Complications associated with an anterior approach hip replacement are similar to those associated with standard hip replacement surgeries. http://holycrossleonecenter.com/blog/hip-resurfacing-or-total-hip-replacement-a-candid-discussion/, http://holycrossleonecenter.com/blog/metal-on-metal-hip-replacements/, I wish you the very best recovery. 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. A hip replacement can greatly reduce the pain associated with arthritis of the hip, with almost all patients having complete or near-complete relief. Some other methods are effective, but they are less effective for patients who leave the hospital earlier. Also, if this nerve injury occurred, I would expect these symptoms to be present immediately surgery, not five months post-op. It is critical that the patient is aware of the risks, benefits, and alternatives of the procedure. Specific protocols, therapy and what positions you will be asked to avoid after surgery and for how long will be directed by your surgeon. 2015 Aug. 3 (13):179. Patient does not provide medical advice, diagnosis or treatment. I believe a THR will benefit you tremendously. Yes, Im angry. . That's all I know. Which approach did the doctor take? For risks she mentioned all the usual I knew about from the first surgery blood clots/loss, dislocation, etc. The anterior approach has a lower incidence of sciatic nerve injury and a higher incidence of femoral nerve injury. Most patients decide not to wait as long to have their contralateral hips or knees replaced after having undergone a successful surgery on the first side. I had an MRI by a different hip doctor (a preservationist) who diagnosed me with a birth defect (hip dysplasia). Stay was 2.5 days. Do either of your techniques require the traditional anterior or posterior precautions? 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. SuperPath Total Hip Replacement - STL Ortho Each approach has advantages and disadvantages. Hip Resurfacing vs Total Hip Replacement - sosbones.com The healing and maturation of this tissue takes time. I never seem to know when I am going to get hit with pain. Here are a few of the advantages of anterior hip replacement. Ten out of every fifteen hip replacements will be functional for more than 20 years after they are inserted. The most common reason or diagnosis that leads me to replace the hips of young women is hip dysplasia. Many wonderful physicians are part of various HMO panels. I would rather see my patients go home. If theyre really happy and got well quickly, you probably will too. 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. Behavior. Mar 13, 2013. Usually a hip problem is addressed before a knee or foot problem because by solving the hip problem first, the knee or foot often improves if the pain is referred from the hip (more common with knee pain) or if by addressing the hip, the body mechanics and the fluidity of gait improve. What surgical approach is typical for a complex total hip replacement? Hip replacement - Doctors & Departments - Mayo Clinic Thank you, It would be interesting to hear what you have to say Doug. Even in my practice, which is starting its 27th year, we continue to refine the surgical procedure, pre- and post-operative instructions and rehab (this is huge), pre- and post-operative pain management, and even anesthesia. 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. In Dr. Lawrence Dorrs opinion, doctors and hospitals should not market a specific type of surgery as the most effective. Hip Preservation Surgery | Duke Health Just getting your thoughts I will discuss it more with my surgeon at the pre-op meeting. How long will my hip replacement last? I think its reasonable to request a tour of the facility where youre considering having the procedure. An artificial joint is used to replace the worn out hip joint during a hip replacement procedure known as posterior hip replacement. In addition, patients prefer the anterior approach due to the absence of pressure on the Femoral nerve in the anterior approach. Other preoperative guidelines, such as using a prescribed pain medication and keeping the incision clean and dry, should also be followed by patients. If you would like a personal consultation, please contact our office at 954-489-4575 or by email at LeoneCenter@Holy-cross.com. The surgeon will be building a construct that hopefully will last her life time and change her life profoundly. I am feeling like this is a business like everything is else. Also, patients with shorter femur necks and genu varus (lower angle between the shaft of the femur and the femoral neck) are more difficult anteriorly. What, if anything, can be done to revive femoral nerve and get my thigh muscles back in normal? Notes on SuperPath experiences good or bad, https://patient.info/forums/discuss/superpath-experiences-good-or-bad-718788. The parts may be attached to the bones in one of two ways. Very strange Its from a malformation. Nobody wants a long recovery. 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. Patient is a UK registered trade mark. I am temped to wait but it is getting worse. By continuing to browse the site, you are agreeing to our use of cookies. Thanks! I have since read that hips with this condition might get worse after labrum repair due to this structural defect. I would rather this not happen with my right leg when I have the THR in Jan 2017. Robert H. Sigmund, MD | Signature Orthopedics There is a 1-2% risk of fracture of the femoral neck. I had an anterior right hip replacement in late 2010, I was 72. Le has extensive experience in primary joint replacements, complex revision surgery, periprosthetic fractures, and infection management. I live in Staten Island and need rt hip replacement. I dont know what happens on that tablewas he in a hurry on Friday afternoon. Just because hardware in your foot needed to be removed after repairing what sounds like a calcaneal (heel) fracture, absolutely does not mean that your body rejected the metal / hardware or that your body will reject the prosthesis your surgeon will implant to reconstruct your hip. I also would learn about the track record of the surgeon and hospital where you will decide to have the surgery and what implant will be used. An anterior hip replacement is not covered by a specific credential system for orthopedic surgeons. 