Finally, hip replacement surgery is expensive and may not be covered by insurance. My advice is to have a frank discussion with your surgeon and share these concerns. I live in Staten Island and need rt hip replacement. If, on the other hand, the leg length difference is creating hardship and possibly discomfort in other joints such as the lower back, knee or ankle, I would consider proceeding with contralateral THR sooner rather than later. When the stem is placed in the femur, it still destroys the same amount of bone for implantation, regardless of which approach is used. A hip replacement is the most common cause of complication in about 20% of cases. I already have an artificial knee that is doing great. A recent article published by the Journal of Bone and Joint Surgery has demonstrated that the direct anterior hip replacement has more blood loss, a higher risk of intraoperative fractures, an overall higher complication rate and no difference in outcomes versus other techniques. I also would encourage you to choose your surgeon first not the procedure, approach or prosthesis. All: Pain Management In has been my experience in life that if others are happy and had a good experience then that speaks strongly to me, if I were to do the same thing. Im 51, 59 and 148 and want to get back to tennis etc, this has been long frustrating process. I would emphasize choosing your surgeon and not the approach. Lastly, if one has had P or AL is there anything that can be done to offset the need for restricitons? Did you have the surgery via Superpath method? Patients can also have as little as a 3-inch incision. Should I go for this or should I opt for the mini posterior. Length of hospital stay with SuperPath hip replacement approach. An anterior approach hip replacement is one of the most minimally invasive surgical options for replacing a hip. There are many different quality implants (just like surgeons and hospitals). 2004 Apr. Not quite in the past. Posted I have had problems with my hip for the last several yrs. All have advantages and disadvantages. My hope is that some of these symptoms will improve with time. Both of these are very successful ways of doing a hip replacement. Raleighs orthopaedic clinic is board certified and has fellowship training in total joint replacement. I encourage my patients to talk to other patients for whom Ive cared and learn about their experiences. I am now bracing myself for THR surgery within the next year and am wondering if there is any big advantage in trying to have this done by a surgeon who offers the customised implant, as above. I again suggest you concentrate on finding a surgeon in whom you have faith and then trust that doctor. 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. Glad that after lots of PT and massage and medial branch block for back issues with NO!!! Im now 6 weeks out and doing good. Hip replacement is the second most common type of joint replacement, trailing only total knee replacement. It is important that these medical and cardiac conditions be optimized by your PCP and cardiologist preoperatively. The first is that it is a major surgery, so there is a risk of complications such as infection. I did have a total knee replaced two years ago. 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. Additionally, people with certain health conditions such as diabetes or heart disease may also not be good candidates. It is a mix of anterior & posterior. If I have a 2nd revision of my right hip is it posterior approach or the mini-posterior approach as you discuss above? Types of Hip Replacement (Approach) Hip replacements can be preformed through a direct anterior approach, an anterior lateral approach, a lateral approach, a posterior approach, and a superior approach. The bone isn't dislocated in surgery. He is well known as a top doc for 20 yrs & I was persuaded because the mini posterior has less chance of nerve damage & the surgeon has more options for types of spikes, which your article explains well. I think there may be increased associated complications. A major hip replacement can take up to four months to fully recover from. Glazener C, Fraser C, Hutchison J, Vale L. Single mini-incision total hip replacement for the management of arthritic disease of the hip: a systematic review and meta-analysis of randomized controlled trials. Total hip replacement is one of the most successful operations ever developed and is a remarkably predictable way to relieve pain from arthritic conditions. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in It is important that the individual who ultimately implants your next THR uses the approach which he or she feels comfortable with and has the best chance to deliver the optimal result. Pain is almost gone and I am beginning to get back to my life. And, I Do. Most traditional hip replacement models are metal-on-plastic varieties. Inpatient footage of the patient compilation has been edited out to accommodate hospital rules. I am thoroughly confused at this point. In 2014 I had to do another THA, this time on my right side. Thanks. For risks she mentioned all the usual I knew about from the first surgery blood clots/loss, dislocation, etc. Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis.Hip replacement surgery can be performed as a total replacement or a hemi (half) replacement. 4. You can also change some of your preferences. How the soft tissues are handled and respected, the patients expectations before the surgery and the surgeons experience do. THR if a MRI or Pet Scan isnt done? Mini posterior refers to the approach or tissue interval the surgeon uses to implant the Total Hip. During the hip replacement procedure, the surgeon makes a small incision near the front of the hip to allow for the removal of damaged anterior bone and cartilage, as well as the implantation of an artificial hip without damaging the surrounding muscles and tendons. I am Australian so no business from me but it has helped me become happier with my prospective surgeons judgement that he will offer me a posterior THR (hopefully the minimally invasive) when my insurance allows the procedure to occur. I needed no physical therapy at all. 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. THOUGHTS? Tossed the cane at three weeks and went back to work. How would a hip replacement be done? The bigger the ball, the bigger the ROM without impingement and the bigger the jumping distance that would be required for the hip to dislocate. Also, if a surgeon knows in advance that a certain range of motion is desired, can they provide some adjustment in surgery to help accommodate that desired movement? Consult your doctor to determine if joint replacement surgery is right for you. An anterior capsule is the only soft tissue cut during this procedure to insert the implants. Patient does not provide medical advice, diagnosis or treatment. Registered in England and Wales. I can still do 30-45 mile rides, but I need to take something before each ride, because of the undone left hip. Recognize that the underlying etiology is not being corrected by this procedure, so relief of symptoms probably will be temporary and possibly partial. Patient is a UK registered trade mark. Will I be able to dance, hike, bike, swim, exercise after a 3rd surgery? I would like your opinion. Because the patient is lying on his back, it facilitates using a fluoroscope or moving x-ray throughout the procedure. I wish you the best of luck with your care. Total hip replacement is a step-by-step surgery to replace the hip socket and the ball at the top of the thighbone (femur). My advice would be to avoid the extremes of any motion that exceed your hips ROM. Having physio It seems that whatever their particular approach is that is what they sell. Conserves the two main muscles that make up the front of the hip and upper thigh aspirated via the direct anterior approach. I would encourage you to discuss with your surgeon the difficulties and pain you experienced after the first surgery, and together explore if another plan can be created for a better outcome the second time around. Thank you for this! In the front of the hip, fewer muscles are present, so the surgeon works between them instead of cutting through them and then detaching them (and then repairing them after the surgery). Our clinical information meets the standards set by the NHS in their Standard for Creating Health Content guidance. Brian Tinsley. I have read your articles about procedures (anterior vs posterior). I believe a THR will benefit you tremendously. I wish you a full and speedy recovery. Potential Disadvantages of Anterior Hip Replacement Anterior hip replacement does have a few limitations: There may be wound healing issues Research suggests that people who undergo anterior hip replacement may be more likely to have a problem with wound healing, particularly infection. Super path appears to come with it's hazards due to bone sawing rather than dislocation of the hip to be replaced, making revision much more difficult if issues occur later down the line. I was out of bed walking around the evening of the surgery . It allows the surgeon to work between the muscles and tendons without removing them from their anchoring points on the hip or thighbone. 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. Still going to rehab to reduce stiffness and increase strength but I am in better shape now than before surgery. I decided to stick with my trusted orthopedic surgeon (who did two knee scopes on me) who believes the minimally invasive posterior approach is the safest approach. Conclusions SuperPATH approach showed better results in decreasing incision length and early pain intensity as well as improvement of short-term functional outcome. Patient Resources Mayo Clinic researchers have studied ways to reduce blood loss, control pain and speed recovery for people who undergo hip replacement surgery. Hip pain, soreness, and stiffness can quickly become unbearable and sideline us from the things we enjoy the most. Here is his perspective based on careful observation of outcomes. There are many benefits to posterior hip replacement surgery including a quicker return to daily activities, a more natural feeling hip joint, and a decreased risk of dislocation. I absolutely would not insist on minimally invasive surgery and a small incision, especially considering your mom is short, obese and has osteoporosis. What is most important is that the surgery is expertly done, that the tissues are