Thank you for this great informative discussion. If I think you may be a candidate, I will refer you to a doctor in our area that does. The highly crossed linked polyethylene liners are now the gold standard in this country. 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. Ann Transl Med. I also would learn about the track record of the surgeon and hospital where you will decide to have the surgery and what implant will be used. Surgical Techniques 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. SuperPath approach is the least invasive due in part to the minimal amount of tissue damage. 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. I would emphasize choosing your surgeon and not the approach. Specific protocols, therapy and what positions you will be asked to avoid after surgery and for how long will be directed by your surgeon. A hip replacement can be delayed until it is absolutely necessary if the replacement parts can fail over time. It sounds like he did fabulous job. Gary. What you can do is keep as good an attitude as possible and keep rehabilitating your leg. I have the hospital but am deciding on the surgeon and which approach is best. Also on MRI there was a cyst (good size). An anterior capsule is the only soft tissue cut during this procedure to insert the implants. I am a 73 year old woman who has been having severe hip pain for the last seven months. Hip replacements might keep you out of action for a considerable period. Raleighs orthopaedic clinic is board certified and has fellowship training in total joint replacement. Start your day off right, with a Dayspring Coffee There is also a small risk of death associated with any surgery. Registered in England and Wales. appropriate medical assistance immediately. 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. What reasons would there be to use the regular over the mini? The SUPERPATH technique is a tissue-sparing procedure which aims to get patients back on their feet within days (possibly hours) instead of weeks or months. Im sorry to hear that you struggled after your first, anterior-approach THR. By 2016 and over 300 SuperPATH cases, the results of very first 100 SuperPATH surgeries (the so called 'learning Curve') were published in a peer reviewed journal with . Sometimes, it simply isnt possible to accomplish. I am now bracing myself for THR surgery within the next year and am wondering if there is any big advantage in trying to have this done by a surgeon who offers the customised implant, as above. This allows you to resume normal daily activities quickly while also returning to normal range of motion and function. Would you recommend treating plantar 1st? Dear Dr. Leone: 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. My surgeon wants to use the posterior approach and indicates that I eventually should be able to play golf again. I would encourage you to discuss your concerns with you surgeon. I have congenital hip dysplasia which has gradually caused more pain as Ive gotten older. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in
Once youve decided, you then need to trust that he or she will take the best care of you possible to deliver the best results. 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. A ball and socket are used to connect the new joint to the thigh bone (femoral bone), which is made of metal, plastic, and ceramic. But I am now in chronic low grade pain thats getting worse and dont know what I should do. It is nice to see honest Q&A versus a marketing page. One of the biggest changes that Ive seen in my practice over the past 25 years is how quickly patients get well and go home. I would like your opinion on the stem cell injections as I am really afraid of the second surgery on the same side of my body. My question is, what will my restrictions be? What determines the differences? Other health issues include congenital heart ASD corrected about 12 yrs ago with an amplatzer occluder implant by the right femoral approach resulting in possible femoral nerve compression, Lateral right leg numbness and leg discomfort since the implant, Groin pain and restriction in extending the right leg back has been a problem for some time and masked the fact that at least a portion of my increasing pain was from my hip. The idea is it should be a little less painful if the muscle, tendons and nerves are not disturbed. The questions youre asking are 100 percent appropriate. For risks she mentioned all the usual I knew about from the first surgery blood clots/loss, dislocation, etc. 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. Back to work/driving in 10 days. Along these same lines, there is a smaller incidence of sciatic nerve injury with the anterior approach but an increased incidence of femoral nerve injury. 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'm scheduled for THR on the 22nd. Can you suggest any pain medication that would not interfere with anti rejection drugs? Posterior approach. If possible, speak with other health professionals who work at the hospital or at least in the same geographical area. This can cause you persistent pain, stiffness . 