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The risk of revision surgery after a posterior hip replacement is the most serious concern. This suggests that something changed after five months. Doc, Ive worked out and been physically active forever running, biking, skating, etc. Fax: 954-489-4584
And, I Do. The mini-posterior is considered a more straightforward approach then the anterior, resulting in lesser complication rates. The only problem Ive had post hip replacement is some on/off again groin pain. Im sorry to learn that you are so disappointed with your hip replacement. Update what hes cutting is the adductor so my question is the same is this just a normal part of some THRs? Im hoping to play tennis, go dancing and horseback riding once Ive healed. Your article lacks the pros of the AMIS and the cons of min invasive posterior. Lastly, where can I find a great surgeon that takes FL Workmans Comp? Dr. William Leone. Hip replacement surgery is less painful than arthritis or fracture-related pain. I will need the other hip done within the next 6 months, and despite all the talk of the anterior approach- I can use myself as the best judge to the best method. Most of my patients now go home the day after their surgery or the next. The traditional posterior approach is the most commonly used in the United States and throughout the world (about 70 percent). Remember, what youre hoping to do is have a hip construct that will last 20 years or more. I think seeing several surgeons for different opinions is good judgment. An anterior hip replacement procedure, on the other hand, performs the same function as an anterior hip replacement in terms of tissue shaving. The highly crossed linked polyethylene liners are now the gold standard in this country. I am deciding that my quality of life is in the toilet and need to get the THR done. Every . These cookies collect information that is used either in aggregate form to help us understand how our website is being used or how effective our marketing campaigns are, or to help us customize our website and application for you in order to enhance your experience. 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. Here is his perspective based on careful observation of outcomes. Do you have any advice or ballroom dancer THR stories to share? In a posterior hip replacement, the procedure is done on the side of the hip. Ive done PT and plan to continue working on strengthening my core and flexibility of those large muscles. I was really careful bending etc for four weeks until I saw the physio, who said "oh you could have touched your toes if you had wanted to!" All: I find it curious that you report having a good result for the first five months after your surgery as this suggests that the surgery was done for the right indication, i.e., you did well and were pleased for the first five months after THR. disadvantages of superpath hip replacement This effectively moves the hip joint center, toward the bladder or midline, and improves hip mechanics. Many modern-day femoral stems are considerably smaller or more bone sparing than well-functioning stems of the past. I would rather this not happen with my right leg when I have the THR in Jan 2017. In my experience, after four to six months most patients simply return to normal activity. If you have these arthritis symptoms, you should consider a hip replacement: severe hip pain that is not relieved by medication and that interferes with your work, sleep or everyday activity hip stiffness that restricts motion and makes it difficult to walk To learn more, read Here's What to Know if You Think You Need a Hip Replacement. Dr. Robert Sigmund is a board-certified orthopedic surgeon and a sports medicine physician based in St. Louis, Missouri. The actual length of the incision really is not important, but rather how well the components were implanted and the hip mechanics restored. Other jobs, which tend to be more structured and / or more physical, may require more time off. I would also like to know about the customized implant, as I havent yet heard much about it. He treats a variety of hip, knee, and shoulder conditions, and performs hip and knee total joint replacements. results, I decided to see and orthopedic doctor was advised to have THR. In 2014 I had to do another THA, this time on my right side. Any feedback will be appreciated. This improved quality of life will be beneficial. A miniposterior approach uses the same intervals as the standard posterior approach but simply less tissue is released for the exposure. I again suggest you concentrate on finding a surgeon in whom you have faith and then trust that doctor. My doc said the angle of my hips is not the worst but also not the best. I have since read that hips with this condition might get worse after labrum repair due to this structural defect. The SuperPATH Hip Replacement: A Novel Less Invasive Radid Recovery The best of luck to you, According to Dr. Gililand, patients should not try to change their surgeons opinion based on their preferences. Conserves the two main muscles that make up the front of the hip and upper thigh aspirated via the direct anterior approach. Fortunately, many folks who experience back symptoms before THR report improvement or resolution after. Sex After a Hip Replacement: Positions, Tips, and More - Healthline What are your thoughts on the use of robotics? Registered in England and Wales. I am having the mini posterior done in June and my surgeon gave me the pros & cons of both. With SuperPath, there is no surgical dislocation of the hip. Really Great. For risks she mentioned all the usual I knew about from the first surgery blood clots/loss, dislocation, etc. The source of your hip pain must be diagnosed. Everyone is. He is passionate about helping his patients achieve the best possible outcome and is committed to providing the highest quality of care. Can You Go Home the Same Day After Hip Replacement? There are various ways of doing a hip replacement. Im 56 years of age, 6 1 and 180 pounds. Your primary goal should be to find a surgeon in whom you trust and who will take the workmans compensation insurance. Some surgeons believe that a patient who