not brutalized, and that the surgeon can see what he or she is doing. I am sure you should not listen to what I did!! Ive come to the conclusion that perceived benefits do not outweigh the risks with the anterior approach, especially when I can achieve the same or more using the mini-posterior. Does it really not matter which approach I have, posterior or anterior? Email us. Ive never foulnd information from any doctor or research-site but that there is always no legs-crossing, no more than 90-degrees (for the most part), and no twisting for anything but full Anterior. I wish you the best of luck. In my last blog post, I discussed minimally invasive surgery with regard to hip replacement. If not, what will my restrictions be? . Hey, thanks for the forum topic.Thanks Again. Thank you. There is less risk of neurological injury. Dr. William Leone. A mini posterior approach is a modification of the classical posterior approach. Check to enable permanent hiding of message bar and refuse all cookies if you do not opt in. Many wonderful physicians are part of various HMO panels. However, I now have quite severe OA in my right hip apparently I have no cartilage left and have been told by a surgeon that I am just lucky not to be in constant pain. Is it really as good as it sounds? I seem to be able to hike just fine up hill and down but not always on the flat. Blood-thinning medications can reduce this risk. Being cared for in a hospital that specializes in joint replacement and has an extensive specialty medical staff also is key. This improved quality of life will be beneficial. I am unsure whether the minimal invasive posterior is available in SA. Fax: 954-489-4584 I plan to retire from working full time June 2017 and am concerned about having appropriate insurance after that. These scores are not aggregated. The first surgeon never mentioned this condition at all. Ultimately, you and your husband need to choose the surgeon who you both feel will provide the possible best care, based on reputation and your personal comfort level. Does anyone ever attempt to do both at the same time if THR is determined? I dont know what happens on that tablewas he in a hurry on Friday afternoon. In anterior and posterior surgeries, the outcome is essentially the same a new hip. Im hoping to play tennis, go dancing and horseback riding once Ive healed. A modern artificial hip joint is designed to last for at least 15 years. Because of the restricted view provided by the anterior incision, the anterior incision is a technically demanding procedure. Such joint replacement orthopaedic surgery is generally conducted to relieve arthritis pain or in some hip fractures.A total hip replacement (total hip arthroplasty or THA . The first is that it is a major surgery, so there is a risk of complications such as infection. Advantages of an anterior approach to hip replacement A major muscle is not cut during the anterior procedure. My strategy is to make as small an incision as possible, but one that allows for excellent exposure and reconstruction without brutalizing the tissues. By adhering to the surgeons instructions as well as their pre- and post-operative instructions, you can reduce your chances of complications. Walking is the best exercise. Some in the early period have good track records, others do not. Time will tell if this generation of shorter press-fit stems fares as well. Ive done PT and plan to continue working on strengthening my core and flexibility of those large muscles. Typically, the new cup will be medialized to gain coverage and correct the abnormality that lead to your arthritis. The incidence of dislocations has further decreased over the past decade with our ability to implant larger size femoral heads. We are now in a situation where we have found two extremely good surgeons and we gel with both extremely well. I had the surgery on June 22 and I am about 5 weeks post op. I would not anticipate them improving with time, but rather worsening, and I cant imagine you being able to resume the activities you described without having surgery to treat this. SuperPath hip approach. I am a!so told by the orthopedist who referred me that I need arthroscope on my right hip. An operating room that can support safe Anterior or SuperPATH minimally invasive joint replacement surgery costs around $1.5 million. I would love to hear some stories about the SuperPath hip replacement. Would not make eye contact. 4 mts later am using Only Dr. Leone will be using the most recent hip technique known as the SPAIRE technique as of 2020. I furniture surfed in the house and used a stick outside.I was hopeless with crutches, but I think it is recommended we should use them, particularly to ensure we don't get a limp and build our leg up properly. Femor fracture. I think its vitally important that you go into surgery truly believing in your heart that you are going to do well, and that you are with the best surgeon and team who will help you. I'm hoping to read some posts post surgery. Soon my right hip started bothering me. I just saw a patient with a femoral neuropraxia after a anterior approach THR. Every hip implant has benefits and risks. I encourage you to do the same. Proponents of minimally invasive hip replacement say small-incision operations can lessen blood loss, ease post-operative pain, trim hospital stays, improve scar appearance, and speed healing.. Some hospitals and surgery centers are promoting one method of hip replacement over another. All rights reserved. 