Should I go for this or should I opt for the mini posterior. What Ive seen in my practice is that the more total hips I do, the less restrictions I place on my patients and the more active my patients are. That's all I know. This risk is greatest in older females with bone of sub-optimal quality. I would recommend having an honest discussion with the surgeons you are considering. There is a possibility that blood loss may be reduced as there is less unnecessary exposed bone surface left to bleed. Following anterior hip replacement surgery, avoid soaking in hot tub, sauna, or swimming pool immediately after surgery.
Because these cookies are strictly necessary to deliver the website, refusing them will have impact how our site functions. 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. Having diabetes and two organ transplants does significantly increase your risk for post-op infection as well as other complications. I am going to get evals from 3 docs. Try our Symptom Checker Got any other symptoms? If possible, speak with other health professionals who work at the hospital or at least in the same geographical area. The hip joint can be supported by the socket, which is designed to fit over the ball and provide stability. Iliotibial (IT band) damage, had 2 months of ART release work on this issue. When the joint is held together by gravity and asymmetric anterior muscle tension, the tension between the ball and socket may change in various directions. Mini posterior refers to the approach or tissue interval the surgeon uses to implant the Total Hip. Patient Resources My mom is obese, short and has osteoporosis.
Robert H. Sigmund, MD | Signature Orthopedics However, I now have quite severe OA in my right hip apparently I have no cartilage left and have been told by a surgeon that I am just lucky not to be in constant pain. The following cookies are also needed - You can choose if you want to allow them: You can read about our cookies and privacy settings in detail on our Privacy Policy Page. How long will my hip replacement last? I feel that at 10 weeks with profuse denervation potentials on the quad muscles, the prognosis is not good, even at 6 months. I had a consult with a surgeon who does posterior and cuts muscle & tendons. I have seen a number of patients who were reconstructed with the anterior approach who developed painful anterior scarring after the procedure. 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. What reasons would there be to use the regular over the mini? We provide the best cash prices and customer care in the industry. Some patients who have recently had anterior hip replacement may suffer from complications such as wound healing. Changes will take effect once you reload the page. In the dark to find out about this myself. I can still do 30-45 mile rides, but I need to take something before each ride, because of the undone left hip. In my experience, most patients who undergo a total hip replacement dont limp after their surgery and most feel their legs are the same length.
Hip Replacement Surgery Technique Pros & Cons | Portsmouth Every surgery should be done with as minimally invasive approach as possible taking into account these other critical factors. In Dr. Lawrence Dorrs opinion, doctors and hospitals should not market a specific type of surgery as the most effective. After reading your articles, I have decided not to have anterior. A hip replacement involves removing the ball (femoral head) and replacing it with a metal or ceramic prosthetic ball. I have cared for many patients over the years with significant heart and peripheral vascular disease. I have been doing ALOT of research about the different approaches to THR and looking for the absolute best surgeon. SuperPath hip approach. I thought the newer procedure on the special table was the best way to go. One thing I do not want is any muscles or tendons cut in the procedure. Patients can also have as little as a 3-inch incision. 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. Further, rehab after hip arthroscopy often requires partial weight bearing on the operative side and that would be difficult with newly operated THR on contralateral side. 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. I very rarely transfuse any patients now. What is your experience and take on this ? No feeling in my leg and no movement What do you consider to be the most important factors in choosing a surgeon? My advice is to consult with your surgeon regarding how stable the replaced hip is and the most appropriate rehab to follow post-operatively. 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. Many, many interactions and decisions go into the final result as well as someones perception of his or her result and experience. If I think you may be a candidate, I will refer you to a doctor in our area that does. Thank you. As long as you do the necessary surgeries, you will eventually break your femur, but only if you do enough. Above the ankle to the thigh.Had to use leg brace to Fortunately, if the components are stable (bone-in grown or cemented) and optimally positioned, and the surrounding tissues has fully healed and matured, then that risk is very small. Your out-of-pocket costs for your hipreplacement will be impacted by a number of . Dont let PR marketing confuse the big picture. A hip replacement can be delayed until it is absolutely necessary if the replacement parts can fail over time. Thanks. After reading a few articles on anterior vs posterior including yours, I know now that his decision to use the posterior approach is the best one for me! Should one of these events occur during a mini-posterior procedure, they are easier to recognize and correct. But I am now in chronic low grade pain thats getting worse and dont know what I should do. Dear Jo Anna, Note that blocking some types of cookies may impact your experience on our websites and the services we are able to offer. Anterior vs. Posterior, Posterior vs Mini-posterior. Posted
