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Often in this group of patients, their X-rays show only minimal cartilage space compromise (it may appear thinned and irregular) and I observe at time of surgery that the labrum appears hypertrophied (to compensate for lack of head coverage) and often torn. I believe this is an important discussion you should have with your surgeon preoperatively. 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). Regardless, the overall incidence of dislocation for every approach is smaller due to use of larger femoral heads and enhanced closure techniques. After the direct anterior approach, there is generally no hip precautions required, and motion is not restricted. Im a very healthy long distance bicycle rider. Return to the work place is an individual decision. You can be successful by staying healthy by sticking to less pain. The most important thing is that tissue is handled gently and trauma is minimized, whichever approach is used. Posterior, mini posterior or anterior? Being cared for in a hospital that specializes in joint replacement and has an extensive specialty medical staff also is key. I have a good surgeon (same one as last time) but I dont know how he would feel about my asking if a mini posterior (or posterior) procedure be carried out, so as to preserve as much strength in my right leg as I now have.Do as many muscles need to be cut in the mini posterior procedure? Many others feel the same. My recommendation is to go back to your surgeon and share your concerns and issues to see if a fresh and thorough reevaluation wont help define the problem(s) and solutions. In my experience, there is a faster and more-consistent recovery with the mini-posterior. These cookies are strictly necessary to provide you with services available through our website and to use some of its features. You always can block or delete cookies by changing your browser settings and force blocking all cookies on this website. I began using the superior approach for total hip replacement in February of 2014. . Patients can also have as little as a 3-inch incision. Spring 2014 had trouble playing tennis, hip kept feeling like it was popping out of joint, groin pain, aching. In comparison to traditional methods, anterior approaches to the hip joint are more effective. Length of hospital stay with SuperPath hip replacement approach. Complications from infection account for approximately 10% of all cases. We are always refining and trying to make it better. Uncemented. I was discharged within 24 hours. Any feedback will be appreciated. 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. This approach has a number of potential advantages, including a shorter hospital stay, less pain, and a quicker recovery. As of 2020 only Dr. Leone is using the latest hip technique called the. Is a prerequisite for THR to have a MRI or Pet Scan? Walker to get around. Others continue to follow traditional guidelines. My doctor does not do mini posterior, therefor I have a 6 incision. Some surgeons believe that a patient who is neither obese nor overly muscular is a good candidate for anterior hip replacement surgery. Further, the extent of dissection is more minimally invasive, which also improves stability. My surgeon has told me I will need PT 3 times a week for 6-12 weeks is this too long? Infection. I have insurance with very high deductible and I am scared of the debts I might incur afterwards too ( where I am planning to do it I might not have to pay any money). Report / Delete Reply kelly1010 nicole66881 It allows the surgeon to work between the muscles and tendons without removing them from their anchoring points on the hip or thighbone. More likely, its because ones activity increases after the first THR. I am so sorry to learn that you have had such a bad experience after THR. You should keep in mind that the vast majority of hip replacement pain reduction surgery patients are satisfied with their final results. Last summer I wiped out on my bike and snapped off the top of my right femur, with a diagonal break. Your surgeon will know better than anyone else just how stable your new hip is immediately after your surgery and how securely the surrounding tissues were repaired after the reconstruction. 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. I think seeing several surgeons for different opinions is good judgment. Today, everything from tools to techniques has improved. Some patients who have recently had anterior hip replacement may suffer from complications such as wound healing. I understand they have good results in Thailand or India for half that. I think speaking to a patient with whom you can relate and who has been treated by the physician youre considering also is invaluable. Sitting seems to irritate it the most. Also, if this nerve injury occurred, I would expect these symptoms to be present immediately surgery, not five months post-op. Once again, I think your decision to proceed with THR is the most reasonable. After reading your articles, I have decided not to have anterior. Overall, however, anterior hip replacement is a safe and effective procedure with a high success rate. Results of the surgery numbness in the right thigh, inability to stand on the right leg, muscle atrophy all confirmed by EMG and second orthopedic surgeon. They may be: Cemented to the bone.
