In anterior and posterior surgeries, the outcome is essentially the same a new hip. Each approach has advantages and disadvantages. All orthopaedic surgery demands a long recovery period. 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. Registered number: 10004395 Registered office: Fulford Grange, Micklefield Lane, Rawdon, Leeds, LS19 6BA. Soft tissue contractures often are associated with long-standing arthritis. With a significant learning curve, it is likely that you will have to replace about 100 hips before you are truly comfortable with the approach. Hip anatomy Hi, If you decide to have your hip replaced in another country, I would consider carefully who would care for you if you develop a complication such as an infection, or a major medical problem like a pulmonary emboli or heart attack after surgery. 2. In bed for long periods with little or no movement. We need 2 cookies to store this setting. Thank you. What has changed the most in my career, once again in a very positive way, is how quickly patients start walking (day of surgery), and go home and return to their active lives after THR, as compared with just a few years ago. There arent any activities that you can do with a resurfaced hip that you cant do with a total hip. Years ago, experts assumed that anterior hip replacement had lower rates of hip dislocations and nerve damage than other forms of hip replacement. Lazaru P, Marintschev I. Thank you for sharing. An operating room that can support safe Anterior or SuperPATH minimally invasive joint replacement surgery costs around $1.5 million. There is also a small risk of infection at the surgical site. Hip replacement surgery can open up a world of possibilities for people who have lived with pain and restricted movement. The surgical technique for a SUPERPATH Hip Replacement was developed as an advancement to traditional total hip replacement. When we quote probability of longevity after hip replacement based on following people who had the operation, it is based on standard length stems. I already have an artificial knee that is doing great. I then would trust your doctor to select the prosthetic that would deliver the best result according to your goals and allow you to return to activities that you enjoy. I wish you a full recovery. Once again, I think your decision to proceed with THR is the most reasonable. Nobody wants a long recovery. I saw a surgeon who does the posterior approach only and will see another on 4/14/15 who does both approaches. I have never operated on another surgeon who asked me to make as small an incision as possible or use the minimally invasive approach. Welcome to Brandon Orthopedics! I had good results into 5th month post op and then everything went downhill. I am deciding that my quality of life is in the toilet and need to get the THR done. No one tells me the same thing? William Leone. Achieving legs that feel equal in length after surgery is imperative. and Privacy Policy and steps will be taken to remove posts identified
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 My advice is to have a frank discussion with your surgeon and share these concerns. On July 17th, I had a left THR. Hip implants are medical devices intended to restore mobility and relieve pain usually associated with arthritis and other hip diseases or injuries. It requires surgical insight and skill to accomplish. Some patients who have recently had anterior hip replacement may suffer from complications such as wound healing. There is a more than 200% chance of knee infection, most likely because the knee has more surfaces that can become infected with an infection. I am a!so told by the orthopedist who referred me that I need arthroscope on my right hip. Ken. There are risks and recovery times associated with surgery. After reading your article I see there are many reasons to go with the posterior approach but nothing about having to use a smaller prosthesis with the anterior approach. He is passionate about helping his patients achieve the best possible outcome and is committed to providing the highest quality of care. I live in Staten Island and need rt hip replacement. A hospital outpatient surgery can cost between one-third and one-half the cost of an outpatient surgery atCOSC. As of 2020 only Dr. Leone is using the latest hip technique called the. I would love to hear some stories about the SuperPath hip replacement. (PATH) and Supercapsular percutaneously assisted total hip (SuperPATH) arthroplasty: learning curves and early outcomes. Having diabetes and two organ transplants does significantly increase your risk for post-op infection as well as other complications. Patient is a UK registered trade mark. The most common reason or diagnosis that leads me to replace the hips of young women is hip dysplasia. Also there are concerns about disruption of blood supply to femoral head with this operation. No groin pain NOW.but all the other mess of it all. A typical recovery time from anterior hip surgery is six months. I was told to wait 6 weeks before I resumed my exercise regiment. My worry is that I will end up with one leg shorter than the other. Thanks! I ski, hike (steep terrain) with a pack -about 25 pds, kayak, horse back ride, swim, water ski and bike, which is getting increasingly more difficult. I wish you only the best. 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. You can do anything you want after a hip replacement. Also, since I am only 51, I am concerned about component longevity. It helps the surgeon implant the acetabular component in a very precise position. I am 37 and have suffered from AVN since I was 14. Im pleased that you will be coming in for an appointment. In 2013 I had a THA done on the left hip. I have the surgery planned, but then another medical professional warned me that the posterior approach will limit my twisting range of motion and prevent me from playing golf. Again, trust your doctor. 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. An anterior hip replacement procedure, on the other hand, performs the same function as an anterior hip replacement in terms of tissue shaving. 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. Dear DR Leone, If an MRI demonstrates no cartilage damage or subchondral cystification (the development of degenerative cysts), a repairable labral tear and minimal dysplasia, then a hip arthroscopy may be considered. Having a THR is a major undertaking and it is reasonable to expect the hip construct to function optimally for twenty and more years. Traditional Hip Replacement - Traditional surgery requires a large incision of 10 to 12 inches and detachment of muscles from the hip. 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. Fortunately, the incidence of hips dislocating after THR is very small, especially after first-time hip replacement. I understand they have good results in Thailand or India for half that. On the other hand, there may be a slightly increased incidence of anterior instability. What are your thoughts with regard to Stem cell therapy in lieu of THR? 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). Many, many interactions and decisions go into the final result as well as someones perception of his or her result and experience. 