Do you have any advice or ballroom dancer THR stories to share? July 2013 my left hip was scoped for a labral repair. During anterior approaches, fracture repair is much more difficult and necessitates the use of a separate incision. From what Ive seen, most THR patients dont need very much PT, although I do encourage exercising in a pool. 3. I wish you only the best. I have a tilted sacrum, sway back and a very large posterior. When the anterior approach is used, the soft tissues in the hip stay intact, allowing for better hip alignment. We now have too many other proven bearing surfaces available. Finally, hip replacement surgery is expensive and may not be covered by insurance. I would rather this not happen with my right leg when I have the THR in Jan 2017. I was so against doing this surgery but groin pain was very bad and crushed bone in the groin. This improved quality of life will be beneficial. 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. The SUPERPATH technique is a tissue-sparing procedure. The hip is replaced without the need for surgery to dislocate the joint. My surgeon has told me I will need PT 3 times a week for 6-12 weeks is this too long? 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. The idea is it should be a little less painful if the muscle, tendons and nerves are not disturbed. Back to work/driving in 10 days. 3 years ago,
Optimal component positioning also is critically important for the best stability and longevity. It exploits the inter-muscular interval between the tensor fascia lata and the gluteus medius. Click to enable/disable essential site cookies.
Advantages and Disadvantages of Anterior Hip Replacement There are hybrids of the surgey from what I can see. Its Inosine and Sphingolin. Choose your surgeon. My advice is to have a frank discussion with your surgeon and share these concerns. Regarding restrictions after your hip replacement, this too is an area that has changed drastically over my 25 year career. Are my findings that posterior approach in my situation would have been more appropriate? The size of the incision is determined by how large and tight the hip/thigh is and how much tissue (fat and muscle) exists between the bones of the hip and the overlying skin. During the procedure, the patient must have a small incision made in the side of his hip. Lastly, where can I find a great surgeon that takes FL Workmans Comp? It is nice to see honest Q&A versus a marketing page. Every . Behavior. I have read your articles about procedures (anterior vs posterior). I think the recovery time is the same though. Conserves the two main muscles that make up the front of the hip and upper thigh aspirated via the direct anterior approach. I believe a THR will benefit you tremendously. I understand that most surgeons now do a spinal rather than general anesthesia. Because my husband has circulation problems in his leg and vein removed for open heart surgery last yearhis surgeon recommended the Mini posterior surgery. 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. 1.2. Most patients after a bilateral procedure would not go home but rather a rehab unit. Please comment. I was thinking of a Hip Resurfacing for my left hip and was convinced by my other top hip surgeons to stay away from it. Just need reassuranceI am stressing he is fine. Sitting seems to irritate it the most. You should consult with your doctor before deciding to have an anterior total hip replacement. After reading your blog Im thankful he suggested this approach. I still have some questions I hope you can answer as this is so distressful for me. Both have valid cons against the others methods and pros on their method. Also, since I am only 51, I am concerned about component longevity. Really Great. If, on the other hand, the leg length difference is creating hardship and possibly discomfort in other joints such as the lower back, knee or ankle, I would consider proceeding with contralateral THR sooner rather than later. What determines the differences? 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. Many patients approach this by researching online and speaking to other patients who have been cared for at a particular facility. Infection: You are given IV antibiotics before and after surgery. In May of 2015, I had a Labial tear repaired. As of 2020 only Dr. Leone is using the latest hip technique called the SPAIREtechnique where patients no longer have hip precautions after surgery. Individual results and activity levels after surgery vary and depend on many factors including age, weight and prior activity level. Dr. I recently had a spontaneous hip fx and was diagnosed with hip displasia.
What Is Superpath Hip Replacement - HipsAdvice.com Surgical approach is important but its just one of many important variables. I did have a total knee replaced two years ago. I am female and I weigh 115 pounds.