10 users are following. The first step to rule out infection is to have two simple blood studies done, an ESR and CRP. If so, how long until I can get back to normal living? I understand and respect that many surgeons prefer doing them simultaneously. There are a few disadvantages to hip replacement surgery. I wish you luck on your journey. It is highly recommended that you avoid bending your hips and turning your feet together as part of hip precautions. Posterior or Anterior? 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). Also there are concerns about disruption of blood supply to femoral head with this operation. Some patients who have recently had anterior hip replacement may suffer from complications such as wound healing. It is critical at time of surgery that an excellent range of motion be created without impingement. Hip replacements might keep you out of action for a considerable period. If youve had a failed hip arthroscopy, almost certainly you also have acetabular pathology and a total hip rather than a partial hip replacement may give you a more consistent, longer-lasting and more perfect result. There is a 1-2% risk of fracture of the femoral neck. Fortunately, many folks who experience back symptoms before THR report improvement or resolution after. I am a 73 year old woman who has been having severe hip pain for the last seven months. Hip anatomy The doctor is planning a traditional posterior. My walking is very limited, shoe is built up as leg is shorter and in recent months Ive realized my leg is bowed. It is difficult to get that from information which I find curious. It exploits the same soft intervals but it typically accomplishes prosthetic implantation and soft tissue balancing through a smaller incision and, more importantly, with less underlying soft tissue dissection. Our overall findings suggested that the short-term outcomes of THA through SuperPATH were superior to DAA. I ride horses, water ski and kayak. You helped me tremendously in my research of the track record of my HMO, now I have one more quick question to run by you. Can I make an appointment with you. Notes on SuperPath experiences good or bad, https://patient.info/forums/discuss/superpath-experiences-good-or-bad-718788. I think it is important to define and isolate why youre doing so poorly. It is also possible to have an anterior hip replacement during pregnancy. Sitting seems to irritate it the most. The big difference in anterior vs posterior hip replacement is primarily where the incision is made and how long it is. Consuming excessive-fibre and wholegrain meals will assist to keep you feeling full, and will be My recommendation is for you to discuss this with your surgeon if you have further concerns. The technique allows recovery that is as rapid as a mini-posterior approach while conferring stability of the hip joint that is equal to other exposures that . Even a task as simple as putting on socks and shoes can result in debilitating discomfort when a severely damaged or arthritic hip is involved. Ann Transl Med. Try our Symptom Checker Got any other symptoms? Personally, I would not gamble with my health. In the case of a worn or damaged ball and socket, artificial parts can be used to restore joint function. Comments about life-long hip restrictions between Posterior, Anteriorlateral and Anterior approaches? The main limitation after surgery is a lack of comfort. It is critical that the patient and the doctor consider whether the patient is a good candidate for surgery, the cost and recovery time, and the surgeons expertise. I just want to thank you for the information on this site. I have seen 4 surgeons. Once again, it sounds as if you had a wonderful surgeon, which is the most important variable. Introduction An anterior hip replacement procedure, on the other hand, performs the same function as an anterior hip replacement in terms of tissue shaving. Ceramic-on-polyethylene is currently the most popular hip replacement material, representing 50.6% of all hip replacement cases back in 2014. But this will always prompt you to accept/refuse cookies when revisiting our site. Since I previously had both knees replaced (by another surgeon) about 5 years ago and still have problems with the knees i.e. A metal or plastic implant is used to replace a damaged or diseased hipbone. A femoral nerve injury is devastating and is more vulnerable during an anterior approach than with other approaches. The SuperPATH technique is arguably the least invasive hip replacement technique. I have seen 2 doctors one doing posterior, the other anterior. Thank you, It is important to understand that "less invasive" does not only refer to the incision but . According to Dr. Rosen, the most important thing to remember is what you leave behind rather than how you get there. If I think you may be a candidate, I will refer you to a doctor in our area that does. Finally, hip replacement surgery is expensive and may not be covered by insurance. Remember, what youre hoping to do is have