What is the best hip replacement option: anterior or Posterior? I have cared for many patients over the years with significant heart and peripheral vascular disease. We are always refining and trying to make it better. Its from a malformation. An anterior capsule is the only soft tissue cut during this procedure to insert the implants. out the next afternoon and using a walking stick from day 2 to day 10 when I ditched it altogether . Report / Delete Reply kelly1010 nicole66881 The hip replacement needs to correct the abnormal hip mechanics that lead to the arthritis. The doctor is planning a traditional posterior. The doctor has scheduled me for total hip replacement in two weeks and he uses the Posterior approach, he didnt say anything about the mini part. One disadvantage to the mini posterior approach is that patients are instructed not to place the newly implanted leg in certain positions for the first six weeks after surgery. Lastly, if one has had P or AL is there anything that can be done to offset the need for restricitons? Testimonials 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 . I would recommend having an honest discussion with the surgeons you are considering. I am planning to have a THR this summer. I began using the superior approach for total hip replacement in February of 2014. . I have linked back to several blog posts below that will give you more in-depth information. Historically in my practice I performed many Bilateral THR and TKR and have backed away from that practice. Hip replacement is the second most common type of joint replacement, trailing only total knee replacement. I am still a very active 67 yr old, I like to ski, bike, hike (steep terrain) with about 25 pds. Many of these stems have very little if any long term follow-up, although some appear to be doing well in the short term. This absolutely does not require a special table. With the ease of movements during pregnancy, you will be able to move around more freely. Minimally invasive versus standard incision anterolateral hip replacement: a comparative study. In another day I was able to take short walks without any limping, etc.. If your surgeon did a great job, that is something to respect. Before my hip problems, I really enjoyed playing golf and would like like to play again after surgery. Our overall findings suggested that the short-term outcomes of THA through SuperPATH were superior to DAA. Also, be aware that as the nerve recovers, the smallest C fibers within the nerve recover first, which can cause a burning discomfort. 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. 3. Each is safe, effective, and capable of delivering exceptional results. Mine certainly have. The last page is asking the participant to self score their health that day out of 100. The first is that it is a major surgery, so there is a risk of complications such as infection. I understand they have good results in Thailand or India for half that. What do you consider to be the most important factors in choosing a surgeon? Registered in England and Wales. I dont know what type of procedure was used for my first op but it was sucessful and now can do a half lotus position with no problem.I do find however that the muscles at the front of that leg are not as strong as my unoperated right leg and lifting the left leg to a vertical position in yoga, when lying on my back, is quite difficult. 5 Things to Know About Anterior vs Posterior Hip Replacement What Is Superpath Hip Replacement - HipsAdvice.com I did have a total knee replaced two years ago. I weigh 185 and am 54 and realize its ideal to lose weight prior to surgery (working on it as always). My surgeon has told me I will need PT 3 times a week for 6-12 weeks is this too long? Can You Use An Inversion Table With A Hip Replacement 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. Nobody wanted to talk That's all I know. Some patients have no pain at all, which is remarkable. If these values are elevated, further investigation with hip aspiration should be considered. Can you explain this approach? Currently, the incidence of dislocation after the posterior approach has been greatly reduced due to technique and other refinements. Regardless, the overall incidence of dislocation for every approach is smaller due to use of larger femoral heads and enhanced closure techniques. Bleeding at the operative site can occur as a result of an anesthesia reaction, such as an allergic reaction. Is THR something that can help? Hip implants are medical devices intended to restore mobility and relieve pain usually associated with arthritis and other hip diseases or injuries. I would not recommend pushing your surgeon to use one specific approach or another. Thank you for sharing with others the nerve supplements that youre finding affective. Ten years ago I had total hip replacement on the left at hss. Fortunately, you have already experienced a THR and have done well. Thanks. Should I look to another approach and surgeon? Enhanced soft tissue techniques also have been developed which more securely close the tissue around the newly placed prosthesis and set the stage for healing. There is less blood loss with a single THR than a bilateral, hence less risk of needing a transfusion. Download scientific diagram | (a) Components of a total hip replacement; (b) The components merged into an implant; (c) The implant as it fits into the hip [15]. I would rather see my patients go home. Last summer I wiped out on my bike and snapped off the top of my right femur, with a diagonal break. Im 51, 59 and 148 and want to get back to tennis etc, this has been long frustrating process. 