is neither obese nor overly muscular is a good candidate for anterior hip replacement surgery. Ultimately, you and your surgeon should discuss all procedures and technologies available and then trust that your surgeon will choose the best course of treatment and surgical procedure for you. Patient Concerns Thanks so much for your help, very grateful. At the end of the day, I promise, it is not the approach but rather the person who is doing the surgery. Until now. I was so against doing this surgery but groin pain was very bad and crushed bone in the groin. I'm so encouraged to hear your successful story. Its been 9 months(Ive had it 2xs bf and got rid of it and have tried everything and no results this time). Celle said: Superpath may give you a faster early recovery, but whatever method is used, recovery is still going to take a long time. Hip replacement - Mayo Clinic These can include damage to blood vessels or nerves, dislocation of the hip, and infection. The anterior approach has a lower incidence of sciatic nerve injury and a higher incidence of femoral nerve injury. Advantages of this procedure include: The direct anterior approach involves dissecting between the natural intervals of the two main muscles located at the front of the hip and upper thigh. Hip replacement surgery can open up a world of possibilities for people who have lived with pain and restricted movement. Our overall findings suggested that the short-term outcomes of THA through SuperPATH were superior to DAA. SuperPath Hip Replacement Baton Rouge | SuperPath Surgeons Baton Rouge Fortunately, if the components are stable (bone-in grown or cemented) and optimally positioned, and the surrounding tissues has fully healed and matured, then that risk is very small. Advantages of an anterior approach to hip replacement A major muscle is not cut during the anterior procedure. What are the risks involved? I was thinking of a Hip Resurfacing for my left hip and was convinced by my other top hip surgeons to stay away from it. The femoral prosthesis is inserted into the hollow part of the femoral shaft. Appalachian orthopedic surgeons perform revision surgery as well as mini-posterior and anterior approaches. I am 37 and have suffered from AVN since I was 14. What Ive seen in my practice is that the more total hips I do, the less restrictions I place on my patients and the more active my patients are. No i just had the posterior method which has a larger incision. If possible, choose a hospital that specializes in joint replacement and can back that up with excellent statistics and reputation. I am a sixty five year old active male and need THR on my right hip. Hip Resurfacing vs Hip Replacement: Know The Difference Yes, Im angry. The femoral nerve functions to extend the knee and also is responsible for sensations over the anterior and medial aspects of the thigh, medial shin, and arch of the foot. They are addictive, can cause depression, their analgesic effects are short lived and if the condition persists, you will require an increasingly higher dose to relieve the pain. The approach planned is a frequent topic of Continued I had the mini posterior approach done and it gets better everyday. I would encourage you to discuss your expected recuperation time and specific restrictions with your surgeon. Ann Transl Med. I think it is important to define and isolate why youre doing so poorly. Also many folks develop peripheral neuropathy in their lower legs, which also becomes more common with age. Choosing a surgeon based on his or her experience and complication rate also is exactly right., My strong advice is to choose your surgeon, not the approach. Glad that after lots of PT and massage and medial branch block for back issues with NO!!! That being said, in order to meet your goals, if need to leave your area and consult with surgeons in other areas, I think that is reasonable also. Following surgery, the surgeon will devise a routine for the patient to engage in that is both comfortable and safe. 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. In hopes that THA would let me live my normal life without arthritis, instead I can barely walk more than 100 yards without having to stop, my gait is crooked causing lower back problems and my personal life is less than perfect. Clearly, he or she has earned your respect and confidence. Blog United States. But after reading your articles, I am hesitant about that choice now. During the procedure, the patient must have a small incision made in the side of his hip. The surgeon I went to said he does THR using a lateral approach. I would emphasize choosing your surgeon and not the approach. Thanks. When people loose independence and mobility, not only does the quality of life suffer, they are much more likely to develop a myriad of medical problems requiring even more-expensive and/or long-term care, including loss of independent living. The posterior approach is used frequently again, in large part due to the fact that it is an extensile approach. Click to enable/disable _ga - Google Analytics Cookie. Im now 6 weeks out and doing good. Nobody wanted to talk The surgical technique for a SUPERPATH Hip Replacement was developed as an advancement to traditional total hip replacement. I choose to do them in a staged fashion because it is a significantly shorter procedure (more than half time-wise) and some think this lessens the risk of infection. In my 25 years of practice, the variable that seems to have changed the most is how quickly people recover from this surgery when done well. Hip replacements might keep you out of action for a considerable period. I wish you a full and speedy recovery. I assume PTHR is referring to partial hip replacement. 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. The bone isn't dislocated in surgery. The hip is replaced without the need for surgery to dislocate the joint. Posterior, mini posterior or anterior? Hip replacement is the second most common type of joint replacement, trailing only total knee replacement. 