My doctor does not do mini posterior, therefor I have a 6 incision. I understand that most surgeons now do a spinal rather than general anesthesia. But after reading your articles, I am hesitant about that choice now. Also, since I am only 51, I am concerned about component longevity. Also on MRI there was a cyst (good size). It is possible that you will be required to avoid certain high-impact activities to protect your new hip. Ten years ago I had total hip replacement on the left at hss. Did you have the surgery via Superpath method? Thanks! 2021 May 20;16(1):324 . Between your legs, you should sleep with a pillow for the next six weeks. The anterior hip can be easily and naturally recovered by walking, simple home exercises, and isometric exercises. Introduction. I had the surgery on June 22 and I am about 5 weeks post op. 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. In my experience, after four to six months most patients simply return to normal activity. Can you compare/contrast to the other approaches; posterior, mini posterior, anterior? The incision made for the operation can be as small as three inches. for Orthopedic Care Note that blocking some types of cookies may impact your experience on our websites and the services we are able to offer. Not wanting to go through all the restrictions, I was considering anterior for my right hip, which would require not having it done locally since doctors here have been doing it for only 1 year. Because the patient is lying on his back, it facilitates using a fluoroscope or moving x-ray throughout the procedure. Thru X-rays Ive been told both hips are bone on bone! Nobody wants a long recovery. I know the most important decision you will make is choosing the doctor who will perform your surgery. I have read your articles about procedures (anterior vs posterior). Should I go for this or should I opt for the mini posterior. I wish you only the best, Like you said, consistent outcome is important and this surgeon is excellent and I have great faith in him (Im a physical therapist and see his patients post-op so get to see the, at least short term, results myself). 3. 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. Walker to get around. Clots can form in the leg veins after surgery. Further, the extent of dissection is more minimally invasive, which also improves stability. I do not have dials and no one seems to know where the neuropathy stems from. Back to work/driving in 10 days. Each question is scored from 1-5, with 1 being no problems and 5 being severe problems. Clearly, yours was. The source of your hip pain must be diagnosed. My worry is that I will end up with one leg shorter than the other. Im pleased that you will be coming in for an appointment. I still maintain that by far the most important decision patients must make is choosing the surgeon who will do their surgery and take care of them, then trusting that individual to choose the approach, prosthesis and make a million other decisions that deliver as perfect a result as possible. I would encourage you to discuss your expected recuperation time and specific restrictions with your surgeon. My question is: should I just tolerate the pain and limp, or take a chance with the hip replacement. Its reasonable to inquire about his or her experience using the Mako robot. Thank you, Lisa. I can still do 30-45 mile rides, but I need to take something before each ride, because of the undone left hip. I came home with crutches, abandoned them at the front door and have not used them since. 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. This effectively moves the hip joint center, toward the bladder or midline, and improves hip mechanics. 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. The most important thing is to get a top notch surgeon and go with whatever approach they offer. I sit on a cushion in the car to lift me up. 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! I have many patients who are accomplished and passionate ballroom dancers. Hip replacements might keep you out of action for a considerable period. An anterior hip replacement is, in many ways, less risky than any other type of hip replacement. Thank you for sharing. Please comment. Before proceeding, it is a good idea to review the recommendations and specific parts that your surgeon may recommend. Read our editorial policy. It all comes down to the surgeons comfort as well as the patients. It is nice to see honest Q&A versus a marketing page. If this occurs, the patient usually requires a total hip replacement. I live in the UK so again Im afraid I wont be able to consult you personally! I prefer spinal anesthesia when possible because fewer drugs are used and often the experience is gentler. 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. With that said, I would have probably just done the posterior with you if we lived in the US based exclusively on the time you take to respond! There are hybrids of the surgey from what I can see. Ive since met 3 others who ended up with the mess that Im dealing with also. I spoke in person to probably 4-5 of his success patients and went with hearing from them. If possible, try to get in writing any verbal promises made. What is most important is that you find a surgeon who understands the particular complexities with your problem and whom you trust. In severe cases, I will use my patients own femoral head, which is removed as a bone graft to help stabilize the new cup and garden new bone for the future. A major muscle is not cut during anterior hip replacement surgery, so pain is reduced and major muscles are not cut after the operation. It can lead to numbness in the thigh and, in rare cases, skin irritation due to the nerves presence. My recommendation is for you to discuss this with your surgeon if you have further concerns. I think tennis, dancing and horseback riding are fine. 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 expect to use does the Direct Anterior approach. It is also important to avoid any sudden movements or twisting motions. All: The new prosthetic socket must be medialized (placed further toward the midline) and sometimes through the medial wall of the native socket. Woke up with Additionally, people with certain health conditions such as diabetes or heart disease may also not be good candidates. My surgeon does the SuperPath method. Hard-on-hard bearings, such as ceramic-on-ceramic as well as metalon-metal articulations, also resulted in larger femoral heads being implanted. 