3. The surgeon makes 2 incisions one bigger than the other on the rear side and separates the muscle and tendon to get to the hip instead of cutting the muscle and tendons to get to the hip. When a patient feels better, they can return to work almost immediately, though it usually takes two weeks or longer. SuperPath brings some of the best benefits such as; earlier ambulation, no loss of strength, quicker recovery, less pain, decreased dislocation risk, and easier exposure for future revision surgery. I try not to bring up my mess but its hard when its with one 24/7. We provide the best cash prices and customer care in the industry. Its reasonable to inquire about his or her experience using the Mako robot. Your frustration is completely understandable. I, too, am struggling which approach to have. About how much does this cost? If youre impressed by how clean it appears and the movement and professionalism of the staff, that obviously is a good sign. I was so against doing this surgery but groin pain was very bad and crushed bone in the groin. The pain in my hip is strange in that I can hike uphill and down hill, bike and X-country ski but have a very hard time walking on the flat, especially after sitting for awhile or getting out of bed. Soft tissue contractures often are associated with long-standing arthritis. The SUPERPATH technique is a tissue-sparing procedure. Getting those studies will not change the reality that you will need THRs. Today, everything from tools to techniques has improved. superpath total hip replacement animation - YouTube Six weeks or longer is the exception. Im sorry to hear that you struggled after your first, anterior-approach THR. Infection. I deal with OA lower back mess so know I see most likely how all this has played into the surgery. Are my findings that posterior approach in my situation would have been more appropriate? To have your other hip replaced through a different approach is a decision you need to make with your surgeon. I am a very active and young 69 year old female who had a THR on my left side 5 years ago. The first is that it is a major surgery, so there is a risk of complications such as infection. I think it perfectly ok to discuss different approaches and ask for an opinion. Sex After a Hip Replacement: Positions, Tips, and More - Healthline Many studies suggest that any limp or clinical weakness resolves after approximately three months. Imagine your femoral head lacking full acetabular coverage, resulting in an overloading of the superior aspect of your socket, hence the cartilage and labrum becoming damaged and ultimately breaking down. My hope is that some of these symptoms will improve with time. 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. All rights reserved. While it is a surgery that does help many, many people, clearly you are struggling. Also, in the U.S., nearly all stems which are being implanted through the anterior approach are press-fit rather than cemented. But I am now in chronic low grade pain thats getting worse and dont know what I should do. I would not recommend pushing your surgeon to use one specific approach or another. Surgical Approaches To Hip Joint Dr. Apoorv Jain D'Ortho, DNB Ortho . The surgeon I expect to use does the Direct Anterior approach. 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. The parts may be attached to the bones in one of two ways. There are a number of different potential surgical approaches available for hip replacement, each with their own potential advantages and potential drawbacks. It helps the surgeon implant the acetabular component in a very precise position. I have been doing ALOT of research about the different approaches to THR and looking for the absolute best surgeon. Had a total hip replacement aug 2013. In 2010, more than 310,000 hip replacements were performed in the United States. When the capsule is fully healed, it forms strong ligaments that will eventually regrow (it will take about 4 months for the capsule to form again). Hip Resurfacing vs Hip Replacement: Know The Difference Six months ago I had a right posterior THR due to severe scfe; now my right leg is 5/8 longer than my left leg. 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. There is a possibility that blood loss may be reduced as there is less unnecessary exposed bone surface left to bleed. Tina, which procedure did you have? When we quote probability of longevity after hip replacement based on following people who had the operation, it is based on standard length stems. The impingement can lead to a levering out of the ball from the socket. My strategy is to make as small an incision as possible, but one that allows for excellent exposure and reconstruction without brutalizing the tissues. The SuperPATH technique is arguably the least invasive hip replacement technique. What are the experiences of other countries with THR? I suggest you discuss your concerns with your surgeon. Full Function, Faster . Hips that are out of joint have an anterior hip replacement. Between your legs, you should sleep with a pillow for the next six weeks. Seeing that a THR is considered major surgery, my question is, should I have my left hip done sooner than later to address the length difference or wait until I can no longer tolerate the pain? A lot of hospitals and ambulatory surgical centers offer what's called outpatient surgery. 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. Conclusions SuperPATH approach showed better results in decreasing incision length and early pain intensity as well as improvement of short-term functional outcome. The other things that can affect the op is your fitness beforehand, your attitude and your age, although you may have difficulty getting younger!! 