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). Would you recommend treating plantar 1st? I have had to modify my activity level by cutting back greatly and also trying new activities that might not strain my hips so much(tried water walking in the deep end which cause deep pain for 2-3 days afterwards). It's a hip replacement surgery where you lie on your side. My worry is that I will end up with one leg shorter than the other. I am about to have a hip replacement and would like to know what kind of limitations Ill have afterward. Report / Delete Reply kelly1010 nicole66881 Thank you, Lisa. Dear Jo Anna, The SUPERPATH technique is a tissue-sparing procedure which aims to get patients back on their feet within days (possibly hours) instead of weeks or months. Because of the concerns of posterior dislocation, in the past patients were taught certain positions to avoid. These positions include crossing your legs, bending your hip more than 90 degrees, or lying on your stomach. Apples to apples which procedure has the lowest incident of complications? I had an anterior approach hip replacement. We thank you for your readership. The hope is that your nerve injury will recover with time. Again, considering my own practice, I routinely see my patients recover faster and easier after their second hip or knee replacement because they are more confident having had a good first experience. Long-term outcomes of SuperPATH approach need to be investigated. Does Medicare Cover Hip Replacement Surgery? - Healthline Losing weight and strengthening your muscles pre-operatively will make surgery easier and greatly facilitate your rehab. Sitting seems to irritate it the most. As long as you do the necessary surgeries, you will eventually break your femur, but only if you do enough. Also there are concerns about disruption of blood supply to femoral head with this operation. It's cut off and removed through the hole. A number of patients who have undergone this procedure are able to walk unassisted the day after surgery . 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. The impingement can be between the metal neck of the stem and edge of the cup or between soft tissues. My advice is to focus on finding a surgeon with whom you are comfortable and have the best chance of doing well. I ride horses, water ski and kayak. I wish you the best of luck. Click to enable/disable Google reCaptcha. The art of surgery should mimic a well rehearsed ballet or symphony. Finally, I would choose a doctor with whom you connect and whose staff is engaged and knowledgeable. If a patient has abnormal anatomy (such as dysplasia, posttraumatic arthritis, or morbid obesity), or if their body mass index is higher than 35, it may be impossible for them to be considered for direct anterior surgery. Because the mini-posterior is more straightforward, many surgeons think it provides an increased margin of safety for the patient, because the incision can easily be extended if exposure is poor, or if a fracture occurs. I definitely would not recommend a hip scope and THR during one anesthetic setting. and Privacy Policy and steps will be taken to remove posts identified
Very sorry to hear of the difficulties you experienced! I have seen 2 doctors one doing posterior, the other anterior. It is much better to precisely release and cut rather than tear or fracture. An anterior hip replacement is, in many ways, less risky than any other type of hip replacement. Start your day off right, with a Dayspring Coffee I also would find out your surgeons recommendation regarding activities and restrictions. I wish you a full and satisfactory recovery. My question is: should I just tolerate the pain and limp, or take a chance with the hip replacement. Unfortunately, short of conservative and supportive measures, only time will tell. Can You Use An Inversion Table With A Hip Replacement . Personally, it I were caring for you, I would have advised you exactly as the orthopedic surgeon who took care of you did. but it was more torn than they thought and they had to cut out about 1/4 of it. I did have a total knee replaced two years ago. There is a chance of nerve injury with any type of hip replacement. Hip replacement surgery is typically performed in a hospital and requires at least one night in the operating room. Even if the hip doesnt dislocate, prosthetic or soft tissue impingement is not beneficial. out the next afternoon and using a walking stick from day 2 to day 10 when I ditched it altogether . Infection. I am already limping when walking and was hoping that the limp would disappear after the hip surgery. THR - Posterior or Superpath Decision - Joint Replacement Patient Forum Your article is the first Ive read in which no muscle or tendons are cut in any approach other than the direct anterior approach. SuperPath Hip Replacement Surgery Chesterfield | SuperPath Hip Surgery Because visualizing the femur is easier, an experienced surgeon can choose the most appropriate femoral implant rather than just the one that is easiest to implant, taking into account the patients bone quality, activity level and age. That being said, you should have the additional surgery where you feel you will have the best chance of doing well. You should avoid sitting in low chairs, beds, or toilets. 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. 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. 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. Very strange It also helps to stabilize the acetabular shell and prevent soft tissue irritation on the out edge of the cup. 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. Evidence review for hip replacement approach - NCBI Bookshelf Its interesting that when we critically analyze all the variables that ultimately make up the experience that one person has compared with another, or that one person experiences on one side versus the other, we come to recognize its not so straightforward. What To Expect From Anterior Hip Replacement Surgery & Recovery Clearly, he or she has earned your respect and confidence. The socket of the pelvis is machined into a hemisphere and a metal hemisphere is inserted into the socket. The experiences will vary greatly . Infection: You are given IV antibiotics before and after surgery. I would like to share my experience with both procedures. Currently, I seldom do bilateral THRs under a single anesthesia but instead stage the surgeries 2 1/2 to 4 weeks apart, depending on my particular patient and his or her needs and desires. Thank you for this great informative discussion. The same is true for a surgeon who employs the anterior or anterior technique. This technique avoids cutting muscles and tendons, minimizing surgical trauma and improving the post-operative experience. The pain I get is in the groin and a sharp pain in the buttocks, that feels like muscle pain. My advice is to consult with your surgeon regarding how stable the replaced hip is and the most appropriate rehab to follow post-operatively. 