With the ease of movements during pregnancy, you will be able to move around more freely. I wrote to you in January, now my surgery is in a couple of weeks. Walker to get around. Personally, I would not gamble with my health. I think there may be increased associated complications. Pam. Hip Replacement Surgery: How it Works, Recovery Time | HSS My strategy is to make as small an incision as possible, but one that allows for excellent exposure and reconstruction without brutalizing the tissues. The information I have gathered seems to indicate the anterior approach is more inherently stable, making precautions unnecessary. Patient Resources (PATH) and Supercapsular percutaneously assisted total hip (SuperPATH) arthroplasty: learning curves and early outcomes. 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. My husband tells me that I cry out in pai as I turn over during the night. as being in breach of those terms. You should consult with your doctor before deciding to have an anterior total hip replacement. It turned out to be more torn than they thought and they had to cut about a forth of it out. With a bilateral procedure during a single anesthetic, the blood loss would be double and there would be a much higher likelihood that my patient would need transfusion post-operatively. It is critical that the patient and the doctor consider whether the patient is a good candidate for surgery, the cost and recovery time, and the surgeons expertise. How long will my hip replacement last in your opinion? Do you have any thoughts on this issue? 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. Does my prothesis not last as long since I am now doing a 3rd surgery? The surgeon I saw said that my body structure and gait does not affect which approach would be ideal for my body. Sometimes the pain goes away as I walk and sometimes it doesnt. Currently we use standard ways, called either posterior or direct lateral approach. . Which is the best? Some in the early period have good track records, others do not. I am scheduled to have total hip replacement surgery in 2 weeks. I know the most important decision you will make is choosing the doctor who will perform your surgery. I now need the right hip replaced. [QxMD MEDLINE Link]. Finally, I would choose a doctor with whom you connect and whose staff is engaged and knowledgeable. I would discuss fully your goals and concerns. 4 mts later am using Your article lacks the pros of the AMIS and the cons of min invasive posterior. In has been my experience in life that if others are happy and had a good experience then that speaks strongly to me, if I were to do the same thing. The second advantage of a small incision is that it makes it easier to clean and care for the hip. Simply, we keep trying to get better. In 2013 I had a THA done on the left hip. Robert H. Sigmund, MD | Signature Orthopedics The femoral nerve functions to extend the knee and also is responsible for sensations over the anterior and medial aspects of the thigh, medial shin, and arch of the foot. I am about 5 6 and 185 lbs, age 58, he did not think the weight was an issues. Return to the work place is an individual decision. 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. Also, be aware that as the nerve recovers, the smallest C fibers within the nerve recover first, which can cause a burning discomfort. Share your concerns with your surgeon. Would you recommend treating plantar 1st? This too will lower your anxiety and improve your experience. There are numerous complications associated with hip replacement surgery, but blood clots in the legs and hips are two of them. 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 . SuperPath hip approach. I wish you a full recovery. In my experience, there is a faster and more-consistent recovery with the mini-posterior. This often leads to a less than optimal component position. I am 5 weeks out and have been doing beautifully! 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 . The rest is marketing. 1000 NE 56th Street, I am about to have a hip replacement and would like to know what kind of limitations Ill have afterward. We now have less-invasive techniques, better surgical methods of closing soft the tissue and more experience. As a result of the interventions, the surgeon has a better view of the hip joint. In 2014 I had to do another THA, this time on my right side. So my concerns include having the range of motion to perform moves like promenade where my body is roughly facing forward and my right leg will take a step left across my body at about 90 degrees. Ten out of every fifteen hip replacements will be functional for more than 20 years after they are inserted. How long will my hip replacement last? Also, the surgeon said that I would end up having one leg shorter than the other is this true? I was so against doing this surgery but groin pain was very bad and crushed bone in the groin. SuperPath approach is the least invasive due in part to the minimal amount of tissue damage. The hope is that your nerve injury will recover with time. I would rather my patient get half as much anesthesia. I just saw a patient with a femoral neuropraxia after a anterior approach THR. SuperPath hip replacement is a differentiated total hip technique being performed by a growing number of experienced surgeons. I emphasize continuing exercises at home especially walking. My clinical impression is that more patients experience some degree of residual groin discomfort or tightness after the anterior approach as compared to the posterior approach, but that it tends to resolve with time. Because the anterior hip replacement surgery is a minimally invasive procedure, no cuts are made to the muscles surrounding the hip. My doc said the angle of my hips is not the worst but also not the best. more nutritious, too. 