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Thank you. Does my prothesis not last as long since I am now doing a 3rd surgery? I have the hospital but am deciding on the surgeon and which approach is best. 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. 4 mts later am using There arent any activities that you can do with a resurfaced hip that you cant do with a total hip. I would encourage you to discuss with your surgeon the difficulties and pain you experienced after the first surgery, and together explore if another plan can be created for a better outcome the second time around. I think there may be increased associated complications. After reading your article I am concerned about the issues you discussed. Choose your surgeon. 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. My worry is that I will end up with one leg shorter than the other. Some other methods are effective, but they are less effective for patients who leave the hospital earlier. This effectively moves the hip joint center, toward the bladder or midline, and improves hip mechanics. 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. Patients understand the risks that metal joints and sockets bring to their long-term health and are moving away from the material. A modern artificial hip joint is designed to last for at least 15 years. Superpath total hip replacement animation. In addition, patients prefer the anterior approach due to the absence of pressure on the Femoral nerve in the anterior approach. I understand they have good results in Thailand or India for half that. 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. If not, what will my restrictions be? Felt very uninformed and left The intended interval between the front thigh muscles can be difficult to recognize and there has been an associated increase in injury to the femoral nerve or vessels. The idea is it should be a little less painful if the muscle, tendons and nerves are not disturbed. What are the experiences of other countries with THR? You helped me tremendously in my research of the track record of my HMO, now I have one more quick question to run by you. That being said, I agree completely with your surgeons advice to have a total hip replacement and not a hip resurfacing. No special surgical equipment is required when performing a mini posterior. The doctor is planning a traditional posterior. I had a consult with a surgeon who does posterior and cuts muscle & tendons. I have been doing ALOT of research about the different approaches to THR and looking for the absolute best surgeon. I also think its reasonable to look forward to returning to all of the listed activities that you enjoy. Doc says once recovered I should avoid flexion with adduction and internal rotation. I also think infection must be investigated and ruled out. 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. I love that you take time off to reply to these messages it is commendable. According to Dr. Gililand, patients should not try to change their surgeons opinion based on their preferences. 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. July played my last match when I buckled. J Bone Joint Surg Am. I am so sorry to learn that you are struggling. 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. A orthopedic surgeon may insert a numbing agent directly into a new joint, which can last up to 48 hours. Technologies, The Leone Center Problems such as osteoarthritis, rheumatoid arthritis and avascular necrosis can destroy the protective cartilage around the hip joint, disrupting the smooth contact between the femoral head (ball) and hip socket. Sometimes during surgery it is necessary to release particularly tight structures to expose the joint for reconstruction or to better balance surrounding soft tissues after reconstruction. What is most important is choosing your surgeon. 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. Sometimes, when a surgeon is working too hard to reconstruct through a very small incision, the ends of the incision tear and the tissues are traumatized. Femor fracture. Comparison of short-term outcomes between direct anterior approach (DAA) and SuperPATH in total hip replacement: a systematic review and network meta-analysis of randomized controlled trials. Most importantly, I would meet with your surgeon and discuss all of these concerns. We are an online blog dedicated to providing comprehensive and accurate information about orthopedics and injury prevention. Nerve regeneration can occur up to 18 months following injury, but the chance of full recovery decreases with delay in recovery time. My physical life is diminished. The anterior approach has a lower incidence of sciatic nerve injury and a higher incidence of femoral nerve injury. Finally, hip replacement surgery is expensive and may not be covered by insurance. I think it is important to define and isolate why youre doing so poorly. 1000 NE 56th Street, I have seen 2 doctors one doing posterior, the other anterior. Yes, you can do very well. Maybe someday our nations health care system will measure up to that of France, Norway, Switzerland and others, in which their governments are investing half of the GDP that we are wasting. Finding the right surgeon is critical, because your care is about so much more than just fixing your hip. The anterior hip can be easily and naturally recovered by walking, simple home exercises, and isometric exercises. I have never operated on another surgeon who asked me to make as small an incision as possible or use the minimally invasive approach. In 2010, more than 310,000 hip replacements were performed in the United States. If they did develop five months post-op, then you have to consider that it could be a manifestation of back pathology compromising a nerve root. I think it perfectly ok to discuss different approaches and ask for an opinion. What, if anything, can be done to revive femoral nerve and get my thigh muscles back in normal? My hope is that some of these symptoms will improve with time. Is the hospital where the surgery will be performed also top rated?. Note that blocking some types of cookies may impact your experience on our websites and the services we are able to offer. 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 take care of many individuals who have a total knee and hip replacements on the same side. SuperPath hip approach. Remain upright . The hip replacement needs to correct the abnormal hip mechanics that lead to the arthritis. The surgical area of anterior hip replacement is located in the vicinity of the lateral cutaneous femoral nerve. There tends to be a lesser incidence of posterior instability with the anterior approach. I had to cut some strength exercises out leg lifts, hip sled. I have seen a number of patients who were reconstructed with the anterior approach who developed painful anterior scarring after the procedure. Most of the restrictions are removed at that time, although I still advise common sense, particularly for the first three or four months. I really appreciate this website. . Good question. 