The surgery is more difficult and more exacting . Should I go for this or should I opt for the mini posterior. what is the super path method I've never heard of that before, superpath is just the fancy name for a smaller incision , less trauma and quicker recovery or so they say from what I have read along with more surety of the length of leg . Other combinations of materials have advantages and disadvantages (for instance, some researchers believe that ceramic-on-ceramic types may be more durable, but they have also been known to make squeaking and popping sounds.) An anterior hip replacement procedure, on the other hand, performs the same function as an anterior hip replacement in terms of tissue shaving. I have the hospital but am deciding on the surgeon and which approach is best. Remember, what youre hoping to do is have a hip construct that will last 20 years or more. 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. Very slow recovery. I tore my labrum at age 43 and only discovered then that I had bilateral dysplasia. Hi guys im 43 and live in Australia and due to have hip replacement in 7 weeks but im so confused as my surgeon is doing the posterior and im off work for 6 weeks where i here people having the anterior and going back sooner and no restrictions on hospital discharge any advice. The anterior approach, as opposed to the lateral or posterior approach, uses a small incision in the front of the hip. Not quite in the past. I am thoroughly confused at this point. I was released to go back to work after only 10 days. The SUPERPATHTM procedure provides a number of advantages over traditional hip replacement surgery. Also had I have cared for many patients over the years with significant heart and peripheral vascular disease. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in
I was so against doing this surgery but groin pain was very bad and crushed bone in the groin. There arent any activities that you can do with a resurfaced hip that you cant do with a total hip. All of these releases may be necessary as part of the surgery and patients do well. Other preoperative guidelines, such as using a prescribed pain medication and keeping the incision clean and dry, should also be followed by patients. Cant afford a dislocation or other complications cause Im sole caregiver for severely handicapped son. Comments about life-long hip restrictions between Posterior, Anteriorlateral and Anterior approaches? Thank you, Rita. Anterior hip replacement has the potential to cause complications and pose some risks. For many years, I performed bilateral THR and bilateral TKR procedures, but have backed away for a variety of reasons. I was initially sent to a surgeon to consider repair but he said my chances of being happy with the outcome were only 30% and suggest a THR. 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. 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. In a posterior hip replacement, the procedure is done on the side of the hip. By 2016 and over 300 SuperPATH cases, the results of very first 100 SuperPATH surgeries (the so called 'learning Curve') were published in a peer reviewed journal with . SuperPath hip approach. If not, what will my restrictions be? Thru X-rays Ive been told both hips are bone on bone! 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. But I feel that time could be lost and all my symptoms may become irreversible. Or are x-rays definitive for determining the exact reason for THR? If you have an abnormal anatomy or are morbidly obese, you may not be a good candidate. My mom is obese, short and has osteoporosis. I was told to wait 6 weeks before I resumed my exercise regiment. If youre impressed by how clean it appears and the movement and professionalism of the staff, that obviously is a good sign. Thanks for any feedback. 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. My husband, who is only 35, has to consider a THA in the near future and Im very torn over which approach as the surgeon we really like dos a posterior but I am concerned about dislocation rates in posterior vs anterior. It is not a substitute for excellent surgery. Original Medicare (Part A and Part B) will typically cover hip replacement surgery if it's medically necessary. Even after the procedure is completed and the patient is on pain medications, pain and discomfort may occur in some cases. If you refuse cookies we will remove all set cookies in our domain. This treatment is commonly recommended for patients suffering from osteoarthritis of the hip. The parts may be attached to the bones in one of two ways. 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. Dear Dr. Leone, I would consider talking to other patients who had their hips replaced by that physician and learn about their experiences. I was told the joint lubricant had migrated into the hip bone creating the cyst, There is effusion in the joint and stress areas. I had a posterior, the surgeon did not cut any muscle, they just move them now. I ride horses, water ski and kayak. Prior to surgery, you need to be evaluated by your primary care doctor and any other specialist who helps manage your care, so the conditions you have can be optimized. I have had both hips replaced about 13 months apart, one anterior and one posterior, and there is no doubt that I would recommend anterior. 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. Blood-thinning medications can reduce this risk. The size and placement of the incisions will be different. 