My acyive 60 year old husband is scheduled to have Mini posterior total hip replacement in 6 weeks. It is 100 percent normal and expected to be scared before surgery. During the procedure, the patient must have a small incision made in the side of his hip. I prefer reconstructing the most symptomatic side first. The surgeon was not at the pre-op meeting, but the PA assured me it was not that big of a deal (but to me, ALL surgery is a big deal!). Your out-of-pocket costs for your hipreplacement will be impacted by a number of . Egton Medical Information Systems Limited. The amount of PT you need after surgery will be determined by you and your surgeon. Patients who work for themselves are very motivated to return to work and often do so between procedures. I have since read that hips with this condition might get worse after labrum repair due to this structural defect. Ten years ago I had total hip replacement on the left at hss. Does this mean my body may reject the metal of the post or cup? For many years, I performed bilateral THR and bilateral TKR procedures, but have backed away for a variety of reasons. My advice is to consult with your surgeon regarding how stable the replaced hip is and the most appropriate rehab to follow post-operatively. The hope is that these new designs will, but time will tell. 1. Potential Disadvantages of Anterior Hip Replacement Anterior hip replacement does have a few limitations: There may be wound healing issues Research suggests that people who undergo anterior hip replacement may be more likely to have a problem with wound healing, particularly infection. Can I expect any problems with the bilateral it was my choice. Can You Go Home the Same Day After Hip Replacement? SuperPath hip replacement is a differentiated total hip technique being performed by a growing number of experienced surgeons. So im going back to the surgeon that did my left hip and left me in agonizing pain for 2 months after procedure. This is because the nerve is located in front of the hip. from publication: Current and . Often in this group of patients, their X-rays show only minimal cartilage space compromise (it may appear thinned and irregular) and I observe at time of surgery that the labrum appears hypertrophied (to compensate for lack of head coverage) and often torn. What is the best hip replacement option: anterior or Posterior? A major muscle is not cut during anterior hip replacement surgery, so pain is reduced and major muscles are not cut after the operation. 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. It's a hip replacement surgery where you lie on your side. I am a 55 year old with a labral tear and moderate arthritis. There are potential drawbacks to anterior hip replacement. I cant find anything that addresses replacing a hip that is dysplastic. In comparison to traditional methods, anterior approaches to the hip joint are more effective. Finally, I would choose a doctor with whom you connect and whose staff is engaged and knowledgeable. Will meet with doctor soon but when I was finally able to really exercise after surgery I overdid it and developed plantar fasciitis. There are many different quality implants (just like surgeons and hospitals). Hip Resurfacing vs Total Hip Replacement - sosbones.com Hi guys im 43 and live in Australia and due to have hip replacement in 7 weeks but im so confused as my surgeon is doing the posterior and im off work for 6 weeks where i here people having the anterior and going back sooner and no restrictions on hospital discharge any advice. Surgery carries increased risks because of these conditions, but by defining the risks and optimizing any underlying conditions, the risks can be minimized and hopefully managed. The traditional posterior approach is the most commonly used in the United States and throughout the world (about 70 percent). When the anterior approach is used, the soft tissues in the hip stay intact, allowing for better hip alignment. It is critical to consider the pros and cons of each option before making a decision. And, I Do. Report / Delete Reply kelly1010 nicole66881 If you were in Los Angeles and needed a THR who would you choose to do your surgery? What Is Superpath Hip Replacement - HipsAdvice.com What are the experiences of other countries with THR? Hip dysplasia is a very common underlying cause of hip osteoarthritis. Every prosthetic joint has a mechanical range of motion. I very rarely transfuse any patients now. If the tissues are traumatized and / or the final components are not optimally positioned, then it certainly is not an advantage. It is important to understand that "less invasive" does not only refer to the incision but . I ask my patients to restrict certain positions that exceed the mechanical limits of the artificial hip for the first six weeks. Dear Dr. Leone, I am having Makoplasty ( robotic imaging) to my right hip in February. 