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 Hanna bed, general anesthesia machines, spinal setup, medications, ventilation, instruments, and their sterilization are all prerequisite. Obese or extremely muscular people may not be the best candidates for this surgical procedure. Or are x-rays definitive for determining the exact reason for THR? Tina, which procedure did you have? It does sound as if proceeding with a THR is appropriate, since your attempt to repair the joint arthroscopically did not pan out. Dr. William Leone. There are a number of different potential surgical approaches available for hip replacement, each with their own potential advantages and potential drawbacks. 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. Thanks! Depending on the degree of injury, you may need a knee brace to lock you knee in extension when walking until the quad function returns. I had a posterior, the surgeon did not cut any muscle, they just move them now. Posterior hip surgery may be the best option if your surgeon makes a larger incision at the side or back of the hip joint. Pain and disability are reduced. I was told the joint lubricant had migrated into the hip bone creating the cyst, There is effusion in the joint and stress areas. If possible, choose a hospital that specializes in joint replacement and can back that up with excellent statistics and reputation. 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. Regardless, the overall incidence of dislocation for every approach is smaller due to use of larger femoral heads and enhanced closure techniques. A hip replacement is the most common cause of complication in about 20% of cases. 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. I try not to bring up my mess but its hard when its with one 24/7. You can be successful by staying healthy by sticking to less pain. This is described as a posterior approach because the actual hip . There is also a risk of the hip joint not fusing correctly, which can lead to pain and instability. Would appreciate any input you might have on the auto immune issue, and weight etc. Sometimes, it simply isnt possible to accomplish. I am a 67 year old woman who has danced semi-professionally and has always been very active including doing Ashtanga yoga and caopeira. Here are a few of the advantages of anterior hip replacement. If so, is it possible to have both hips done at the same time? disadvantages of superpath hip replacement Yes, Im angry. The bone isn't dislocated in surgery. Such joint replacement orthopaedic surgery is generally conducted to relieve arthritis pain or in some hip fractures.A total hip replacement (total hip arthroplasty or THA . Full Function, Faster . Comments about life-long hip restrictions between Posterior, Anteriorlateral and Anterior approaches? I'm scheduled for THR on the 22nd. There is a chance of nerve injury with any type of hip replacement. The anterior approach is not as muscle sparing as some would argue. SuperPATH or Superior Approach To The Hip In Total Hip Replacement When a patient feels better, they can return to work almost immediately, though it usually takes two weeks or longer. I am wondering if having mild hip dysplasia is a factor in which approach is used. Back to work/driving in 10 days. 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. Consult your doctor to determine if joint replacement surgery is right for you. United States. SuperPath Hip Replacement? | Joint Replacement Patient Forum Rather, they say Bill, please just do what you have to do and do a great job. Adult patients who have a deteriorated hip may be candidates for total hip replacement. Very few metal-on-metal bearings are being placed today due to the serious potential of metallosis. The surgeon does about 200 a year and people say he has a good reputation. No feeling in my leg and no movement Typically, most are eager to go home the very next day; many have already progressed to a cane, which they will not use very long. Very strange Dr. William Leone. An anterior hip replacement is not covered by a specific credential system for orthopedic surgeons. She provided all kinds of benefits with this approach, as faster recovery, less motion restrictions et.al. Dr. Many wonderful physicians are part of various HMO panels. How would a hip replacement be done? 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. Getting those studies will not change the reality that you will need THRs. Overall, it sounds as if youve had an excellent result and wonderful recovery following your hip replacement. Have you ever performed the Mini on a patient 1 year after major open heart surgery? I love that you take time off to reply to these messages it is commendable. That's all I know. I believe choosing your physician is the most important decision you can make. Here is his perspective based on careful observation of outcomes. This means you could go home within 23 hours after surgery. Pain is almost gone and I am beginning to get back to my life. Conclusions SuperPATH approach showed better results in decreasing incision length and early pain intensity as well as improvement of short-term functional outcome. Some patients who have recently had anterior hip replacement may suffer from complications such as wound healing. Dont let PR marketing confuse the big picture. In a posterior hip replacement, the procedure is done on the side of the hip. When people loose independence and mobility, not only does the quality of life suffer, they are much more likely to develop a myriad of medical problems requiring even more-expensive and/or long-term care, including loss of independent living. So im going back to the surgeon that did my left hip and left me in agonizing pain for 2 months after procedure. Even though I was positive I wanted this method done, I was still questioning my decision. This is because the nerve is located in front of the hip. Dr. William Leone. I came home with crutches, abandoned them at the front door and have not used them since. It is generally agreed that the temporary numbness is more than balanced out by the substantially improved recovery, reduced pain, absence of a limp, faster return to function, and virtual elimination of the risk of hip dislocation. Also, if this nerve injury occurred, I would expect these symptoms to be present immediately surgery, not five months post-op. Ultimately, it is important to discuss all of the available options with your doctor to determine which