Hip replacement - Mayo Clinic It seems reasonable and I trust my surgeon but would like to know what I'm in for post op and beyond. I am now 59, still in good condition but that is being compromised by lack of working out as my hips get sore from most everything I try. 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. Very slow recovery. DAA and SuperPATH were equal in functional outcome and acetabular cup positioning. I'm scheduled for THR on the 22nd. My right leg is already a bit longer than the left. There are 5 questions, mobility, self-care, usual activities, pain and anxiety. I came home with crutches, abandoned them at the front door and have not used them since. In another day I was able to take short walks without any limping, etc.. I wish you a full and speedy recovery. Dear Dr. Leone,
Hip replacement - NHS I didnt spend time on boards talking for eons about peoples outcomes.probably a good thing I didnt. I'm hoping to read some posts post surgery. Should I be though? If youve had a failed hip arthroscopy, almost certainly you also have acetabular pathology and a total hip rather than a partial hip replacement may give you a more consistent, longer-lasting and more perfect result. Surgeons do not cut across muscles. Sometimes the pain goes away as I walk and sometimes it doesnt. They may be: Cemented to the bone. Dr. Leone, I am coming in to see you for an appointment for a THR to my left hip. Have you heard of something like this, and if so, is it worth it? Because the femur is more difficult to expose during the anterior approach vs. the posterior approach, many surgeons will select a shorter femoral component to facilitate reconstruction and lessen chance of fracture. Also, after an accident, I had 12 screw and an L shaped plate in my heel. They may have a certain cut-off criteria (for example, a BMI of less than 35). Technologies, The Leone Center
Rather, they say Bill, please just do what you have to do and do a great job. The vascular supply of your leg must be assessed preoperatively as part of you work-up, but most do very well. Personally, it I were caring for you, I would have advised you exactly as the orthopedic surgeon who took care of you did. I have never operated on another surgeon who asked me to make as small an incision as possible or use the minimally invasive approach. I began using the superior approach for total hip replacement in February of 2014. . United States. 10 users are following. A hip replacement is a common type of surgery where a damaged hip joint is replaced with an artificial one (known as an implant). Any info would be appreciated. Further, the extent of dissection is more minimally invasive, which also improves stability. 2023 Brandon Orthopedics | All Right Reserved, hip replacement pain reduction surgery patients, The Best Sneakers For Hip Replacement Patients, Anterior Hip Replacement Surgery: The Pros And Cons, The Truth About Spinal Stenosis: Causes Symptoms And Treatments, Can Years Of Surfing Contribute To Spinal Stenosis, The Effects Of Spinal Stenosis And Carpal Tunnel, Should I Apply Ice Or Heat To A Compression Fracture, How Does A Soft Bed Prevent Healing Of Herniated Disc, Herniated Discs: How To Sleep Without Worrying About Rupturing Your Discs, If You Have A Herniated Disc You Know The Excruciating Pain It Can Cause. Mayo Clinic researchers have studied ways to reduce blood loss, control pain and speed recovery for people who undergo hip replacement surgery. We can help you make the best decision for your knee replacement, and our friendly staff is available to answer any questions you may have. We are now in a situation where we have found two extremely good surgeons and we gel with both extremely well. Can you please on the various points in the post and perhaps also elaborate on the last point. My legs are very muscular and trim. Also I have read that there is a sharp learning curve that must take place in order to do the direct anterior approach. 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. I assume its something near my groin. I believe going home is very therapeutic and often safer. This technique avoids cutting muscles and tendons, minimizing surgical trauma and improving the post-operative experience. We can do this because of improved plastics. 1. Of note, I am a RN with 30 years of experience and took this decision very seriously. As a result, patients can return to their normal activities much sooner than if they had had traditional hip replacement surgery. 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 was not aware that any of the local surgeons who is doing anterior approach. No groin pain NOW.but all the other mess of it all.