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? Dr. Tom Miller gives you the five best options for hip replacement surgery. It sounds like he did fabulous job. Even though I was positive I wanted this method done, I was still questioning my decision. Fortunately, many folks who experience back symptoms before THR report improvement or resolution after. We thank you for your readership. This treatment is commonly recommended for patients suffering from osteoarthritis of the hip. That means you have an excellent track record. Thank you, Lisa. OTC nerve supplements suggested by a naturopath. I saw a surgeon who does the posterior approach only and will see another on 4/14/15 who does both approaches. We provide you with a list of stored cookies on your computer in our domain so you can check what we stored. Appalachian orthopedic surgeons perform revision surgery as well as mini-posterior and anterior approaches. I wish you a full and speedy recovery. I had an anterior right hip replacement in late 2010, I was 72. It typically requires a 4 to 5 day hospital stay, 3 to 6 month recovery period . What are your thoughts with regard to Stem cell therapy in lieu of THR? I then stage the second surgery as early as 2 or 3 weeks post-operatively. It is critical that the patient is aware of the risks, benefits, and alternatives of the procedure. Just getting your thoughts I will discuss it more with my surgeon at the pre-op meeting. Anterior vs. Posterior, Posterior vs Mini-posterior. There is some concern that this weakens the abductor and leads to a limp. This procedure differs from traditional hip replacements in the following ways: There is no surgical dislocation of the hip. Hip pain, soreness, and stiffness can quickly become unbearable and sideline us from the things we enjoy the most. Blog I went in with high expectations of coming out so much better off and here I am 5 yrs out limping more than ever and a NUMB thigh and worse knee and weak ankle. Having physio Still going to rehab to reduce stiffness and increase strength but I am in better shape now than before surgery. I think it was sensible being careful on the other hand and I was told not to cross my legs. Im so against any other replacements as I have other issues, but working with alternative treatments, out of pocket money, as my hip replacement has been a horrible drama/saga. If your surgeon has recommended surgery, I assume youre no longer getting adequate relief of pain or able to remain active with conservative measures. I typically do hip replacement on the get anterior approach in 90% of my patients. It will help desensitize and help get your muscles working in synchrony. THR if a MRI or Pet Scan isnt done? Historically, higher dislocation rates were reported with the posterior approach, but it still was used for its many other advantages. Many wonderful physicians are part of various HMO panels. It is 100 percent normal and expected to be scared before surgery. Lastly, if one has had P or AL is there anything that can be done to offset the need for restricitons? An anterior approach hip replacement is one of the most minimally invasive surgical options for replacing a hip. Consult your doctor to determine if joint replacement surgery is right for you. Thru X-rays Ive been told both hips are bone on bone! Hip dysplasia is a very common underlying cause of hip osteoarthritis. The posterior approach is used frequently again, in large part due to the fact that it is an extensile approach. With SuperPath, there is no surgical dislocation of the hip. and Privacy Policy and steps will be taken to remove posts identified We fully respect if you want to refuse cookies but to avoid asking you again and again kindly allow us to store a cookie for that. Does it really not matter which approach I have, posterior or anterior? The size and placement of the incisions will be different. 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. Pain Management Are expected to be out of bed (hips and knees patients) the afternoon of their surgery and at least taking a few steps if not walking. You can also change some of your preferences. There are hybrids of the surgey from what I can see. Sometimes, it simply isnt possible to accomplish. Typically, the new cup will be medialized to gain coverage and correct the abnormality that lead to your arthritis. Consuming excessive-fibre and wholegrain meals will assist to keep you feeling full, and will be Yes, Im angry. Hip replacement is the second most common type of joint replacement, trailing only total knee replacement. Our insurance covers both. Help. Patient Concerns If you would like a personal consultation, please contact our office at 954-489-4584 or by email at [email protected]. I am a 70 yr old female with a 4grade thickness loss at acetabulum and head of femur. In bed for long periods with little or no movement. as being in breach of those terms. There is less risk of neurological injury. Each question is scored from 1-5, with 1 being no problems and 5 being severe problems. Adult patients who have a deteriorated hip may be candidates for total hip replacement. What reasons would there be to use the regular over the mini? I wish you a full and uneventful recovery. Conserves the two main muscles that make up the front of the hip and upper thigh aspirated via the direct anterior approach. At the end of the day, I promise, it is not the approach but rather the person who is doing the surgery. Are my findings that posterior approach in my situation would have been more appropriate? Rush joint replacement surgeons are leaders in hip replacement surgery and research. Going in for THR in July. 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. This does not necessarily mean they will have more pain or take longer to get well. Further, the extent of dissection is more minimally invasive, which also improves stability. 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 just saw a patient with a femoral neuropraxia after a anterior approach THR. Any feedback will be appreciated. I had the surgery on June 22 and I am about 5 weeks post op. In the United States, a traditional posterior approach is the most commonly used. I would recommend having an honest discussion with the surgeons you are considering. Im hoping to play tennis, go dancing and horseback riding once Ive healed. I do participate in competitions and showcase presentations. In the case of a worn or damaged ball and socket, artificial parts can be used to restore joint function. The experiences will vary greatly . The most common type of total hip replacement is done in the anterior anterior part of the hip. All of these releases may be necessary as part of the surgery and patients do well. The majority of teaching institutions in the United States continue to instruct as well as perform the traditional posterior as their primary approach. I have done everything I can think of to preserve my right hip, but sadly this too needs replacing.
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