a hip construct that will last 20 years or more. Dear Dr. Leone, I have cared for many patients over the years with significant heart and peripheral vascular disease. I dont think one surgical approach is better or worse than the other for you to accomplish this. What is SuperPath Hip Replacement? I was released to go back to work after only 10 days. Thank you for all you do and for providing me with the information when I needed it. I am just under 5 ft and weigh 185. Pain modifying drugs as well and as a course of NSAIDs might also be appropriate. We can help you make the best decision for your knee replacement, and our friendly staff is available to answer any questions you may have. Studying a hospital and physicians track record before you commit is important. This often leads to a less than optimal component position. Until now. Operating through too small an incision and not releasing tissue that would improve exposure and result in a more balanced joint in my opinion does a disservice. If your little voice is questioning if you are overdoing it or hurting yourself, then listen to it and ease up. A hip replacement can greatly reduce the pain associated with arthritis of the hip, with almost all patients having complete or near-complete relief. The highly crossed linked polyethylene liners are now the gold standard in this country. There are a number of different surgical ways (approaches) to access the hip joint. The second most-common injury is to the femoral nerve. When compared to the anterior approach to hip replacement, which is typically more painful, there are several advantages to recovering from an anterior approach, including the fact that you will not be required to follow any specific anterior hip replacement precautions, such as bending or crossing your leg. The incision made for the operation can be as small as three inches. How do you ask your doctor the questions you want to ask? This effectively moves the hip joint center, toward the bladder or midline, and improves hip mechanics. The hip joint can be supported by the socket, which is designed to fit over the ball and provide stability. Also available today are larger modular heads, made possible because our plastics are so much better than years prior. A ceramic-on-ceramic bearing is also a very good bearing. Publications SuperPATH is a micro-invasive method of performing a standard total hip replacement where the surgeon utilizes a smaller initial incision and, more importantly, a very limited dissection in the deep tissues. Back then my surgeon advised me to perform a posterior surgery as opposed to anterior saying that I was overweight, short and a very muscular person and it would be easier and safer to do so. Though the duration of your hospital stay can vary, many patients having hip replacement surgery don't need to stay in the hospital very long. According to the meta-analysis, DAA (depressing the anterior hip joint by using a metal rod) is associated with significantly shorter hospitalizations than lateral approaches, as well as increased functional rehabilitation and lower perceived pain during the first few days after surgery. Because the muscle fibers are separated, not cut, the nerve path is not disturbed and the muscle is not injured. Do you agree? Which approach did the doctor take? Honestly, most 59-year-old active women do best with a well done THR. I am about to have a hip replacement and would like to know what kind of limitations Ill have afterward. All of these releases may be necessary as part of the surgery and patients do well. Share your concerns with your surgeon. The Pros and Cons of Two Approaches to Hip Replacement: Mini-Posterior https://holycrossleonecenter.com/wp-content/uploads/2018/12/Screen-Shot-2018-12-10-at-3.48.24-PM.png, https://holycrossleonecenter.com///wp-content/uploads/2017/11/Leone-Center-Logo@2x.png, The Pros and Cons of Two Approaches to Hip Replacement: Mini-Posterior and Direct Anterior, Copyright 2018 - 2023 The Leone Center for Orthopedic Care. Select a surgeon based on your impression of that individual: how engaged was he or she in your care, will you have access to that person as well as his or her team before and after surgery? One of the biggest changes that Ive seen in my practice over the past 25 years is how quickly patients get well and go home. Most individuals who have had total hip replacement surgery fall into this category and simply resume their lives.. I thought the newer procedure on the special table was the best way to go. The Hanna bed, general anesthesia machines, spinal setup, medications, ventilation, instruments, and their sterilization are all prerequisite. It does sound as if proceeding with a THR is appropriate, since your attempt to repair the joint arthroscopically did not pan out. daniel neeleman net worth . A ball and socket are used to connect the new joint to the thigh bone (femoral bone), which is made of metal, plastic, and ceramic. Risks of Hip Replacement Surgery The major risks include the following: Blood clot: We do reduce risk of this by using blood thinners (Enoxaparin, Aspirin or Coumadin), TED hose (compressive stockings) and compression boots on your feet to increase circulation.
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