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. Surgeons do not cut across muscles. This left hip remained tender based on my exercise level which I did modify but always my hip had some soreness. 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). While new techniques, instruments and prostheses have been developed specifically for minimally invasive surgeries, there are many well-established approaches to hip replacement. If your little voice is questioning if you are overdoing it or hurting yourself, then listen to it and ease up. A metal or plastic implant is used to replace a damaged or diseased hipbone. I encourage you to do the same. I ask my patients to restrict certain positions that exceed the mechanical limits of the artificial hip for the first six weeks. I really appreciate this website. Thank you for sharing. Proponents of minimally invasive hip replacement say small-incision operations can lessen blood loss, ease post-operative pain, trim hospital stays, improve scar appearance, and speed healing.. This effectively moves the hip joint center, toward the bladder or midline, and improves hip mechanics. I exhausted all other non-surgical options, such as physical therapy and meds but to no avail, so now plan to have a THR in March. Does this mean my body may reject the metal of the post or cup? Thanks again for this great blog! 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 . SuperPath is a portal assisted THA approach that accesses the capsule superiorly through the interval between the gluteus medius and piriformis without requiring the cutting of any muscles or tendons. He is highly respected by the medical and chiropractic community, so i plan to have a appointment to discuss his plans for my surgery. Total hip replacement is one of the most successful operations ever developed and is a remarkably predictable way to relieve pain from arthritic conditions. Does my prothesis not last as long since I am now doing a 3rd surgery? Common conditions that often lead people to have either posterior or anterior hip replacement surgery include the following: Osteoarthritis Rheumatoid Arthritis Osteonecrosis, also known as Avascular Necrosis Injury Fracture Bone Tumors I suspect there is significant underlying osteoarthritis related to your labral pathology. Many manufacturers are responding to the surgeons desire for shorter stems and many are now available on the market. I am planning to have a THR this summer. 1. I would rather see my patients go home. THOUGHTS? What is SuperPath Hip Replacement? Some patients who have recently had anterior hip replacement may suffer from complications such as wound healing. Patient Resources I would look for a surgeon who is busy, has a strong track record and who practices at a hospital with a stellar reputation and where many joint replacement surgeries are done. Patient is a UK registered trade mark. 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. Technologies, The Leone Center
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. Do I have a risk of fractures during a posterior right hip revision due to my prior complications already? He is the founder and main author of brandonorthopedics.com, a website that offers valuable resources, tips, and advice for patients looking to learn more about orthopedic treatments and physiotherapy. It's a hip replacement surgery where you lie on your side. As a result, patients can return to their normal activities much sooner than if they had had traditional hip replacement surgery. thank you for your time. If theyre really happy and got well quickly, you probably will too. Excess weight causes a hip joint that has already been stressed to become more painful and disability-causing. The rule of thumb is that recovery occurs over a 12-18 month period following injury. These scores are not aggregated. Total hip replacement is a step-by-step surgery to replace the hip socket and the ball at the top of the thighbone (femur). Thank you very much for taking time to reply me. Fax: 954-489-4584
If so, how long until I can get back to normal living? Most receive a simple spinal with sedation. What is the best hip replacement option: anterior or Posterior? The most important thing is that tissue is handled gently and trauma is minimized, whichever approach is used. Lazaru P, Marintschev I. SuperPath approach uses about a 3-inch incision at the side of . The pain is really inconsistent, one min I will be walking fine and the next it catches and is very painful, then it may go away or may not. The impingement can lead to a levering out of the ball from the socket. When the stem is placed in the femur, it still destroys the same amount of bone for implantation, regardless of which approach is used. These other conditions need to be defined and hopefully ruled out as the primary source of pain. I now need the right hip replaced. About this injury to me. Since then, SuperPATH has enjoyed excellent success. My question is: should I just tolerate the pain and limp, or take a chance with the hip replacement. From what Ive seen, most THR patients dont need very much PT, although I do encourage exercising in a pool. 