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. If you do not want that we track your visit to our site you can disable tracking in your browser here: We also use different external services like Google Webfonts, Google Maps, and external Video providers. I now need the right hip replaced. Mayo Clinic researchers have studied ways to reduce blood loss, control pain and speed recovery for people who undergo hip replacement surgery. This is not true for bilateral cases. After awhile the screws started shifting and poking up under the skin and they removed them. 2. Does anyone ever attempt to do both at the same time if THR is determined? Total Hip Replacement Surgery | Kaiser Permanente My clinical impression is that more patients experience some degree of residual groin discomfort or tightness after the anterior approach as compared to the posterior approach, but that it tends to resolve with time. I feel good now and walking good now but feel so disabled as I dont know if my hip will dislocate again.I am sorry if you may have responded to some of these questions already as it is so much information to absorb and I dont want to make a wrong decision again. I have been told that I can fly 48 hours after surgery?? 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. Not quite in the past. The rule of thumb is that recovery occurs over a 12-18 month period following injury. I wish you a full recovery. This is particularly true if the person is overweight, has very muscular thighs or is short. While it is a surgery that does help many, many people, clearly you are struggling. I would recommend having an honest discussion with the surgeons you are considering. I, too, am struggling which approach to have. results, I decided to see and orthopedic doctor was advised to have THR. Some surgeons will use 2 incisions, both the anterior and superior approach. Risks associated with hip replacement surgery can include: Blood clots. There is a chance that the hip will fall out of the socket, or that it will be levered out by twisting it. It does sound as if proceeding with a THR is appropriate, since your attempt to repair the joint arthroscopically did not pan out. Hip Replacement Surgery Technique Pros & Cons | Portsmouth I am a very active and young 69 year old female who had a THR on my left side 5 years ago. Going in for THR in July. In 2010, more than 310,000 hip replacements were performed in the United States. I tore my labrum at age 43 and only discovered then that I had bilateral dysplasia. Ann Transl Med. for Orthopedic Care I had a consult with a surgeon who does posterior and cuts muscle & tendons. My advice is to consult with your surgeon regarding how stable the replaced hip is and the most appropriate rehab to follow post-operatively. For the prevention, diagnosis, and treatment of hip pain and other problems affecting your hips, call Advanced Sports Medicine Center today at (941) 957-1500. SuperPATH showed better results in decreasing operation time, incision length, intraoperative blood loss, and early pain intensity. I really dont know where to go from here. People who have anterior hip replacements tend to stop using walkers, canes, and other aids 5 to 7 days sooner than people who have conventional hip surgery. The most important thing is to get a top notch surgeon and go with whatever approach they offer. Complications SuperPath hip approach. Im a very healthy long distance bicycle rider. I am concerned that I may have a pinched nerve and that that is what is causing all this pai as the pain is severe only in certain positions but when I am tired I also have a throbbing pain in the sciatic region.talk about the golden yearsI thank you from the bottom of my heart for the kindness and caring that you do in answering all these questions. They may be: Cemented to the bone. Because the muscle fibers are separated, not cut, the nerve path is not disturbed and the muscle is not injured. Dr. Robert Sigmund is a board-certified orthopedic surgeon and a sports medicine physician based in St. Louis, Missouri. 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. Above the ankle to the thigh.Had to use leg brace to We are always refining and trying to make it better. Surgical approach is important but its just one of many important variables. 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. The most important variable is how quickly the person is motivated to return to work. The hope is that your nerve injury will recover with time. What is your experience and take on this ? In my experience, there is a faster and more-consistent recovery with the mini-posterior. I would emphasize choosing your surgeon and not the approach. I am just under 5 ft and weigh 185. Dr. Leone, I am coming in to see you for an appointment for a THR to my left hip. Which is the best? Im getting close to needing my left hip done. Patients can also have as little as a 3-inch incision. SUPERPATH Hip Replacement Surgery - Health Pages . 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. I often suggest to my patients that they speak to other patients for whom Ive cared and to whom they can relate to learn about their experiences. Im hearing no restrictions (once recovery is done) for Anterior, but always some for the other two. My surgeon is doing posterior and my reason is I am self employed with limited Time off available and hope to be back to work at least walking and driving in 4 to 5 weeks is this possible? About my surgery: I had to wait 30 hours before surgery, two days later I was released, within two more days I stopped using my walker. How would a hip replacement be done? SuperPath Hip Replacement: The Major Benefits You should consult with your doctor before deciding to have an anterior total hip replacement. A ceramic-on-ceramic bearing is also a very good bearing. The nerve which supplies sensation to the front and side of the thigh is vulnerable. Patient Resources I read about this type of mini hip replacement being done in the UK and just wondering if mini hip replacement means the same thing in the US . How do you ask your doctor the questions you want to ask? Dear DR Leone, The bone isn't dislocated in surgery. We may request cookies to be set on your device. It is 100 percent normal and expected to be scared before surgery. 