2 x week. That being said, if the foot is now a much bigger problem than the hip, you may have to deal with that first. This treatment is commonly recommended for patients suffering from osteoarthritis of the hip. Some people may find that traditional hip replacement surgery is the best option for them, while others may prefer a minimally invasive procedure. My problem isnt from a worn-down joint with no cartilage. 4 mts later am using Notes on SuperPath experiences good or bad, https://patient.info/forums/discuss/superpath-experiences-good-or-bad-718788. Orthop Clin North Am. There are hybrids of the surgey from what I can see. I never seem to know when I am going to get hit with pain. I am so sorry to learn that you have had such a bad experience after THR. from publication: Current and . Thank you for this! I saw a hip surgeon last year for an opinion, but because I had almost no arthritis on the x-ray he said he saw no need for surgery. Having diabetes and two organ transplants does significantly increase your risk for post-op infection as well as other complications. I try not to bring up my mess but its hard when its with one 24/7. The leg lifts really aggravate the front of the hip. If it is from intra-articular hip pathology such as osteoarthritis, which is very common especially in your age group, then most likely stem cell injections will not be affective and you would benefit from a total hip replacement. It is critical to make the right decision regarding anterior hip replacement surgery in each case. Finally, hip replacement surgery is expensive and may not be covered by insurance. You should consult with your doctor before deciding to have an anterior total hip replacement. I dont think there is one best prosthetic. Some have features that are more suited to one persons anatomy and needs than others. Therapy hopefully will help any contractures and scaring within your muscles that might have developed after surgery. I can still do 30-45 mile rides, but I need to take something before each ride, because of the undone left hip. Femor fracture. 1.2. Some patients who have recently had anterior hip replacement may suffer from complications such as wound healing. Many also mate this with a ceramic femoral head. Again, trust your doctor. Over time, untreated hip dysplasia or hip impingement can lead to arthritis and, eventually, hip replacement surgery. Being out of bed and moving soon after surgery adds to a patients safety and speeds the recovery. I wish you the best of luck, I was told to wait 6 weeks before I resumed my exercise regiment. Fort Lauderdale, FL 33334
The anterior approach exploits an interval between muscles that cross the front of your hip and thigh. Its been my experience that patients who go into surgery well informed have a better experience and seem to rehabilitate more quickly. Not sure exactly what that means. Historically, higher dislocation rates were reported with the posterior approach, but it still was used for its many other advantages. I am a 70 yr old female with a 4grade thickness loss at acetabulum and head of femur. Contact Dr. Moor, Orthopedic Surgeon at Advanced Sports Medicine Center. Thank-you. I also think infection must be investigated and ruled out. bible teaching churches near me. Although anterior approaches can be useful for some, they are not for everyone. It also is more difficult for patients with some patterns of arthritis such as protrusio, which causes the worn out ball to migrate inward rather than upward into the socket. They may have a certain cut-off criteria (for example, a BMI of less than 35). There is significantly less bleeding with the mini-posterior approach, notably reducing the necessity of a blood transfusion after the surgery. It's cut off and removed through the hole. Hip Surgery Techniques - Hip and Knee My surgeon mentioned also cutting something to free me up at the same time he will be doing the posterior approach surgery. 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. When studying the hospital credentials, try and learn how many joint replacements are performed at that hospital each year, their infection rate and their 30-day readmission rate. I wish you a full and speedy recovery. Further, I would contact your insurance carrier and the hospital so you will not be surprised with any unexpected costs. Your back does need to be evaluated as well. My walking is very limited, shoe is built up as leg is shorter and in recent months Ive realized my leg is bowed. Regarding restrictions after your hip replacement, this too is an area that has changed drastically over my 25 year career. 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. Iliotibial (IT band) damage, had 2 months of ART release work on this issue. When the joint is held together by gravity and asymmetric anterior muscle tension, the tension between the ball and socket may change in various directions. I would look for a surgeon who is busy, has a strong track record and who practices at a hospital with a stellar reputation and where many joint replacement surgeries are done. 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. It requires surgical insight and skill to accomplish. Because the dissection is over the front of the hip, a number of patients will experience residual pain and tightness anteriorly (in the front of the hip) at least early on. If so, how long until I can get back to normal living? I now need the right hip replaced. Doctors use metal, ceramic, or plastic replacement parts.
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