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]. You can also change some of your preferences. Similarly, an engaged medical team needs to be available to help with care after surgery. Does my prothesis not last as long since I am now doing a 3rd surgery? Patient is a UK registered trade mark. I also recommend that you look at the track record and reputation of the hospital where the surgery will be performed, especially considering the underlying cardiac and vascular issues. OTC nerve supplements suggested by a naturopath. Complications The anterior approach, as a marketing tool, has grown in popularity among surgeons. Dont let PR marketing confuse the big picture. There are risks and recovery times associated with surgery. With SuperPath, there is no surgical dislocation of the hip. It is important that you find a doctor who is experienced in caring for people with complex issues. Will I still be able to do the things I like to do? I would not recommend pushing your surgeon to use one specific approach or another. I am scheduled to have total hip replacement surgery in 2 weeks. Its been my experience that patients who go into surgery well informed have a better experience and seem to rehabilitate more quickly. Posterior, mini posterior or anterior? It exploits the inter-muscular interval between the tensor fascia lata and the gluteus medius. 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. I am not sure that is true any more. 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. That means you have an excellent track record. I cant find anything that addresses replacing a hip that is dysplastic. If possible and a pool available, I encourage my patients to walk and exercise in a pool and / or swim, starting at two weeks when their suture is removed. A long surgery time, on the other hand, was also associated with DAA. As of 2020 only Dr. Leone is using the latest hip technique called the. I have seen 2 doctors one doing posterior, the other anterior. Procedures I wish you luck on your journey. 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. However, there are also some potential drawbacks to this type of surgery including a longer surgery time, a greater risk of blood loss, and a higher risk of nerve injury. I would say that in terms of posterior total hip replacement, the procedure is better than the old gold standard, which I believe was performed after 7 years and almost 1000 anterior total hips. I am deciding that my quality of life is in the toilet and need to get the THR done. The socket of the pelvis is machined into a hemisphere and a metal hemisphere is inserted into the socket. Many others feel the same. Other conditions, to which you alluded, such as having a back condition and an arthritic knee and foot, all can masquerade what the real or most debilitating problem is. The surgery time is much less with a single joint and therefore the sterile surgical instruments are opened and exposed to the environment for a shorter time. I am a 53 year old active, distance runner. Lift your knee rather than your hip at the same time. Im so pleased to learn that you had a good experience. 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. Tina, which procedure did you have? I had an anterior approach hip replacement. Many also mate this with a ceramic femoral head. For many years, I performed bilateral THR and bilateral TKR procedures, but have backed away for a variety of reasons. I think its always beneficial to speak to other patients who have been cared for by that physician and learn about their experiences and results. No feeling in my leg and no movement What determines the differences? Should one of these events occur during a mini-posterior procedure, they are easier to recognize and correct. In another day I was able to take short walks without any limping, etc.. Achieving legs that feel equal in length after surgery is imperative. During the procedure, the patient must have a small incision made in the side of his hip. This treatment is much more definitive and predictable. 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. Thanks, The majority of teaching institutions in the United States continue to instruct as well as perform the traditional posterior as their primary approach. I think the recovery time is the same though. What to Expect I assume its something near my groin. Despite the fact that this usually takes two weeks or longer, patients can return to work when they feel completely comfortable. A major hip replacement can take up to four months to fully recover from. Avascular Necrosis AVN of the femoral head happens when part of the ball at the top of your thigh bone loses blood supply, causing that segment of bone to die. 2015 Aug. 3 (13):179. Thigh feels so Heavy and I massage that area a lot. The earlier the recovery begins, the better chance for a more-complete recovery. Finally, hip replacement surgery is expensive and may not be covered by insurance. Gililand, our physician, explained the concept of health. . You are free to opt out any time or opt in for other cookies to get a better experience. I think they are happier and rehab more quickly. I love that you take time off to reply to these messages it is commendable. It turned out to be more torn than they thought and they had to cut about a forth of it out. Any feedback will be appreciated. In my practice, patients who undergo a THR using a mini posterior or posterior approach: 1. If this occurs, the patient may experience pain and swelling. Choosing a surgeon should be based on published data (if available), as well as his or her reputation in the community, according to Dr. Delcore. The approach planned is a frequent topic of Continued He is one of the few surgeons in the U.S. that performs total hip replacement via a superior capsular approach, the most soft tissue-sparing hip replacement available and is an industry educator in the . I think there may be increased associated complications. Ceramic-on-polyethylene is currently the most popular hip replacement material, representing 50.6% of all hip replacement cases back in 2014. The bone isn't dislocated in surgery. My hope is that some of these symptoms will improve with time. Thank you for sharing with others the nerve supplements that youre finding affective. Thanks again! I am scheduled for bilateral hip replacement at the end of August. The other things that can affect the op is your fitness beforehand, your attitude and your age, although you may have difficulty getting younger!! It is much better to precisely release and cut rather than tear or fracture. Complications associated with an anterior approach hip replacement are similar to those associated with standard hip replacement surgeries. So frustrating. Because the muscle fibers are separated, not cut, the nerve path is not disturbed and the muscle is not injured. Does it really not matter which approach I have, posterior or anterior? SuperPath hip replacement is a differentiated total hip technique being performed by a growing number of experienced surgeons. 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. Risks associated with hip replacement surgery can include: Blood clots. Thanks so much for this information! hi im following as im due a superpath soon, there is no one size fits all everyones different I've had 2 hip replacements in 2 yrs one in 2017 then a revision to change the ball and socket to the smallest one they had and now I'm going for a smaller stem I had the anterior approch done which is in the front which is way better then the posterior as the front they can just move ur muscles over to the side to accsess ur hip rather then go through the back or side where they have to cut the muscles.