method of hip replacement is best for you. There are risks and recovery times associated with surgery. Comparing Short-term Outcomes After Direct Anterior and SuperPATH Hip In my experience, usually releasing the ileopsoas tendon insertion onto to lessor trochanter and medial hip joint capsule, and then manually stretching the leg into an abducted position after THR reconstruction, obviates the need for formal release. This technique is also referred to as the . Dear Doctor Leone, 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. Historically, higher dislocation rates were reported with the posterior approach, but it still was used for its many other advantages. I advise both my total hip and my total knee patients to avoid repetitive impact activities like distance running. Im hoping to play tennis, go dancing and horseback riding once Ive healed. I tore my labrum at age 43 and only discovered then that I had bilateral dysplasia. Types of Hip Replacement (Approach) Hip replacements can be preformed through a direct anterior approach, an anterior lateral approach, a lateral approach, a posterior approach, and a superior approach. J. Dear Dr. Leone, Lazaru P, Marintschev I. Hip replacement surgery can open up a world of possibilities for people who have lived with pain and restricted movement. I have been in excruiting pain and unable to do everyday normal activities. thank you for your time. There are several positions to avoid after anterior hip replacement, as they can put unnecessary stress on the new hip joint and lead to dislocation. Select a surgeon based on your impression of that individual: how engaged was he or she in your care, will you have access to that person as well as his or her team before and after surgery? DAA had a lower rate of hospitalization and functional rehabilitation as compared to the lateral approach, as well as a lower perceived level of pain. The hip joint can be supported by the socket, which is designed to fit over the ball and provide stability. I wish you the best of luck, My knee and foot and ankle are messed up too since leg ended up at least 3/4 shorter.I wear a shoe lift, but probably needed it sooner than I realized the shorter issue, My knee is pretty stiff and pain when I walk too much, but I deal with it, it bends good, I sleep good, no pain when I do nothing, so Im working all to do NO knee surgery, This hip was ENOUGH to last a lifetime.. Im 76 and use a lot of supplements to save knee and OA in general..I am looking at other protocols for the knee too.not insurance covered, what else is new.if its good, its out of pocket. Less tissue damage during surgery allows for a much faster recovery and no restrictions in range of motion when compared to traditional hip surgery. While it is a surgery that does help many, many people, clearly you are struggling. Thank you so much for taking the time to inform us! Minimally-Invasive Total Hip Replacement Surgery Have you heard of something like this, and if so, is it worth it? As a result, patients can return to their normal activities much sooner than if they had had traditional hip replacement surgery. Because my husband has circulation problems in his leg and vein removed for open heart surgery last yearhis surgeon recommended the Mini posterior surgery. I, personally, have not had a patient dislocate following a primary total hip replacement in many years. Many patients approach this by researching online and speaking to other patients who have been cared for at a particular facility. Check to enable permanent hiding of message bar and refuse all cookies if you do not opt in. By far the most important variable is the doctor who is doing your surgery and managing your post-op care. That being said, if the foot is now a much bigger problem than the hip, you may have to deal with that first. Hip replacement is the second most common type of joint replacement, trailing only total knee replacement. I again suggest you concentrate on finding a surgeon in whom you have faith and then trust that doctor. 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. Ill be 60 at the time and Im 54 and weight about 130 lbs in fairly good shape. After reading your article I see there are many reasons to go with the posterior approach but nothing about having to use a smaller prosthesis with the anterior approach. There is no definitive answer to this question as different people will have different opinions and preferences. In the United States, a traditional posterior approach is the most commonly used. Individual results and activity levels after surgery vary and depend on many factors including age, weight and prior activity level. results, I decided to see and orthopedic doctor was advised to have THR. 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. 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. My walking is very limited, shoe is built up as leg is shorter and in recent months Ive realized my leg is bowed. A hip replacement can be delayed until it is absolutely necessary if the replacement parts can fail over time. 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. Hip Replacement Surgery & Recovery | University of Utah Health You are free to opt out any time or opt in for other cookies to get a better experience. Lateral femoral cutaneous nerve injury is the most common injury incurred during an anterior approach. In a very positive way, surgical techniques for both anterior and posterior approaches have evolved wonderfully since your surgery was done 10 years ago. I am allergic to narcotics . There does appear to be an increased incidence of stem instability when implanted through the anterior approach, but I believe this is largely a function of the surgeon experience. We can do this because of improved plastics. Some surgeons will use 2 incisions, both the anterior and superior approach. Surgical approach is important but its just one of many important variables. surgeons certainly do not go out of their way to cut anything, they move stuff about, if tendons do get damaged, it's more likely from the anterior approach as they have less 'sight' of the procedure due to the smaller incision.