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. My two questions are: 1. Its from a malformation. I have written to you to learn what are the surgical considerations for someone with shallow hip sockets like mine. A typical recovery time from anterior hip surgery is six months. In a very positive way, surgical techniques for both anterior and posterior approaches have evolved wonderfully since your surgery was done 10 years ago. When a patient feels better, they can return to work almost immediately, though it usually takes two weeks or longer. We have an appointment today to discuss the plan of action. There is a chance that the hip will fall out of the socket, or that it will be levered out by twisting it. I am 63 years old, 54, 115 pounds. Your surgeon will know better than anyone else just how stable your new hip is immediately after your surgery and how securely the surrounding tissues were repaired after the reconstruction. The most common total hip replacement method is the anterior approach, which allows the surgeon to see better, more precisely place implants, and perform less invasive total hip replacement surgeries. I would encourage you to discuss your expected recuperation time and specific restrictions with your surgeon. I had the posterior approach, the surgeon did not cut any muscle plus I had no pain at all after the op. 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. The anterior approach is not as muscle sparing as some would argue. I am 37 and have suffered from AVN since I was 14. On the other hand, there may be a slightly increased incidence of anterior instability. Patient Resources This is not true for bilateral cases. This does expose the patient to more radiation but can help with component positioning and sizing. It is highly recommended that you avoid bending your hips and turning your feet together as part of hip precautions. Blood clots or bleeding. Its been six months since surgery, my operating doctor keeps feeding me with lets wait another month stuff. I never seem to know when I am going to get hit with pain. The doctor used the posterior procedure. I would anticipate that you would be able to return fully to your activity once the tissues around your total hip heel. I understand that most surgeons now do a spinal rather than general anesthesia. 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. Dr. Robert Sigmund is a board-certified orthopedic surgeon and a sports medicine physician based in St. Louis, Missouri. Thank you for sharing with others the nerve supplements that youre finding affective. In my 25 years of practice, the variable that seems to have changed the most is how quickly people recover from this surgery when done well. Potentially there also is less pain and a quicker recovery. I am a 67 year old woman who has danced semi-professionally and has always been very active including doing Ashtanga yoga and caopeira. Each surgeon approaches these issues individually. What do you mean by painful anterior scarring and soft tissue exposure and trauma? Mayo Clinic researchers have studied ways to reduce blood loss, control pain and speed recovery for people who undergo hip replacement surgery. We have to get ok from cardiologist and get ekg, chest xray, etc. I think the recovery time is the same though. I wish you only the best. 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 am temped to wait but it is getting worse. Lazaru P, Marintschev I. Supercapsular Percutaneously-Assisted Total Hip surgery or SuperPATH surgery is a novel method of hip replacement where your surgeon can perform total hip replacement through 2-3 inch incision into the tip of the hip and without dislocating the hip or damaging the surrounding soft-tissue (muscles and tendons). The particular surgeon who did your hip is also uniquely qualified to advise you with regard to the postoperative stability of your particular hip, because he or she physically tested your hip intra-operatively. Consuming excessive-fibre and wholegrain meals will assist to keep you feeling full, and will be 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. He also used the term anterolateral. #1. It is important that these medical and cardiac conditions be optimized by your PCP and cardiologist preoperatively. 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. I wish you a full and satisfactory recovery. Over the years, these precautions and the length of time to adhere to these limits have been challenged both by clinicians and patients. Hip Replacement | Rush System Click to enable/disable Google reCaptcha. 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. Our team of experts, doctors, and orthopedic specialists are here to share their knowledge and experience with you in order to help you make informed decisions about your health and well-being. There are a number of different potential surgical approaches available for hip replacement, each with their own potential advantages and potential drawbacks. 