2012 Oct 17;94(20):1897-905. doi: 10.2106/JBJS.K . Remember, what youre hoping to do is have a hip construct that will last 20 years or more. I am sure you should not listen to what I did!! Check to enable permanent hiding of message bar and refuse all cookies if you do not opt in. Your blog on anterior vs posterior approach was very informative. Since then, SuperPATH has enjoyed excellent success. I have not seen this before because in the past, the complication from hip surgery were sciatic nerve injury from posterior approach. SuperPath hip replacement is a differentiated total hip technique being performed by a growing number of experienced surgeons. Mini posterior refers to the approach or tissue interval the surgeon uses to implant the Total Hip. The mini posterior approach works wonderfully and predictably when expertly performed. It's what compelled me to seek out different methods and post here.. You will find the surgeons will all give the pros but never the cons what ever the method. Or are x-rays definitive for determining the exact reason for THR? No feeling in my leg and no movement All have advantages and disadvantages. Doc says once recovered I should avoid flexion with adduction and internal rotation. The activity that I wish to have the most success with after the surgery is ballroom dancing. I am about 5 6 and 185 lbs, age 58, he did not think the weight was an issues. I should think that all your expectations are appropriate for the activities you look forward to, especially considering youve already done so well after your knee replacement. The socket of the pelvis is machined into a hemisphere and a metal hemisphere is inserted into the socket. Pros and Cons of Robotic Assisted Surgery - Carrothers Orthopaedics If possible, try to get in writing any verbal promises made. Until now. My worry is that I will end up with one leg shorter than the other. (a) Components of a total hip replacement; (b) The - ResearchGate Can you explain it to me as he didnt go into detail. After reading your article I am concerned about the issues you discussed. I have cared for many patients over the years with significant heart and peripheral vascular disease. If I think you may be a candidate, I will refer you to a doctor in our area that does. Personally, I would not gamble with my health. 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. My surgeon has told me I will need PT 3 times a week for 6-12 weeks is this too long? Following anterior hip replacement surgery, avoid soaking in hot tub, sauna, or swimming pool immediately after surgery. Appalachian orthopedic surgeons perform revision surgery as well as mini-posterior and anterior approaches. What Is Superpath Hip Replacement - HipsAdvice.com It turned out to be more torn than they thought and they had to cut about a forth of it out. Most patients after a bilateral procedure would not go home but rather a rehab unit. But after reading your articles, I am hesitant about that choice now. What is most important is that you find a surgeon who understands the particular complexities with your problem and whom you trust. Does either procedure in this discussion present restrictions or advantages for this sort of movement? It is difficult to get that from information which I find curious. If I do a single hip or knee replacement, that patient is out of bed standing and, in most cases, walking the afternoon of surgery. But I am now in chronic low grade pain thats getting worse and dont know what I should do. Posted For many years, I performed bilateral THR and bilateral TKR procedures, but have backed away for a variety of reasons. Do you agree? 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. Hip Replacement Materials Best to Worst - Bioxcellerator Other health issues include congenital heart ASD corrected about 12 yrs ago with an amplatzer occluder implant by the right femoral approach resulting in possible femoral nerve compression, Lateral right leg numbness and leg discomfort since the implant, Groin pain and restriction in extending the right leg back has been a problem for some time and masked the fact that at least a portion of my increasing pain was from my hip. The information I have gathered seems to indicate the anterior approach is more inherently stable, making precautions unnecessary. When done well, your body does well with this technology. Hip replacements might keep you out of action for a considerable period. A typical recovery time from anterior hip surgery is six months. I saw a surgeon who does the posterior approach only and will see another on 4/14/15 who does both approaches. The new prosthetic socket must be medialized (placed further toward the midline) and sometimes through the medial wall of the native socket. Also, after an accident, I had 12 screw and an L shaped plate in my heel. 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. J. Dear Dr. Leone, I was thinking of doing that 1st, maybe April(Ill be in boot 4 weeks), and then the PTHR in either Sept or next Jan when I have free time. 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? By adhering to the surgeons instructions as well as their pre- and post-operative instructions, you can reduce your chances of complications. THOUGHTS? Felt very uninformed and left The surgeon I am meeting with (Dr Jimmy Chow) is supposed to be top notch in this procedure, and I am just curious as to how different the surgery is from conventional surgeries. Hip replacement surgeries are becoming increasingly popular due to their numerous benefits, such as increased range of motion, reduced pain and disability, improved mobility during pregnancy, and improved quality of life. I sit on a cushion in the car to lift me up. It allows the surgeon to work between the muscles and tendons without removing them from their anchoring points on the hip or thighbone. 1000 NE 56th Street, I havent dropped in here for a while but here I am almost 5 yrs post op Anterior and Femoral Nerve Damage is very alivewhole thigh is numb, IT band is still very sore and numb. The impingement can be between the metal neck of the stem and edge of the cup or between soft tissues. Also, some body structures or anatomy makes approaching a hip anteriorly much more difficult than others. We are always refining and trying to make it better.
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