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. 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. The last page is asking the participant to self score their health that day out of 100. If was 3 weeks after discharge The doctor is planning a traditional posterior. No one tells me the same thing? 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. Thigh feels so Heavy and I massage that area a lot. I'm so encouraged to hear your successful story. This does expose the patient to more radiation but can help with component positioning and sizing. 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. 5. As for doctors, the surgeon I had came highly recommended. It is important that these medical and cardiac conditions be optimized by your PCP and cardiologist preoperatively. I know the most important decision you will make is choosing the doctor who will perform your surgery. I spoke in person to probably 4-5 of his success patients and went with hearing from them. Following surgery, the surgeon will devise a routine for the patient to engage in that is both comfortable and safe. 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. Hello Dr. I live in the UK so again Im afraid I wont be able to consult you personally! A hip replacement can be delayed until it is absolutely necessary if the replacement parts can fail over time. The activity that I wish to have the most success with after the surgery is ballroom dancing. I feel that at 10 weeks with profuse denervation potentials on the quad muscles, the prognosis is not good, even at 6 months. In addition, patients prefer the anterior approach due to the absence of pressure on the Femoral nerve in the anterior approach. My walking is very limited, shoe is built up as leg is shorter and in recent months Ive realized my leg is bowed. I am a 67 year old woman who has danced semi-professionally and has always been very active including doing Ashtanga yoga and caopeira. The SUPERPATH hip replacement is a new technique using superior capsulotomy that allows for implantation of the total hip components under direct vision through a single incision. By continuing to browse the site, you are agreeing to our use of cookies. What are your thoughts on the use of robotics? As a result of this precaution, it is difficult to sit on low chairs, sofas, or toilets. Pam. Patient does not provide medical advice, diagnosis or treatment. Also available today are larger modular heads, made possible because our plastics are so much better than years prior. I wish you the best of luck. I wish you well. A hip replacement is an excellent option for people who suffer from significant pain and disability as a result of arthritis in the hip joint. The bone isn't dislocated in surgery. Hard-on-hard bearings, such as ceramic-on-ceramic as well as metalon-metal articulations, also resulted in larger femoral heads being implanted. Do either of your techniques require the traditional anterior or posterior precautions? I deal with major nerve damage on front of thigh, almost whole thigh. Dear Jo Anna, Gililand, our physician, explained the concept of health. Any info would be appreciated. Hip replacement currently consists of two major approaches: direct anterior and anterior approaches. I am scheduled for bilateral hip replacement at the end of August. 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 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. Its been six months since surgery, my operating doctor keeps feeding me with lets wait another month stuff. I would then let that person decide with what approach they think they can best accomplish the surgery and deliver the best result. Note that blocking some types of cookies may impact your experience on our websites and the services we are able to offer. 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 This most often leaves the patient with an area of decreased or uncomfortable sensation or numbness over the anterolateral thigh (top, outside area of the thigh), not the entire thigh. 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 was not aware that any of the local surgeons who is doing anterior approach. [QxMD MEDLINE Link]. We want the forums to be a useful resource for our users but it is important to remember that the forums are
Does the mini posterior hip replacement conserve more femur and allow for future surgeries if needed ? I recently had a spontaneous hip fx and was diagnosed with hip displasia. We provide the best cash prices and customer care in the industry. 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. Getting in and out of cars, and turning over in bed. I am a 53 year old active, distance runner. 1.2. There is a chance that the hip will fall out of the socket, or that it will be levered out by twisting it. My question is: should I just tolerate the pain and limp, or take a chance with the hip replacement. 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? Patients are typi. I understand that most surgeons now do a spinal rather than general anesthesia. 2015 Aug. 3 (13):179. The actual length of the incision really is not important, but rather how well the components were implanted and the hip mechanics restored. This allows you to resume normal daily activities quickly while also returning to normal range of motion and function. Better luck to you all.