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. Thank you. I think it was sensible being careful on the other hand and I was told not to cross my legs. Irrespective of the approach that is used to implant the prosthesis, the tissues that surround the new prosthetic hip must heal and mature if the hip is to achieve stability. Will I be able to dance, hike, bike, swim, exercise after a 3rd surgery? 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? Nerve regeneration can occur up to 18 months following injury, but the chance of full recovery decreases with delay in recovery time. I'm hoping to read some posts post surgery. Also, only a small percent of C-on-C bearings are being implanted at this time. Introduction 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. They may have a certain cut-off criteria (for example, a BMI of less than 35). I am just under 5 ft and weigh 185. Hip replacement currently consists of two major approaches: direct anterior and anterior approaches. I emphasize continuing exercises at home especially walking. Going in for THR in July. Also, be aware that as the nerve recovers, the smallest C fibers within the nerve recover first, which can cause a burning discomfort. 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. 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. I have not seen this before because in the past, the complication from hip surgery were sciatic nerve injury from posterior approach. Once youve decided, you then need to trust that he or she will take the best care of you possible to deliver the best results. You should feel good that you are aware of your fears and that it hasnt paralyzed you into not acting. Disadvantages of the anterior approach include: The nerve which supplies sensation to the front and side of the thigh is vulnerable. Sometimes the pain goes away as I walk and sometimes it doesnt. I was told the joint lubricant had migrated into the hip bone creating the cyst, There is effusion in the joint and stress areas. My question is, what will my restrictions be? I am female and I weigh 115 pounds. I think researching the hospital where you will have your surgery is very important. Everything does point to posterior being the better of the two, but first i wasnt given a choice, and much easier said to shop for surgeon, than to do it, when only one in this area takes my insurance. The rest is marketing. The first surgeon never mentioned this condition at all. You can resume your active lifestyle as soon as possible thanks to a new prosthetic hip. Getting in and out of cars, and turning over in bed. 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. My personal preference has changed from doing both hips during a single anesthetic to staged procedures two to three weeks apart. 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. 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. A hip replacement with an anterior component does not require major muscle cuts and thus patients are less likely to experience pain and require less medication. Clearly, he or she has earned your respect and confidence. I am a competitive tennis player in my age division. No feeling in my leg and no movement 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. Your blog on anterior vs posterior approach was very informative. Every hip implant has benefits and risks. That's all I know. Which is the best? Hello Dr. Thanks so much for your help, very grateful. In general, people who are older, heavier, or more active may not be good candidates for this type of surgery. It normally takes about 3-6 weeks to resume normal household activities and about 12 weeks to resume recreational activities like bicycling or golfing. It is also important to avoid any sudden movements or twisting motions. emergent norm theory quizlet. According to Dr. Gililand, patients should not try to change their surgeons opinion based on their preferences. My advice would be to avoid the extremes of any motion that exceed your hips ROM. Many patients approach this by researching online and speaking to other patients who have been cared for at a particular facility. I was so against doing this surgery but groin pain was very bad and crushed bone in the groin. In my practice, I cement an Exeter stem in a significant percentage of my patients who undergo THR . What surgical approach is typical for a complex total hip replacement? 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. If you feel confident in your surgeon, I would discuss it frankly follow his or her guidance as to which approach and prosthesis are most appropriate to give you the best result. 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. 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. It's cut off and removed through the hole. The vast majority of my patients return to work one to three weeks post-operatively. Optimal component positioning also is critically important for the best stability and longevity. Should I go for this or should I opt for the mini posterior. There are numerous complications associated with hip replacement surgery, but blood clots in the legs and hips are two of them. No special surgical equipment is required when performing a mini posterior. My legs are very muscular and trim. I'm hoping to read some posts post surgery. I wish you the best of luck, Understand that every total hip, no matter which approach is used to implant it, has the potential to dislocate. Other preoperative guidelines, such as using a prescribed pain medication and keeping the incision clean and dry, should also be followed by patients. What is most important is that you find a surgeon who understands the particular complexities with your problem and whom you trust. Between your legs, you should sleep with a pillow for the next six weeks. Behavior. We can do this because of improved plastics. I suspect there is significant underlying osteoarthritis related to your labral pathology. Most traditional hip replacement models are metal-on-plastic varieties. Surgical approach is important but its just one of many important variables. 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. 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. Brian Tinsley. The questions youre asking are 100 percent appropriate. I was not aware that any of the local surgeons who is doing anterior approach. Rather, they say Bill, please just do what you have to do and do a great job. Thank you so much for your answer, I appreciate your taking the time to care about others. Individual results and activity levels after surgery vary and depend on many factors including age, weight and prior activity level. I would rather see my patients go home. So im going back to the surgeon that did my left hip and left me in agonizing pain for 2 months after procedure. General comments will be answered in as timely a manner as possible. Not only was my recovery twice as fast with the anterior, there was very little pain in comparison. Clots can form in the leg veins after surgery. 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. An artificial joint is used to replace the worn out hip joint during a hip replacement procedure known as posterior hip replacement.