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. After awhile the screws started shifting and poking up under the skin and they removed them. Dear Dr. Leone, It turned out to be more torn than they thought and they had to cut about a forth of it out. My doc said the angle of my hips is not the worst but also not the best. In some individuals, it takes much more force and dissection in order to accomplish this (typically, there is significantly more bleeding from an anterior approach compared to a mini-posterior approach). On July 17th, I had a left THR. Hip replacement surgery can open up a world of possibilities for people who have lived with pain and restricted movement. 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. If you do not have a hip replacement, you will live a sedentary lifestyle and become overweight. These parts have a porous coating that the bone grows into. Even a task as simple as putting on socks and shoes can result in debilitating discomfort when a severely damaged or arthritic hip is involved. An operating room that can support safe Anterior or SuperPATH minimally invasive joint replacement surgery costs around $1.5 million. In my experience, after four to six months most patients simply return to normal activity. Ultimately, you and your husband need to choose the surgeon who you both feel will provide the possible best care, based on reputation and your personal comfort level. Your article is the first Ive read in which no muscle or tendons are cut in any approach other than the direct anterior approach. According to Dr. Rosen, the most important thing to remember is what you leave behind rather than how you get there. It healed well but then I got major psoas pain which a cortisone shot helped. Most receive a simple spinal with sedation. It is a pity that medicine cannot be as definitive as science but relies on historic figures and the future outcome appears to be a statistical probability! This most often leaves the patient with an area of decreased or uncomfortable sensation or numbness over the anterolateral thigh (top, outside area of the thigh), not the entire thigh. You can be successful by staying healthy by sticking to less pain. It sounds like he did fabulous job. This interval must be developed and the muscles must be separated in order to reconstruct the hip. I had the mini-posterior at MGH hospital. Thru X-rays Ive been told both hips are bone on bone! I am so sorry to learn that you are struggling. thank you for your time. Uncemented. 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. It also is more difficult for patients with some patterns of arthritis such as protrusio, which causes the worn out ball to migrate inward rather than upward into the socket. I dont want a long recovery time as I am very active. 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. Pain and disability are reduced. If you would like a personal consultation, please contact our office at 954-489-4584 or by email at LeoneCenter@Holy-cross.com. (I have SCD) It has now become unbearable and I am preparing for surgery. Did you have the surgery via Superpath method? Also, in the U.S., nearly all stems which are being implanted through the anterior approach are press-fit rather than cemented. The new prosthetic socket must be medialized (placed further toward the midline) and sometimes through the medial wall of the native socket. Personally, it I were caring for you, I would have advised you exactly as the orthopedic surgeon who took care of you did. Achieving legs that feel equal in length after surgery is imperative. Optimal component positioning also is critically important for the best stability and longevity. I'm so encouraged to hear your successful story. Can You Use An Inversion Table With A Hip Replacement For centers like Phoenix Spine and Joint that use a robot, there is . In my experience, the restrictions (or those positions we ask our patients to avoid after surgery) have become much less limiting and are off limits for a much shorter period of time. Some patients who have recently had anterior hip replacement may suffer from complications such as wound healing. The posterior approach is used frequently again, in large part due to the fact that it is an extensile approach. What do you consider to be the most important factors in choosing a surgeon? Each question is scored from 1-5, with 1 being no problems and 5 being severe problems. Hip Replacement Surgery | Superpath Hip Replacement Sydney Australia I actually was supposed to get both done at roughly same time but its been 3yrs with this bad right hip, mainly i was in great fear of going through that pain again, but now i think that pain will be better than this everyday pain!! Otherwise you will be prompted again when opening a new browser window or new a tab. The SuperPATH Hip Replacement: A Novel Less Invasive Radid Recovery The idea is it should be a little less painful if the muscle, tendons and nerves are not disturbed. The activity that I wish to have the most success with after the surgery is ballroom dancing. Why would the doctor not have that at their finger tips? Thank-you. Can you explain it to me as he didnt go into detail. There are a few complications that can occur with anterior hip replacement surgery. Thanks for any feedback. Registered number: 10004395 Registered office: Fulford Grange, Micklefield Lane, Rawdon, Leeds, LS19 6BA. It also helps to stabilize the acetabular shell and prevent soft tissue irritation on the out edge of the cup. I am looking at how many hips they have done and where they are doing them. Sitting seems to irritate it the most. I am a 49-year-old female. Brandon Callahan, MD is a board-certified orthopedic physician with a decade of experience in providing comprehensive orthopedic care to patients with musculoskeletal injuries and disorders. Doctors use metal, ceramic, or plastic replacement parts. Some patients have no pain at all, which is remarkable. Email us. 