and its incidence of infection is low. Getting in and out of cars, and turning over in bed. I had an MRI by a different hip doctor (a preservationist) who diagnosed me with a birth defect (hip dysplasia). I was released to go back to work after only 10 days. When a patient feels better, they can return to work almost immediately, though it usually takes two weeks or longer. Lift your knee rather than your hip at the same time. Rush joint replacement surgeons are leaders in hip replacement surgery and research. Why I No Longer Use the Anterior Approach for Primary Total Hip I do not have dials and no one seems to know where the neuropathy stems from. I did have a total knee replaced two years ago. I understand they have good results in Thailand or India for half that. but it was more torn than they thought and they had to cut out about 1/4 of it. Pain Management Dr. Tom Miller gives you the five best options for hip replacement surgery. It will help desensitize and help get your muscles working in synchrony. Share your concerns with your surgeon. Now 1 yr later dont have buckling/giving out but a lot of pain is there and after walking around, after about 20 minutes it hurts to lift leg forward, also good hip starting to hurt. I encourage you to do the same. Dr. Daniel Le | Houston Methodist My question is, what will my restrictions be? disadvantages of superpath hip replacement Walker to get around. General comments will be answered in as timely a manner as possible, Hip & Knee Surgery Hip Preservation Surgery | Duke Health Not sure exactly what that means.
Also if the mini posterior approach is so effective when would it not be preferred over the regular posterior approach? There is a 1-2% risk of fracture of the femoral neck. This complete wall of tissue that surrounds the new hip imparts stability. In my last blog post, I discussed minimally invasive surgery with regard to hip replacement. Many, many interactions and decisions go into the final result as well as someones perception of his or her result and experience. Pain modifying drugs as well and as a course of NSAIDs might also be appropriate.