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. It is also important to avoid any sudden movements or twisting motions. As a result of the interventions, the surgeon has a better view of the hip joint. Advantages and Disadvantages of Anterior Hip Replacement One of the potential disadvantages is that because the surgery is performed through the front of the hip, there is a risk of damaging the hip joint and the surrounding muscles and tendons. The surgeon accesses the hip joint from the front of the hip, rather than from the back or side. How long will my hip replacement last in your opinion? Before proceeding, it is a good idea to review the recommendations and specific parts that your surgeon may recommend. Dr. Daniel Le | Houston Methodist Do you have any thoughts on this issue? Many believe that this results in less risk of infection. Notes on SuperPath experiences good or bad, https://patient.info/forums/discuss/superpath-experiences-good-or-bad-718788. I still have some questions I hope you can answer as this is so distressful for me. The majority of teaching institutions in the United States continue to instruct as well as perform the traditional posterior as their primary approach. Many in business or who own their own businesses will stay home for only one week and then return to their work place because they are bored and would rather be productive and busy. I would focus on the individual doctor, not the approach that the individual choses to use, to deliver the best result. I really appreciate this website. Similarly, an engaged medical team needs to be available to help with care after surgery. My surgeon does the SuperPath method. SuperPath approach uses about a 3-inch incision at the side of . more nutritious, too. Overall, it sounds as if youve had an excellent result and wonderful recovery following your hip replacement. Some hospitals and surgery centers are promoting one method of hip replacement over another. He also used the term anterolateral. In general, people who are older, heavier, or more active may not be good candidates for this type of surgery. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in 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. Hip Replacement Surgery: How it Works, Recovery Time | HSS 2021 May 20;16(1):324 . Dear Doctor Leone, What are your thoughts with regard to Stem cell therapy in lieu of THR? Surgeons do not cut across muscles. I am 63 years old, 54, 115 pounds. Most THR patients do not need significant supervised physical therapy after surgery; they simply do well when their surgery is done well. 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. disadvantages of superpath hip replacement Disadvantages of the anterior approach include: Although I am trained in both approaches and have trained surgeons in both approaches, I have stopped using the anterior approach because I saw my patients get well faster, bleed less, and have a more predictable result when I performed the surgery using a mini-posterior approach. 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. This suggests that something changed after five months. I have been less active this past year and am concerned that losing weight prior to surgery might be an issue, Am also wondering about my auto immune issues and the implant. I do not do hip arthroscopy. I would like to share my experience with both procedures. 5. It seems that whatever their particular approach is that is what they sell. Thanks for any feedback. I had the mini posterior approach done and it gets better everyday. Dr. William Leone. The first step to rule out infection is to have two simple blood studies done, an ESR and CRP. Three Cons of Hip Replacement Although total hip replacement is deemed a very safe procedure, there are associated risks that patients need to be made aware of before surgery. Over the last six years, I have performed more than 2000 primary or first-time total hip replacements using the mini-posterior approach and I am aware of only one patient who dislocated his hip because he fell down stairs. That's all I know. The idea is it should be a little less painful if the muscle, tendons and nerves are not disturbed. The hip is replaced without the need for surgery to dislocate the joint. Additionally, there is a small risk of dislocation after surgery, which can be painful and may require additional surgery to correct. 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). Some other methods are effective, but they are less effective for patients who leave the hospital earlier. I wish you a full and speedy recovery. 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 would rather my patient get half as much anesthesia. We use cookies to let us know when you visit our websites, how you interact with us, to enrich your user experience, and to customize your relationship with our website. Do you also do arthroscope surgery? Cant afford a dislocation or other complications cause Im sole caregiver for severely handicapped son. It's a hip replacement surgery where you lie on your side. Additionally, people with certain health conditions such as diabetes or heart disease may also not be good candidates. Risks associated with hip replacement surgery can include: Blood clots. Le has extensive experience in primary joint replacements, complex revision surgery, periprosthetic fractures, and infection management. Dr. Robert Sigmund is a board-certified orthopedic surgeon and a sports medicine physician based in St. Louis, Missouri. I am so sorry to learn that you are struggling. Once again, it sounds as if you had a wonderful surgeon, which is the most important variable. I had my hip scoped which bought me 8 years, but need a THR now. Check to enable permanent hiding of message bar and refuse all cookies if you do not opt in. Ive done PT and plan to continue working on strengthening my core and flexibility of those large muscles. 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. Others continue to follow traditional guidelines.
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