Is Less-Invasive Hip Replacement Best for You? - WebMD An anterior-approach hip replacement necessitates a small incision in the groin area on the front side of the leg. Also there are concerns about disruption of blood supply to femoral head with this operation. 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. I am already limping when walking and was hoping that the limp would disappear after the hip surgery. I also would encourage pool walking or swimming. You should not proceed unless you know in your heart that you will be taken care of in a manner that has the best chance of giving you as perfect a result as possible. Your symptoms still sound mechanical, positional and episodic. I am thoroughly confused at this point. 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? Can you suggest any pain medication that would not interfere with anti rejection drugs? I think speaking to a patient with whom you can relate and who has been treated by the physician youre considering also is invaluable. Im so pleased to learn that you had a good experience. Once the surrounding tissues fully heal, they then act as a mechanical block to the ball to keep it from being able to jump out.. Until now. Dr Leone, you make the point several times that the surgeon, not the procedure is most important. respect of any healthcare matters. I have many patients who are accomplished and passionate ballroom dancers. This technique is also referred to as the . While it is a surgery that does help many, many people, clearly you are struggling. Ten years ago I had total hip replacement on the left at hss. Long recovery but all is well. I would encourage you to discuss your concerns with you surgeon. The mini posterior approach essentially is the same as the traditional posterior, however a smaller incision is made and less soft tissue is exposed. What is the best hip replacement option: anterior or Posterior? Therapy is often appropriate for stretching, strengthening and electrical stimulation which helps maintain the motor end plates, structures on the muscles that the nerve branches must re-innervate. I would stay away from narcotics. 4 mts later am using 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. With the ease of movements during pregnancy, you will be able to move around more freely. You can do anything you want after a hip replacement. Initially I was hesitant of THR thinking I was way too young for something so drastic but Ive now been miserable enough long enough that I am welcoming the idea of surgery. The surgeon will be building a construct that hopefully will last her life time and change her life profoundly. Hospitsl staff This absolutely does not require a special table. Also, is it immoral for an 80 year old to have THR and cost the nations health care system $25 $35k? If the tissues are traumatized and / or the final components are not optimally positioned, then it certainly is not an advantage. I definitely would not recommend a hip scope and THR during one anesthetic setting. Original Medicare (Part A and Part B) will typically cover hip replacement surgery if it's medically necessary. Kenneth, You saw me in your office yesterday (I am 48 years old) as I had complications following a THR of right hip anterior approach with revision 4 days later for a slipped acetabular and then last week I had a dislocated hip. It would be interesting to hear what you have to say Doug. I am a 49-year-old female. I think its reasonable to request a tour of the facility where youre considering having the procedure. Im 51, 59 and 148 and want to get back to tennis etc, this has been long frustrating process. 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. I read hip dislocation is 28% higher after a revision, is it more then 28% after 2 revisions??? The hip replacement needs to correct the abnormal hip mechanics that lead to the arthritis. The second most-common injury is to the femoral nerve. Because visualizing the femur is easier, an experienced surgeon can choose the most appropriate femoral implant rather than just the one that is easiest to implant, taking into account the patients bone quality, activity level and age. A long surgery time, on the other hand, was also associated with DAA. Ceramic-on-polyethylene is currently the most popular hip replacement material, representing 50.6% of all hip replacement cases back in 2014. If so, is it possible to have both hips done at the same time? Dr. William Leone. Pain is almost gone and I am beginning to get back to my life. Many wonderful physicians are part of various HMO panels. The impingement can lead to a levering out of the ball from the socket. I am totally confused and dont know which procedure to choose. posterior surgery . I am a 55 year old with a labral tear and moderate arthritis. Very sorry to hear of the difficulties you experienced! I try not to bring up my mess but its hard when its with one 24/7. Because the muscle fibers are separated, not cut, the nerve path is not disturbed and the muscle is not injured. Doc says once recovered I should avoid flexion with adduction and internal rotation. Did you have the surgery via Superpath method? (PATH) and Supercapsular percutaneously assisted total hip (SuperPATH) arthroplasty: learning curves and early outcomes. I also have undiagnosed neuropathy in both legs from the knees down. and Privacy Policy and steps will be taken to remove posts identified
I had my hip scoped which bought me 8 years, but need a THR now. Thanks so much for your help, very grateful. The surgeon I expect to use does the Direct Anterior approach. Overall, it sounds as if youve had an excellent result and wonderful recovery following your hip replacement. Complications from infection account for approximately 10% of all cases. Over the years, these precautions and the length of time to adhere to these limits have been challenged both by clinicians and patients. 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. I was released to go back to work after only 10 days. In general, if someone is dedicated to the job, the return is very quick. Personally, I would not gamble with my health. Choosing a surgeon based on his or her experience and complication rate also is exactly right., My strong advice is to choose your surgeon, not the approach. SuperPath approach uses about a 3-inch incision at the side of . I am a very active and young 69 year old female who had a THR on my left side 5 years ago. There are a few disadvantages to hip replacement surgery. This site uses cookies. I assume PTHR is referring to partial hip replacement. We are always refining and trying to make it better. I also regularly receive Rolfing treatments which has helped me manage pain and maintain what mobility I have. Le has extensive experience in primary joint replacements, complex revision surgery, periprosthetic fractures, and infection management. Thanks again for this great blog! Obese or extremely muscular people may not be the best candidates for this surgical procedure. Will I still be able to do the things I like to do? Do I have a risk of fractures during a posterior right hip revision due to my prior complications already? I really dont know where to go from here.