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). I am Australian so no business from me but it has helped me become happier with my prospective surgeons judgement that he will offer me a posterior THR (hopefully the minimally invasive) when my insurance allows the procedure to occur. Comments about life-long hip restrictions between Posterior, Anteriorlateral and Anterior approaches? The anterior approach typically does not violate this structure. Pain and disability are reduced. Im an avid skier and just found out I did not have full Anterior but rather AL. The anterolateral approach or Watson Jones approach is one of the classical hip approaches that can produce excellent results when utilized for THR. Individual results and activity levels after surgery vary and depend on many factors including age, weight and prior activity level. I had my hip scoped which bought me 8 years, but need a THR now. The information I have gathered seems to indicate the anterior approach is more inherently stable, making precautions unnecessary. Had arthroscopy in Jan 15, cleaned up tear and arthritis. I try not to let it get to me, but it causing me to feel handicapped. The best of luck to you, Operating through too small an incision and not releasing tissue that would improve exposure and result in a more balanced joint in my opinion does a disservice. I am very athletic and active even with many years of pain from bone on bone arthritis so I am worried about restrictions since Ill probably forget or something. We thank you for your readership. With a significant learning curve, it is likely that you will have to replace about 100 hips before you are truly comfortable with the approach. Long recovery but all is well. I can still do 30-45 mile rides, but I need to take something before each ride, because of the undone left hip. I would rather this not happen with my right leg when I have the THR in Jan 2017. What are your thoughts with regard to Stem cell therapy in lieu of THR? Thanks for any feedback. If an MRI demonstrates no cartilage damage or subchondral cystification (the development of degenerative cysts), a repairable labral tear and minimal dysplasia, then a hip arthroscopy may be considered. 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. I try not to bring up my mess but its hard when its with one 24/7. Tina, which procedure did you have? Adults of any age can be considered for a hip replacement, although most are done on people between the ages of 60 and 80. Currently we use standard ways, called either posterior or direct lateral approach. I think the money you spend to have a hip replacement is more than just moral or justified, it is smart business. After all, no matter the age, it will determine the likelihood of maintaining your mobility and independence. It is difficult to get that from information which I find curious. The amount of PT you need after surgery will be determined by you and your surgeon. I am so sorry to learn that you have had such a bad experience after THR. Always speak to your doctor before acting and in cases of emergency seek
Can you explain this approach? 2021 May 20;16(1):324 . Patients who work for themselves are very motivated to return to work and often do so between procedures. I saw a surgeon who does the posterior approach only and will see another on 4/14/15 who does both approaches. If its a struggle, then the situation needs to be reassessed. Also, is it immoral for an 80 year old to have THR and cost the nations health care system $25 $35k? 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. All of these releases may be necessary as part of the surgery and patients do well. It would be interesting to hear what you have to say Doug. Unfortunately, injury to the lateral femoral cutaneous nerve is a common complication after the anterior approach for hip replacement. Because the patient is lying on his back, it facilitates using a fluoroscope or moving x-ray throughout the procedure. Sometimes the pain goes away as I walk and sometimes it doesnt. I am a 53 year old active, distance runner. This robotic technique can assist in producing an excellent result. Welcome to Brandon Orthopedics! 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. Talked to my foot doc and we decided on the Topaz procedure which has good results. Over time, some patients may acquire sensitivity or an allergy to the metal particles produced by the metal ball and socket. Here are a few of the advantages of anterior hip replacement. 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? Please comment. The surgical "approach" in total hip replacement describes the anatomical pathway and technique that the surgeon uses to access the hip joint to perform the surgery. I would research and find the physician and hospital that will give you the best chance of doing well. Why is that? Thank you for this! How does it affect the actual success of the Call (919) 781-5600 to find out if you need total shoulder replacement in Raleigh, Cary, North Raleigh, Garner, or Holly Springs. I am experiencing pai. (Of course, I do.) The surgeon will be building a construct that hopefully will last her life time and change her life profoundly.
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