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. Can I make an appointment with you. 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? The first is that it is a major surgery, so there is a risk of complications such as infection. 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. I believe this is an important discussion you should have with your surgeon preoperatively. With degenerative osteoarthritis of the hip developing secondary to a severe slipped capital femoral epiphysis (scfe), recreating normal hip mechanics after THR may have necessitated lengthening the first hip. My hope is that some of these symptoms will improve with time. Once again, it sounds as if you had a wonderful surgeon, which is the most important variable. The vast majority of my patients return to work one to three weeks post-operatively. I had the surgery on June 22 and I am about 5 weeks post op. Im considering this mini posterior approach. If your surgeon has recommended surgery, I assume youre no longer getting adequate relief of pain or able to remain active with conservative measures. The incidence of dislocations has further decreased over the past decade with our ability to implant larger size femoral heads. We thank you for your readership. I am terrified of nerve damage as I am very athletic and a previous professional ballet dancer. posterior surgery . I assume its something near my groin. 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. We can do this because of improved plastics. If your surgeon did a great job, that is something to respect. Introduction I encourage my patients to talk to other patients for whom Ive cared and learn about their experiences. Im pleased that you will be coming in for an appointment. How Much Does Minimally Invasive And Robotic Hip Replacement Surgery Always speak to your doctor before acting and in cases of emergency seek Anterior hip replacement has the potential to cause complications and pose some risks. Many modern-day femoral stems are considerably smaller or more bone sparing than well-functioning stems of the past. The art of surgery should mimic a well rehearsed ballet or symphony. J. Dear Dr. Leone, There are 5 questions, mobility, self-care, usual activities, pain and anxiety. What all this means for patients is a more optimum outcome and faster healing, which can reduce time interval to return to normal activities. The actual length of the incision really is not important, but rather how well the components were implanted and the hip mechanics restored. All orthopaedic surgery demands a long recovery period. Most of the restrictions are removed at that time, although I still advise common sense, particularly for the first three or four months. Femoral nerve function also should be assessed. A major hip replacement can take up to four months to fully recover from. I would focus on the individual doctor, not the approach that the individual choses to use, to deliver the best result. Yes, Im angry. I have cared for many patients over the years with significant heart and peripheral vascular disease. I feel that at 10 weeks with profuse denervation potentials on the quad muscles, the prognosis is not good, even at 6 months. 2. I have many patients who are accomplished and passionate ballroom dancers. It exploits the same soft intervals but it typically accomplishes prosthetic implantation and soft tissue balancing through a smaller incision and, more importantly, with less underlying soft tissue dissection. Because the dissection is over the front of the hip, a number of patients will experience residual pain and tightness anteriorly (in the front of the hip) at least early on. I, too, am struggling which approach to have. The best of luck to you, If this occurs, the patient usually requires a total hip replacement. Because of the straightforward exposure of the femur, there is less risk of femoral fracture or poor implant positioning. I had the mini posterior approach done and it gets better everyday. It is nice to see honest Q&A versus a marketing page. Following the anterior approach, we provide you with a number of precautions and positions that you should avoid if you are in danger of being discomfited. General comments will be answered in as timely a manner as possible. Also, some body structures or anatomy makes approaching a hip anteriorly much more difficult than others.
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